Fatigue in young adults with juvenile idiopathic arthritis 18 years after disease onset: data from the prospective Nordic JIA cohort.

Autor: Arnstad ED; Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Pb 333, 7601, Levanger, Norway. ellen.d.arnstad@ntnu.no.; Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway. ellen.d.arnstad@ntnu.no., Glerup M; Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark., Rypdal V; Department of Pediatrics, University Hospital of North Norway and Department of Clinical Medicine, UIT the Arctic University of Norway, Tromsø, Norway., Peltoniemi S; New Children's Hospital, Helsinki University Hospital, Pediatric Research Center, University of Helsinki, Helsinki, Finland., Fasth A; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Nielsen S; Department of Pediatrics, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark., Zak M; Department of Pediatrics, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark., Aalto K; New Children's Hospital, Helsinki University Hospital, Pediatric Research Center, University of Helsinki, Helsinki, Finland., Berntson L; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden., Nordal E; Department of Pediatrics, University Hospital of North Norway and Department of Clinical Medicine, UIT the Arctic University of Norway, Tromsø, Norway., Herlin T; Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark., Romundstad PR; Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway., Rygg M; Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.; Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway.
Jazyk: angličtina
Zdroj: Pediatric rheumatology online journal [Pediatr Rheumatol Online J] 2021 Mar 18; Vol. 19 (1), pp. 33. Date of Electronic Publication: 2021 Mar 18.
DOI: 10.1186/s12969-021-00499-0
Abstrakt: Background: To study fatigue in young adults with juvenile idiopathic arthritis (JIA) 18 years after disease onset, and to compare with controls.
Methods: Consecutive children with onset of JIA between 1997 and 2000, from geographically defined areas of Norway, Sweden, Denmark and Finland were followed for 18 years in a close to population-based prospective cohort study. Clinical features, demographic and patient-reported data were collected. Inclusion criteria in the present study were a baseline visit 6 months after disease onset, followed by an 18-year follow-up with available self-reported fatigue score (Fatigue Severity Scale (FSS), 1-7). Severe fatigue was defined as FSS ≥4. For comparison, Norwegian age and sex matched controls were used.
Results: Among 377 young adults with JIA, 26% reported severe fatigue, compared to 12% among controls. We found higher burden of fatigue among participants with sleep problems, pain, poor health, reduced participation in school/work, physical disability, active disease, or use of disease-modifying anti-rheumatic drugs (DMARDs)/biologics/systemic steroids. In contrast, participants without these challenges, had fatigue scores similar to controls. Active disease assessed at all three time points (baseline, 8-year and 18-year follow-up) was associated with higher mean fatigue score and higher percentage of severe fatigue compared to disease courses characterized by periods of inactive disease. Predictors of fatigue at the 18-year follow-up were female sex and diagnostic delay of ≥6 months at baseline, and also pain, self-reported poor health, active disease, and previous/ongoing use of DMARDs/biologics at 8 years.
Conclusions: Fatigue is a prominent symptom in young adults with JIA, with higher fatigue burden among participants with poor sleep, pain, self-reported health problems, active disease, or use of DMARDs/biologics. Participants without these challenges have results similar to controls. Patient- and physician-reported variables at baseline and during disease course predicted fatigue at 18-year follow-up.
Databáze: MEDLINE
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