POS0500 FATIGUE AND ITS RELATION TO HEALTH INDICATORS IN A MULTIREGIONAL CROSS-SECTIONAL STUDY IN PATIENTS WITH RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS
Authors: E. Hulander, M. Hallström, A. Deminger, C. Feldthusen, E. Klingberg, J. Beckman Rehnman, T. Zverkova Sandstrom, H. Forsblad-D’elia
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Radiographic axial spondyloarthritis (r-axSpA) is one of the most common chronic inflammatory rheumatic diseases, affecting approximately 0.2% of the population. While treatment has improved through the evolution of pharmacologic therapy, chronic fatigue often emerges as a prevalent issue in individuals with r-axSpA. <h3>Objectives:</h3> The aim of this study was to evaluate the relationship between fatigue and inflammation and self-reported health data in a cross-sectional setting in patients with r-axSpA and its differences between sexes. <h3>Methods:</h3> A total of 296 patients with r-axSpA (modified NY criteria) at the rheumatology clinic in Umeå University Hospital, northern Sweden, as well as patients in south-western Sweden (Sahlgrenska University Hospital, Södra Älvsborgs Hospital and Alingsås Hospital), were recruited. Study protocols have been described elsewhere (1, 2). Fatigue (visual analog scale 0-10 (VAS)) was examined in a multivariable linear regression analysis in relation to sleep patterns (a composite index of 3 questions each scaled from 1-5 on quality of sleep, frequency of waking up early and frequency of not being able to fall asleep), back pain (VAS), anxiety/depression (scale 1 to 3), body mass index (BMI), age, and C-reactive protein (CRP). Dietary nutrient intake was included as a nutrient density score (Nutrient Rich Foods index (NRF)), using data from a semi-quantitative food frequency questionnaire. The analysis was stratified by sex. Multiple choice questionnaire responses were compared between sexes by Fisher-Freeman-Halton Exact test. <h3>Results:</h3> A complete data set was available for 290 patients, 64% male, and 92% HLA-B27+, disease duration (mean ± SD) of 33.0 ± 11.8 years. Fatigue was median (Q1, Q3) 4.7 (2.2, 6.4), females: 5.0 (2.4, 6.7) males: 4.2 (2.0, 6.3). About half (44%) of participants had severe fatigue (VAS scale ≥ 5) (females: 52%, males: 42%). Back pain scores were median (Q1, Q3)) 3.7 (2.0, 5.9), females: 4.6 (2.3, 6.3), males: 3.5 (1.8, 5.7), and CRP at 2.1 (0.84, 4.8), females: 2.1 (0.6, 4.0), males: 2.2 (1.0, 5.0). Sleep pattern, back pain and anxiety/ depression were associated with fatigue (Table 1). In males, only sleep pattern and back pain were related with fatigue. In females, sleep pattern, back pain, anxiety/depression as well as CRP were significantly related to fatigue. Females reported comparatively more difficulty falling asleep (Figure 1). <h3>Conclusion:</h3> A large proportion of patients with long-standing r-axSpA suffered from fatigue. We hypothesize that multimodal care aiming to reduce anxiety, improving sleeping patterns and reduce back pain might reduce fatigue. <h3>REFERENCES:</h3> [1] Forsblad-d'Elia H et al. The Journal of rheumatology. 2021;48(3):352-60. [2] Klingberg E et al. Arthritis research &amp; therapy. 2012;14(3):R108. <h3>Acknowledgements:</h3> We would like to thank research nurse Viktoria von Zweigbergk for her work with the Backbone study. <h3>Disclosure of Interests:</h3> <b>None declared.</b>