Rheumatology Rehabilitation, Our Lady's Hospice, Dublin, and School of Nursing and Midwifery, Trinity College, Dublin, Ireland.
Clin Exp Rheumatol. 2010 May-Jun;28(3):401-4. Epub 2010 Jun 23.
This pilot study examined sensitivity to change and relative independence of fatigue as an outcome measure in patients with psoriatic arthritis (PsA) following anti-TNF therapy.
Patients with PsA commencing anti-TNF therapy were evaluated at baseline and at 3 months. Fatigue was measured using a 0-10 numeric rating scale (NRS). This was a one-dimensional 11-point NRS with anchors of 0 (none) and 10 (a great deal). The words 'none' and 'a great deal' were placed under the NRS corresponding to the anchors 0 and 10, respectively. Sensitivity to change of fatigue was compared with recognised core outcomes and determined by calculating the standardised response means. Multiple regression analysis was employed to determine predictors of fatigue and their independent variance.
Forty-one patients were evaluated. Mean (SD) fatigue levels were 5.6 (2.3) and 3.6 (2.2) (p=0.001) at baseline and at 3-months, respectively. Using the SRM, fatigue ranked sixth relative to the other measures demonstrating a moderate sensitivity to change. Noteworthy was the observation that fatigue was ranked higher than CRP. The relative independent variance in fatigue of 27% was greater than that of the core clinical measures: HAQ 21%, TJC 14%, Pain 4%, SJC 0.4%, GH 0.4%, and less than that of the laboratory measure CRP 33%.
This study demonstrated that fatigue is an independent outcome measure and is sensitive to change in patients with PsA.
本初步研究旨在探讨在接受抗 TNF 治疗的银屑病关节炎（PsA）患者中，疲劳作为结局指标的变化敏感性和相对独立性。
接受抗 TNF 治疗的 PsA 患者在基线和 3 个月时进行评估。使用 0-10 数字评定量表（NRS）测量疲劳。这是一个一维 11 点 NRS，端点为 0（无）和 10（很多）。“无”和“很多”两个词分别放在 NRS 的相应端点 0 和 10 下方。通过计算标准化反应均值来比较疲劳的变化敏感性，并与公认的核心结局进行比较。采用多元回归分析确定疲劳的预测因素及其独立方差。
共评估了 41 例患者。基线时和 3 个月时的平均（标准差）疲劳水平分别为 5.6（2.3）和 3.6（2.2）（p=0.001）。使用 SRM，疲劳在所有测量指标中排名第六，表明其对变化具有中度敏感性。值得注意的是，疲劳的排名高于 CRP。疲劳的相对独立方差为 27%，高于核心临床测量指标（HAQ 21%、TJC 14%、疼痛 4%、SJC 0.4%、GH 0.4%），但低于实验室测量指标 CRP（33%）。
本研究表明，疲劳是一种独立的结局指标，在接受抗 TNF 治疗的 PsA 患者中对变化敏感。
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