FRI0568-HPR Variations of Fatigue in Persons with Rheumatoid Arthritis- A 1 Year Longitudinal Study
Authors: C. Feldthusen, A. Grimby-Ekman, H. Forsblad d'Elia, L. Jacobsson, K. Mannerkorpi
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Beside pain, fatigue is expressed as the most prominent symptom in RA [1,2] and has been described as having a greater impact on daily life than pain [2]. Persons with RA experience that their fatigue vary over time concerning duration and frequency [3]. Longitudinal studies assessing change in fatigue after a period of one year have reported relatively stable fatigue [4] or considerable variations of fatigue [5]. More knowledge is needed about how fatigue in persons with RA vary over time. <h3>Objectives</h3> To study variations of fatigue during one year in persons with RA of working age. <h3>Methods</h3> Sixty-five participants having RA and being of working age (20-65 years) were recruited from a rheumatology clinic in West Sweden. Questionnaires assessing fatigue were given to the participants every other month during 1 year, in total seven times. Fatigue was assessed using both single-item and multidimensional measures: <i>– VAS</i> for global fatigue (0-100 mm) (endpoints no fatigue and worst imaginable fatigue) <i>– The Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire, (BRAF-MDQ)</i> consisting a global score (Total) and four subscales (Physical, Living, Cognition, Emotion) [6-7]. <h3>Results</h3> The fatigue showed statistically significant variation over time for the outcome measures VAS fatigue (p&lt;0.01), BRAF-MDQ Total and the subscales Living, Cognition (p&lt;0.001) and Physical (p&lt;0.05), when analyzed by mixed models. For the subscale Emotion (p=0.08) the variation of fatigue over time was not statistically significant. A statistically significant seasonal variation was shown for global fatigue (VAS p&lt;0.01 and BRAF-MDQ Total p&lt;0.001) and physical aspects of fatigue (BRAF-MDQ Physical and Living p&lt;0.01) indicating less physical fatigue in the summer. No statistical differences over time were seen in fatigue between women and men or between age-groups. <h3>Conclusions</h3> This study show that fatigue in persons with RA vary significantly during one year and further acknowledges the dynamic nature of fatigue and the complexity of its different facets. <h3>References</h3> Wolfe, F., D.J. Hawley, and K. Wilson, The prevalence and meaning of fatigue in rheumatic disease. J Rheumatol, 1996. 23(8): p. 1407-17. Repping-Wuts, H., et al., Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study. Int J Nurs Stud, 2008. 45(7): p. 995-1002. Hewlett, S., et al., Patients9 perceptions of fatigue in rheumatoid arthritis: overwhelming, uncontrollable, ignored. Arthritis Rheum, 2005. 53(5): p. 697-702. Mancuso, C.A., et al., Psychosocial variables and fatigue: a longitudinal study comparing individuals with rheumatoid arthritis and healthy controls. J Rheumatol, 2006. 33(8): p. 1496-502. Treharne, G.J., et al., Predictors of fatigue over 1 year among people with rheumatoid arthritis. Psychol Health Med, 2008. 13(4): p. 494-504. Nicklin, J., et al., Measuring fatigue in rheumatoid arthritis: a cross-sectional study to evaluate the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional questionnaire, visual analog scales, and numerical rating scales. Arthritis Care Res (Hoboken), 2010. 62(11): p. 1559-68. Dures, E.K., et al., Reliability and sensitivity to change of the Bristol Rheumatoid Arthritis Fatigue Scales. Rheumatology (Oxford), 2013. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3502