ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2281

The Prediction of Fatigue in Early Rheumatoid Arthritis Patients

Margot Walter1, T. Martijn Kuijper2, Mieke Hazes2,3, A.E.a.M. Weel4 and J.J. Luime5, 1Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands, 2Rheumatology, Erasmus University Medical Center, Rotterdam, Netherlands, 3Department of Rheumatology, Erasmus MC, University Medical Center, Rotterdam, Netherlands, 4Department of Rheumatology, Maasstad Hospital, Rotterdam, Netherlands, 5Department of Rheumatology, Erasmus Medical Centre, Rotterdam, Netherlands

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Tuesday, November 10, 2015

Title: Epidemiology and Public Health Poster (ARHP)

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

The
prediction of fatigue in early Rheumatoid arthritis patients

Background/Purpose:

Rheumatoid arthritis-related fatigue is a common problem
with a high impact on patients. How fatigue develops over time since early
diagnosis of RA is not well known. The aim of this study was i) to describe the pattern of the fatigue over time in
patients with early RA under T2T ii) to identify predictive factors
/determinants for evolution of fatigue over time stratified for baseline values
of fatigue.

Methods: Data
from the tREACH study (treatment in the Rotterdam
Early Arthritis Cohort) were used. This multi-centered trial compared different
initiation treatment strategies in early RA patients. Patients completed VAS
and FAS on fatigue, CORS, HADS, RADAI, 
SF-36 and were clinically assessed by DAS every 6 month. We stratified the patients into no fatigue (FAS values 10-21) and fatigued
(FAS values 22-50) and assessed the evolution of fatigue over time and the covariates
using a mixed linear model with time lag. Missing covariate data was imputed
using a mixed linear model.

Results:

A total of 270 individuals
classified as RA using the 2010 criteria, 246 could be stratified according to
their baseline fatigue (24 had missing data). The sample resulted in a typical
early RA population with a mean age of 53 years (SD 14.3 years) and 68%
females, 73% rheumatoid factor and 77% anti-CCP antibodies positive. The
percentage of patients with joint damage was 18%.The VAS fatigue was 51.4(SD
25.9) and the FAS 22.2 (SD 7.1). High fatigue at baseline was
univariate associated with higher levels of the CORS, high levels of depression
and anxiety, a worse physical health (SF-36) and more swollen and tender
joints.Over
time fatigue decreased slightly with 2-7% on average as shown in figure 1.

Significant determinants for
the prediction of fatigue in the univariate and multivariate analysis are presented in table 1.

Conclusion:

About half of the
early RA patients reported high levels of fatigue at baseline which for most of
them consisted over time. Only better reported physical health (SF36) predicted
change of fatigue.  Patients with low
fatigue at baseline were more likely to develop fatigue over time if they were
women, had more tender joints, were more anxious and had a worse Physical SF36 scores.

Figure
1 evolution over time of fatigue

s

FAS (≤21)

FAS (>22)

Fatigud (≤21)

FAS (>22)

Univariate analysis

Multivariate analysis

β-Coeff.(CI95%)

β-Coeff.(CI95%)

β-Coeff.(CI95%)

β-Coeff.(CI95%)

Sex

-2.59**

(-4.21–0.97)

-1.17

(-3.61-1.27)

-2.21** (-3.59- -.833)

Age

-0.06**

 (-0.12- -0.003)

-0.023

(-0.10-0.05)

Work

1.24

 (-0.40- 2.89)

1.165

(-1.00- 3.33)

Education

0.18

 (-0.83- 1.20)

 0.44

 (-1.03- 1.92)

Dutch

-1.91

(-4.39-0.55)

0.47

 (-2.69- 3.65)

CRP

-0.035*

(-0.06- -0.004)

-0.018

 (-0.05-0 .01)

ESR

-0.76**

(-1.36- -0.15)

0.11

 (-0.80- 1.02)

-0.03*

 (-0.07- -0.007)

Tender joints

0.098*

 (0.01-0.17)

0.027

 (-0.08-0.13)

0.010*

 (0.02-0.18)

Swollen joints

 -0.036

 (-0.13- 0.06)

-0.064

(-0.186-0.057)

VAS global

0.01

(-0.004-0.04)

 -0.01

 (-0.05-0 .01)

Das28

0.054

 (0-.37-0.47)

-0.19

 (-0.83-0.43)

Radai

0.34*

 (0.031-0.66)

-0.139

(-0.60-0.32)

Hads depression

0.18

(-0.04-0 .41)

0.031

( -0.22-0 .28)

Hads anxiety

0.24*

(0.04-0 .44)

0.24

 (-0.01-0.50)

0.23*

 (0.04-0.42)

Coping pain

0.08

 (-0.05-0.21)

 0.076

 (-0.09-0.25)

Coping limitations

0.08*

(0.009-0.15)

-0.024

(-0.14-0.093)

Physical health (SF36)

-0.07*

( -0.13- -0.013)

0.097*

 (0.015-0.18)

-0.08**

 (-0.15- -0.02)

0.09*

(0.01-0.18)

Mental health (SF 36)

-.020

 (-0.09-0.05)

 -0.021

 (-0.11-0 .07)

Level of significance *p=0.05 /**p=0.01/ ***p=0.001

Cut point for FAS ≤21 no fatigue/ >22 fatigue

Table 1 Univariate and multivariate
analysis divided into two groups

Disclosure: M. Walter, None; T. M. Kuijper, None; M. Hazes, None; A. E. A. M. Weel, None; J. J. Luime, None.

To cite this abstract in AMA style:

Walter M, Kuijper TM, Hazes M, Weel AEAM, Luime JJ. The Prediction of Fatigue in Early Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-prediction-of-fatigue-in-early-rheumatoid-arthritis-patients/. Accessed .

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