OP0201 FATIGUE IN JUVENILE IDIOPATIC ARTHRITIS AFTER 18 YEARS OF FOLLOW-UP
Authors: Ellen Dalen Arnstad, Mia Glerup, Veronika Rypdal, Suvi Peltoniemi, Maria Ekelund, Lillemor Berntson, Anders Fasth, Susan Nielsen, Marek Zak, Kristiina Aalto, Ellen Nordal, Troels Herlin, Pål Richard Romundstad, Marite Rygg
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Fatigue is common in adults with rheumatic disease and has also been shown in adolescents with juvenile idiopathic arthritis (JIA). Knowledge on fatigue in JIA in long-term follow-up is limited. <h3>Objectives</h3> To study the prevalence and severity of fatigue 18 years after onset of JIA. <h3>Methods</h3> In this close to population-based cohort study from defined geographical areas of Norway, Sweden, Denmark and Finland, consecutive cases of JIA with disease onset in 1997 to 2000 were prospectively enrolled (1). At 18-year follow-up, fatigue was measured using Fatigue Severity Scale (FSS, range 0-7) (2), and severe fatigue was defined as FSS ≥4. General health status was measured with Health Assessment Questionnaire (HAQ) and 36-Item Short Form Health Survey (SF-36). Reduced health was defined as HAQ &gt;0, and SF-36 &lt;40 (according to the physical component summary score/mental component summary score (PCS/MCS)). Pain was measured with 10 cm visual analogue scale (VAS), 0 = no pain, &gt;0 = pain. Remission was defined according to the preliminary criteria described by Wallace. A Norwegian healthy cohort was used for comparison. Multivariable logistic regression analyses were performed. <h3>Results</h3> Among 434 eligible JIA participants 377 completed a Fatigue Severity Scale (FSS) measurement at the 18-year follow-up and were included. Of these 72% were girls, 53% had oligoarticular disease six months after onset, median age at onset was 5.6 (IQR 2.6-9.7) years, and age at the 18-year visit was 23.1 (IQR 20.3-27.2). Mean total FSS (±SD) was 3.2 (±1.5), and participants with active disease scored 3.6 (±1.6) compared to 2.9 (±1.4) for those in remission off medication. The highest total FSS was found in those with SF-36 PCS and/or MCS &lt;40 (4.7 (±1.6) and 4.6 (±1.6), respectively). Severe fatigue was considerably more frequent in participants with active disease (36%, odds ratio (OR) 2.5) compared to those in remission off medication (19%), HAQ score &gt;0 (47%, OR 4.1) compared to HAQ score =0 (18%), SF-36 PCS/MCS &lt;40 (64/61%, OR 7.1/6.9) compared to SF-36 PCS/MCS ≥40 (20/19%), and VAS pain &gt;0 (36%, OR 3.8) compared to VAS pain =0 (13%). The proportion of severe fatigue in a healthy Norwegian control cohort was 12%. <h3>Conclusion</h3> At 18-year follow-up fatigue was a prominent symptom in JIA, and we found consistently higher fatigue burden and considerably more severe fatigue among participants with active disease, pain and self-reported health problems, compared to those without. We suggest fatigue to be measured at long-term follow-up both in clinical and research settings. <h3>References</h3> [1] Nordal E, et al. Arthritis Rheum 2011;63:2809-18 [2] Krupp LB, et al. Arch Neurol 1989;46:1121-23 <h3>Disclosure of Interests</h3> Ellen Dalen Arnstad: None declared, Mia Glerup: None declared, Veronika Rypdal: None declared, Suvi Peltoniemi: None declared, Maria Ekelund: None declared, Lillemor Berntson Consultant for: AbbVie, Speakers bureau: AbbVie, Anders Fasth: None declared, Susan Nielsen: None declared, Marek Zak: None declared, Kristiina Aalto: None declared, Ellen Nordal: None declared, Troels Herlin: None declared, Pål Richard Romundstad: None declared, Marite Rygg: None declared