P0355 Comparison between patients with Inflammatory Bowel Disease, Spondyloarthritis or both pathologies; our experience
Authors: Bertani A , Pecchini M , Angri A , Gilda S , Giuggioli D , Colecchia A 
Published: January 2025

Background

Fatigue is the subjective feeling of chronic tiredness and exhaustion that significantly affects patients with chronic diseases. In Inflammatory Bowel Diseases (IBD), it has been observed that the incidence is double in patients compared to the general population, having a higher incidence in Crohn’s Disease (48-62%) compared to Ulcerative Colitis (42- 47%). Similarly, in Spondyloarthritis (SpA), fatigue has been seen to be present in about one in two patients; literature shows that fatigue is reported in about 50-70% of patients with Ankylosing Spondylitis and in about 30-50% of cases of Psoriatic Arthritis. Managing fatigue requires regular reassessment over time with a holistic approach through the work of a multidisciplinary team. The aim of this study is to investigate the incidence of fatigue and the influencing factors in individuals affected by Inflammatory Bowel Diseases, those with axial or peripheral Spondyloarthritis, and those with both conditions.

Methods

This is a prospective study in which patients were enrolled from the IBD Center of the Gastroenterology Department at the AOU of Modena, the Multidisciplinary Outpatient Clinic for Chronic Inflammatory Bowel and Joint Diseases, and the Rheumatology Inflammatory Disease Clinic at the AOU of Modena. These patients were given self-administered scales: the Fatigue Severity Scale (FSS), the Modified Fatigue Impact Scale (MFIS), and the Short Form 36 (SF-36). Each patient’s medical history and the most significant elements of their clinical history were collected. Data were analyzed through univariate and multivariate logistic regression and compared with the latest literature.

Results

Our study found that fatigue is more prevalent in the SpA population using both the MFIS scale (median of 21) and the FSS (median of 25). In the mixed population, the fatigue measured by the MFIS and FSS scales (16 and 20, respectively) showed intermediate medians compared to the other two populations. Finally, in the population with only IBD, we observed lower levels of fatigue compared to the other two populations (median MFIS 14, median FSS 18).

Conclusion

Our analysis indicates that the incidence of fatigue is higher in the SpA population compared to the other studied populations, as well as a higher incidence in the population with both conditions compared to the population with only IBD. Rheumatologic comorbidity appears to be an important factor influencing fatigue. Laboratory data, particularly inflammatory indices and hemoglobin levels do not seem to influence fatigue. The fatigue assessment scales and the SF36 scale proved to be valid and useful tools, with the potential to intervene clinically on these aspects

References

Huppertz-Hauss G, Høivik ML, Jelsness-Jørgensen LP, Opheim R, Henriksen M, Høie O, et al. Fatigue in a population-based cohort of patients with inflammatory bowel disease 20 years after diagnosis: The IBSEN study. Scand J Gastroenterol. 2017;52(3):351–8

Grimstad T, Norheim KB, Isaksen K, Leitao K, Hetta AK, Carlsen A, et al. Fatigue in Newly Diagnosed Inflammatory Bowel Disease. J Crohns Colitis. 2015;9(9):725–30

Ossum AM, Palm Ø, Cvancarova M, Bernklev T, Jahnsen J, Moum B, et al. The Impact of Spondyloarthritis and Joint Symptoms on Health-Related Quality of Life and Fatigue in IBD Patients. Results From a Population-Based Inception Cohort (20-Year Follow-up in the Ibsen Study). Inflamm Bowel Dis. 2020;26(1):114–24