AB0580 EFFECT OF FATIGUE ON DISEASE ACTIVITY AND PATIENT-REPORTED OUTCOMES (PROs) IN PATIENTS (pts) WITH PSORIATIC ARTHRITIS (PsA)
Authors: L. Vorobyova, T. Korotaeva, E. Loginova, Y. Korsakova, E. Gubar, P. Tremaskina
Journal: Annals of the Rheumatic Diseases (2021)

Background: Fatigue is an important symptom in patients (pts) with psoriatic arthritis (PsA) and was recently added to the core domain set for PsA randomized controlled trials (RCTs) due to the impact that it has on a PROs. Objectives: to study the influence of fatigue on disease activity and PROs in pts with PsA. Methods: 187 (M/F=97 (50.2%)/90(48.8%) PsA pts fulfilling the CASPAR criteria were included. Mean age 45.6 + 11.7 years (yrs), median (Me) PsA duration 88 [16;421] mo. 67,8% of pts 67,8% were treat biological DMARDs, 32,1% of pts was monotherapy conventional synthetic disease-modifying antirheumatic drugs (csDMARDs, mostly Methotrexate). On visit PsA activity was evaluated by Tender Joint Count (TJC68), Swollen Joint Count (SJC66), DAPSA. PROs were measured by PtGA VAS, PtPain VAS, BASDAI, HAQ, EQ-5D, PsAID12, WPAI. Fatigue symptoms were assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale. Higher PsAID12 scores are considered to be worse and correspond to poorer PsA-specific health-related quality of life. M±SD, Me [Q25; Q75], %, t-test, Manna-Whitney tests were performed. All p&lt;0.05 were considered to indicate statistical significance. Results: According to the results of the FACIT-F, the patients were identified: no fatigue (52-34 points) – 99 (53.1%), the presence of fatigue (21-33and less points) – 68 (36.3%) and severe fatigue (20 and less points) -20 (10.6%). By patient with fatigue and severe fatigue significant worse in all activity indexes and PROs than in patients not experiencing fatigue (p&lt;0,001 and p&lt;0,0001), (Table 1). Similar results were demonstrated across all PsAID12 domains (Figure 1), especially the domains “Pain”, “Skin problems”, “Work and/or leisure activity”, “Sleep disturbance”, “Function capacity” and “Discomfort” (p&lt;0.0001). Conclusion: In patients with PsA fatigue affected significant and clinically considerable impairment of PsA activity and PROs. Table 1. The effect fatigue on disease activity and PROs Parameters, M±SD No fatigue n=99 Fatigue n=68 Severe fatigue n=20 TJC68 9.51±7.86 14.5±9.89* 19.05±8.15** SJC66 7.66±5.5 11.5±8.2* 13.4±6.9** BASDAI 2.6±1.85 5.8±2.47* 7.2±2.0** DAPSA 21.05±21.03 39.9±21.13* 47.9±15.6** CRP (mg/l) 12.6±9.4 30.0±25.4* 20.9±11.6** PtPain, VAS, mm 33±24.7 59±25.2* 66.8±18.1** PtGA, VAS, mm 30.7±23.8 54.0±22.2* 64.7±16.2** ESR (mm/h) 15.19±11.7 30.1±23.7* 30.1±20.8** Total PsAID12 score (over past week, 0- 10) 1.87±1.76 5.41±2.17* 6.5±1.93** HAQ 0.72±0.59 1.37±0.84* 2.04±0.86** EQ-5D TTO 0.75±0.17 0.46±0.16* 0.51±0.15** Work time missed (absenteeism) 0.08±0.26 0.11±0.25 0.31±0.15** Impairment while working (presenteeism) 0.085±0.15 0.258±0.256* 0.23±0.13** Overall work productivity impairment (absenteeism + presenteeism) 0.15±0.26 0.35±0.34* 0.37±0.26** Daily activity impairment 0.22±0.23 0.59±0.25* 0.73±0.22** *p&lt;0.001 – differences from “No fatigue” to “Fatigue”; ** p&lt;0.0001 – differences from “No fatigue” to “Severe Fatigue”; Disclosure of Interests: None declared.