AB0416 THE IMPACT OF FATIGUE ON SYSTEMIC SCLEROSIS PATIENTS
Authors: B. Samões, D. Fonseca, T. Beirão, M. Guerra, R. Vieira, F. Campos Costa, T. Videira, A. Aleixo, P. Pinto
Journal: Annals of the Rheumatic Diseases (2021)

Background: Fatigue is a frequent and commonly undervalued symptom among rheumatic disease, including Systemic Sclerosis (SSc). 1,2 Objectives: To determine the prevalence of severe fatigue in a SSc cohort and to evaluate how it correlates with disability, quality of life and mental illness. Methods: A cross-sectional study was conducted evaluating a cohort of SSc patients. Fatigue was evaluated using Functional Assessment Chronic Illness Therapy (Fatigue) (FACIT-F) questionnaire. A value &lt; 30 was defined as severe fatigue. Health Assessment Questionnaire (HAQ), Scleroderma HAQ (SHAQ), 36-Item Short Form Health Survey (SF-36), EuroQol-5D (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) questionnaires were also filled. Clinical data was obtained and analysed. Results: We included 20 patients, 17 females [n = 17 (85%)], median (min, max) age was 52.5 (28, 75) years-old. Regarding disease classification, 13 (65%) had limited SSc, 4 (20%) had diffuse SSc and 3 (15%) had early SSc. The median FACIT-F score was 34 (3, 48). The prevalence of severe fatigue was 40% (n = 8). Fatigue had a moderate negative correlation with HAQ (τ = -0.641; p &lt; 0.001) and a weak negative correlation with lung (τ = -0.345; p = 0.039) and gastrointestinal (τ = -0.419; p = 0.011) involvements and with patient global assessment (τ = -0.325; p = 0.047) subtopics of SHAQ. A moderate positive correlation was found between FACIT-F and EQ-5D (τ =0.625; p &lt; 0.001) and physical functioning (τ = 0.560; p = 0.001) and vitality (τ = 0.777; p &lt; 0.001) domains of SF-36. The remaining SF-36 domains had a weak positive correlation with FACIT-F (Table 1). Regarding mental illness, there was a moderate negative correlation between FACIT-F and HADS-D (τ = -0.638; p &lt; 0.001) and HADS-A (τ =-0.535; p = 0.001). Conclusion: Severe fatigue is frequent among SSc patients. The greater the fatigue, the greater the disability, the lower the quality of life and the worse the score on the scale of depression and anxiety. References: [1]F. Basta, A. Afeltra, D.P.E. Margiotta. Fatigue in systemic sclerosis: a systematic review. Clin Exp Rheumatol 2018; 36 (Suppl. 113): S150-S160 [2]Sarah Hewlett, Emma Dures, And Celia Almeida. Measures of Fatigue. Arthritis Care &amp; Research Vol. 63, No. S11, November 2011, pp S263–S286 Table 1. Correlation of FACIT-F with measures of disability, quality of life and mental illness Variables Kendall’s τ coefficient p-value HAQ -0.641 0.000 SHAQ - GI involvement -0.345 0.039 - Lung involvement -0.419 0.011 - Vascular involvement -0.215 0.192 - Digital ulcers 0.102 0.549 - Patient global assessment -0.325 0.047 EQ-5D 0.625 0.000 SF-36 - Physical functioning 0.560 0.001 - Role physical 0.491 0.003 - Bodily pain 0.463 0.006 - General health 0.341 0.045 - Vitality 0.777 0.000 - Social functioning 0.443 0.009 - Role emotional 0.350 0.041 - Mental health 0.376 0.024 HADS-D -0.638 0.000 HADS-A -0.535 0.001 Disclosure of Interests: None declared