AB0732 FATIGUE ASSESSMENT IN EGYPTIAN PSORIATIC ARTHRITIS PATIENTS: RELATION TO SERUM INTERLEUKIN 23, DISEASE ACTIVITY AND QUALITY OF LIFE.
Authors: N. Aboeladl, N. Elsawy, M. Helal, M. Elshafei, N. Lewis
Journal: Annals of the Rheumatic Diseases (2020)

Background: Fatigue is a prevalent and fundamental phenomenon in psoriatic arthritis (PsA) patients. It often interferes with physical and social functions and may lead to social withdrawal, long-standing sick leave, disability and loss of work productivity. Fatigue is a prevalent symptom in patients with chronic rheumatic diseases. Cytokines as interleukin IL-23/17 play a pivotal role in the pathogenesis of PsA. Objectives: To assess fatigue in PsA patients and determine its relation to serum IL 23 levels, disease activity, Skin severity, physical function and quality of life (QoL). Methods: Fifty PsA patients and 46 matched healthy controls were included in this study. Skin severity based on the Psoriasis Area and Severity Index (PASI), the Disease Activity index for Psoriatic Arthritis (DAPSA) and the Functional Assessment of Chronic Illness Therapy (FACIT-F) were assessed. Physical function was assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI) and health-related QoL was assessed using the Short Form Health Survey (SF-36), Psoriatic Arthritis QoL (PsAQoL) and the Dermatology Life Quality Index (DLQI). Serum IL-23 levels were measured in the studied groups. Results: The study included 23 (46%) females and 27 (54%) males with a mean age of 42.78±12.33 years. The mean serum IL-23 level was significantly higher in PsA patients (50.89 ±13.86 pg/ml) than in controls (43.88 ± 6.34 pg/ml) (p=0.006). The FACIT score ranged from 2-41. Severe fatigue (score &lt;30) was reported in 27 (54%) PsA patients. There were significant correlations between FACIT-F and (DAPSA, PASI, HAQ-DI, PsAQoL, DLQI and SF-36). No significant correlations could be detected between FACIT-F and serum levels of IL-23 and CRP. Conclusion: Fatigue was a frequent complaint in PsA patients. There was a mutual negative impact between fatigue and each of PsA joint disease activity and physical function and it worsened the QoL. Fatigue was worsened with increased severity of skin PsO. Although serum level of IL-23 was significantly elevated in PsA patients than the controls, it wasn’t correlated with fatigue score. Hence IL-23 can’t be considered a biomarker for fatigue severity. References: [1]Chandran V, Bhella S, Schentag C, Gladman DD. Functional Assessment of Chronic Illness Therapy-Fatigue Scale is valid in patients with psoriatic arthritis. Ann Rheum Dis 2007; 66(7):936. [2]Mortada M, Abdul-Sattar A, Gossec L. Fatigue in Egyptian patients with rheumatic diseases: a qualitative study. Health Qual Life Outcomes 2015; 13:134. [3]Krajewska-Wlodarczyk M, Owczarczyk-Saczonek A, Placek W. Fatigue - an underestimated symptom in psoriatic arthritis. Reumatologia 2017; 55(3):125-30. [4]Strand V, Mease P, Gossec L, Elkayam O, van den Bosch F, Zuazo J, et al. Secukinumab improves patient-reported outcomes in subjects with active psoriatic arthritis: results from a randomised phase III trial (FUTURE 1). Ann Rheum Dis 2017; 76(1):203-7. [5]Reygaerts T, Mitrovic S, Fautrel B, Gossec L. Effect of biologics on fatigue in psoriatic arthritis: A systematic literature review with meta-analysis. Joint Bone Spine 2018; 85(4):405-10. Table. Correlation between FACIT-F score and different parameters in patients group FACIT-F r s p DAPSA -0.365 * 0.009* PASI -0.424 * 0.002* HAQ-DI -0.464 * 0.001* PsAQoL -0.633 * &lt;0.001* DLQI -0.492 * &lt;0.001* SF-36 0.600 * &lt;0.001* CRP -0.167 0.247 Serum IL-23 levels -0.183 0.204 r s : Spearman coefficient, *: Statistically significant at p ≤ 0.05 Figure. Correlation between FACIT-F and DAPSA in the studied PsA patients. Acknowledgments: I am deeply indebted to my late Professor Abdelmoniem Helal for his expert guidance and keen interest throughout the work. Thanks to My parents and Husband. Disclosure of Interests: None declared