Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment
| Autor: | Joseph O. Sexton, N.P. Sundlisater, L.B. Nordberg, Till Uhlig, E. Moholt, Karen Holten, Espen A Haavardsholm, Siri Lillegraven, Tore K Kvien, Anna-Birgitte Aga, Hilde Berner Hammer |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Visual analogue scale Immunology Arthritis Logistic regression Severity of Illness Index General Biochemistry Genetics and Molecular Biology Arthritis Rheumatoid Young Adult Rheumatology Quality of life Internal medicine medicine Humans Immunology and Allergy In patient Patient Reported Outcome Measures Fatigue Aged Randomized Controlled Trials as Topic business.industry Ultrasound Ultrasonography Doppler Induction Chemotherapy Middle Aged medicine.disease Response to treatment Logistic Models Antirheumatic Agents Rheumatoid arthritis Quality of Life Female business Follow-Up Studies |
| ISSN: | 0003-4967 |
| Popis: | ObjectivesFatigue is a frequent symptom in rheumatoid arthritis (RA) and has high impact on quality of life. We explored associations between disease activity and fatigue in patients with early RA during the initial 24 months of modern treat-to-target therapy and predictors of fatigue after 24 months of follow-up.MethodsData were obtained from the treat-to-target, tight control Aiming for Remission in Rheumatoid Arthritis: a Randomised Trial Examining the Benefit of Ultrasound in a Clinical Tight Control Regime (ARCTIC) trial. Fatigue was measured on a visual analogue scale (VAS) from 0 to 100 mm and defined as clinically relevant if VAS was ≥20 mm. Baseline predictors of fatigue at 24 months were analysed by multivariable logistic regression.Results205 patients with fatigue data at baseline and 24 months were included. Median (25th, 75th percentiles) symptom duration was 5.4 months (2.8, 10.4), fatigue VAS 37.0 mm (13.0, 62.0) and mean Disease Activity Score (DAS) 3.4 (SD 1.1) at baseline. Prevalence of fatigue declined from 69% at baseline to 38% at 24 months. Fewer swollen joints (OR 0.92, 95% CI 0.87 to 0.98, p=0.006), lower power Doppler ultrasound score (OR 0.95, 95% CI 0.90 to 0.99, p=0.027) and higher patient global assessment (PGA) (OR 1.03, 95% CI 1.01 to 1.04, pConclusionsFatigue in patients with early RA was prevalent at disease onset, with a rapid and sustained reduction during treatment. Low objective disease activity and high PGA at baseline were predictors of clinically relevant fatigue at 24 months. |
| Databáze: | OpenAIRE |
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