Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy
| Autor: | Joseph Sexton, T. Uhlig, Brigitte Michelsen, Hilde Berner Hammer, Sella Aarrestad Provan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Immunology Arthritis lcsh:Medicine Rheumatoid Arthritis Logistic regression Disease activity Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Rheumatology Rheumatoid Factor Rheumatoid Immunology and Allergy Medicine Rheumatoid factor Humans In patient 030212 general & internal medicine Patient Reported Outcome Measures Fatigue Ultrasonography 030203 arthritis & rheumatology Biological Products business.industry lcsh:R medicine.disease Biological Therapy Rheumatoid arthritis Antirheumatic Agents Physical therapy Anxiety Biologic DMARD Female medicine.symptom business |
| Zdroj: | RMD Open, Vol 6, Iss 3 (2020) RMD Open |
| ISSN: | 2056-5933 |
| Popis: | ObjectivesTo define fatigue trajectories in patients with rheumatoid arthritis (RA) who initiate biological DMARD (bDMARD) treatment, and explore baseline predictors for a trajectory of continued fatigue.MethodsOne-hundred and eighty-four patients with RA initiating bDMARDs were assessed at 0, 1, 2, 3, 6 and 12 months. Swollen and tender joint counts, patient reported outcomes (PROMs), blood samples and ultrasound examinations were collected at each time point. Fatigue was assessed by the fatigue Numeric Rating Scale (0–10) from the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire. Clinically significant fatigue was predefined as fatigue ≥4. Three trajectories of interest were defined according to level of RAID fatigue: no fatigue (≤3 at 5/6 visits), improved fatigue (≥4 at start, but ≤3 at follow-up) and continued fatigue (≥4 at 5/6 visits). Baseline variables were compared between groups by bivariate analyses, and logistic regression models were used to explore baseline predictors of continued vs improved fatigue.ResultsThe majority of patients starting bDMARD therapy followed one of three fatigue trajectories, (no fatigue; n=61, improved; n=33 and continued fatigue; n=53). Patients with continued fatigue were more likely to be anti–citrullinated protein antibody and/or rheumatoid factor positive and had higher baseline PROMs compared to the other groups, while there were no differences between the groups for variables of inflammation including. Patient global, tender joint count and anxiety were predictors for the continued fatigue trajectory.DiscussionA trajectory of continued fatigue was determined by PROMs and not by inflammatory RA disease activity. |
| Databáze: | OpenAIRE |
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