Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment
Objectives Fatigue 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 mont...
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Online Access: | http://dx.doi.org/10.1136/annrheumdis-2021-220750 https://syndication.highwire.org/content/doi/10.1136/annrheumdis-2021-220750 |
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crjcrbmj:10.1136/annrheumdis-2021-220750 2024-10-06T13:46:54+00:00 Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment Holten, Karen Paulshus Sundlisater, Nina Lillegraven, Siri Sexton, Joseph Nordberg, Lena Bugge Moholt, Ellen Hammer, Hilde Berner Uhlig, Till Kvien, Tore K Haavardsholm, Espen A Aga, Anna-Birgitte EkstraStiftelsen Helse og Rehabilitering 2021 http://dx.doi.org/10.1136/annrheumdis-2021-220750 https://syndication.highwire.org/content/doi/10.1136/annrheumdis-2021-220750 en eng BMJ http://creativecommons.org/licenses/by-nc/4.0/ Annals of the Rheumatic Diseases volume 81, issue 3, page 344-350 ISSN 0003-4967 1468-2060 journal-article 2021 crjcrbmj https://doi.org/10.1136/annrheumdis-2021-220750 2024-09-12T04:55:42Z Objectives Fatigue 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. Methods Data 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. Results 205 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, p<0.001) increased the risk of clinically relevant fatigue at 24 months. Not achieving remission at 6 months was associated with a higher risk of reporting fatigue at 24 months. Conclusions Fatigue 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. Article in Journal/Newspaper Arctic The BMJ Arctic Annals of the Rheumatic Diseases annrheumdis-2021 |
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Objectives Fatigue 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. Methods Data 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. Results 205 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, p<0.001) increased the risk of clinically relevant fatigue at 24 months. Not achieving remission at 6 months was associated with a higher risk of reporting fatigue at 24 months. Conclusions Fatigue 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. |
author2 |
EkstraStiftelsen Helse og Rehabilitering |
format |
Article in Journal/Newspaper |
author |
Holten, Karen Paulshus Sundlisater, Nina Lillegraven, Siri Sexton, Joseph Nordberg, Lena Bugge Moholt, Ellen Hammer, Hilde Berner Uhlig, Till Kvien, Tore K Haavardsholm, Espen A Aga, Anna-Birgitte |
spellingShingle |
Holten, Karen Paulshus Sundlisater, Nina Lillegraven, Siri Sexton, Joseph Nordberg, Lena Bugge Moholt, Ellen Hammer, Hilde Berner Uhlig, Till Kvien, Tore K Haavardsholm, Espen A Aga, Anna-Birgitte Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment |
author_facet |
Holten, Karen Paulshus Sundlisater, Nina Lillegraven, Siri Sexton, Joseph Nordberg, Lena Bugge Moholt, Ellen Hammer, Hilde Berner Uhlig, Till Kvien, Tore K Haavardsholm, Espen A Aga, Anna-Birgitte |
author_sort |
Holten, Karen |
title |
Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment |
title_short |
Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment |
title_full |
Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment |
title_fullStr |
Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment |
title_full_unstemmed |
Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment |
title_sort |
fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment |
publisher |
BMJ |
publishDate |
2021 |
url |
http://dx.doi.org/10.1136/annrheumdis-2021-220750 https://syndication.highwire.org/content/doi/10.1136/annrheumdis-2021-220750 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Annals of the Rheumatic Diseases volume 81, issue 3, page 344-350 ISSN 0003-4967 1468-2060 |
op_rights |
http://creativecommons.org/licenses/by-nc/4.0/ |
op_doi |
https://doi.org/10.1136/annrheumdis-2021-220750 |
container_title |
Annals of the Rheumatic Diseases |
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annrheumdis-2021 |
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1812175191743135744 |