Relation between fatigue and ACR response in patients with psoriatic arthritis treated with tumor necrosis factor inhibitor therapy:a population-based cohort study
| Autor: | Lene Dreyer, Tanja Schjødt Jørgensen, Philip J. Mease, Vibeke Strand, Christine Ballegaard, Marie Skougaard, Rebekka Lund Hansen, Lars Erik Kristensen |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Visual analogue scale Immunology Population Cohort Studies 030207 dermatology & venereal diseases 03 medical and health sciences Psoriatic arthritis 0302 clinical medicine Rheumatology Internal medicine medicine Immunology and Allergy Humans education Fatigue 030203 arthritis & rheumatology education.field_of_study business.industry Tumor Necrosis Factor-alpha Arthritis Psoriatic medicine.disease United States Discontinuation Treatment Outcome TNFi treatment Antirheumatic Agents Cohort Tumor necrosis factor alpha Tumor Necrosis Factor Inhibitors business Cohort study |
| Zdroj: | Jørgensen, T S, Skougaard, M, Hansen, R L, Ballegaard, C, Mease, P, Strand, V, Dreyer, L & Kristensen, L E 2021, ' Relation between fatigue and ACR response in patients with psoriatic arthritis treated with tumor necrosis factor inhibitor therapy : a population-based cohort study ', Journal of Rheumatology, vol. 48, no. 6, 191107, pp. 829-835 . https://doi.org/10.3899/jrheum.191107 Jørgensen, T S, Skougaard, M, Hansen, R L, Ballegaard, C, Mease, P, Strand, V, Dreyer, L & Kristensen, L E 2021, ' Relation between fatigue and ACR response in patients with psoriatic arthritis treated with tumor necrosis factor inhibitor therapy : A population-based cohort study ', Journal of Rheumatology, vol. 48, no. 6, pp. 829-835 . https://doi.org/10.3899/jrheum.191107 |
| DOI: | 10.3899/jrheum.191107 |
| Popis: | OBJECTIVE: The objective of this population-based cohort study was to investigate the association of fatigue with disease activity and drug survival in PsA patients receiving their first tumor necrosis factor inhibitor (TNFi). METHODS: Data on patient characteristics, disease activity and drug survival were obtained from the DANBIO database on all PsA patients in the period 2006 through 2015. Information on comorbidities was obtained through linkage with the Danish National Patient Registry. RESULTS: A total of 880 patients were eligible for analyses. Patients with upper median fatigue scores had statistically significant higher disease activity measure (DAS28CRP), pain and health assessment questionnaire (HAQ) scores, tender joint count, comorbidities (Charlson Comorbidity Index ≥2) and current smoking status at baseline compared to patients with lower median fatigue scores (ptextless0.05). In the upper median fatigue group, less patients achieved ACR responses and improvements in VAS fatigue compared to patients in the lower median fatigue group. Kaplan-Meier curves showed shorter drug survival in patients in the upper median fatigue group compared with the lower median fatigue group at 6-month followup. CONCLUSION: Fatigue remains a dominating symptom after TNFi treatment, and is associated with higher baseline disease activity, pain and HAQ scores, more comorbidities, and increased risk of TNFi treatment discontinuation in a cohort of Danish patients with PsA. The agreement between ACR and VAS fatigue responses is weak to moderate suggesting heterogeneity between experienced fatigue and joint inflammation. Objective. The objective of this population-based cohort study was to investigate the association between fatigue with disease activity and drug survival in patients with psoriatic arthritis (PsA) receiving their first tumor necrosis factor inhibitor (TNFi). Methods. Data on patient characteristics, disease activity, and drug survival were obtained from the DANBIO database on all patients with PsA from 2006 through 2015. Information on comorbidities was obtained through linkage with the Danish National Patient Registry. Results. A total of 880 patients were eligible for analyses. Patients with upper median fatigue scores had statistically significant higher disease activity measures (Disease Activity Score in 28 joints based on C-reactive protein), pain, and Health Assessment Questionnaire (HAQ) scores; tender joint counts; comorbidities (Charlson Comorbidity Index ≥ 2); and current smoking status at baseline compared to patients with lower median fatigue scores (P < 0.05). In the upper median fatigue group, fewer patients achieved American College of Rheumatology (ACR) responses and improvements in visual analog scale (VAS) fatigue compared to patients in the lower median fatigue group. Kaplan-Meier curves showed shorter drug survival in patients in the upper median fatigue group compared with the lower median fatigue group at 6-month follow-up. Conclusion. Fatigue remains a dominating symptom after TNFi treatment, and is associated with higher baseline disease activity, pain, and HAQ scores; more comorbidities; and increased risk of TNFi treatment discontinuation in a cohort of Danish patients with PsA. The agreement between ACR and VAS fatigue responses is weak to moderate, suggesting heterogeneity between experienced fatigue and joint inflammation. |
| Databáze: | OpenAIRE |
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