Gossec Laure, Walsh Jessica A, Michaud Kaleb, Holdsworth Elizabeth, Peterson Steve, Meakin Sophie, Yang Feifei, Booth Nicola, Chakravarty Soumya D, Piercy James, Dennis Natalie, Ogdie Alexis
L. Gossec, MD, PhD, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, and Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Rheumatology Department, Paris, France.
J.A. Walsh, MD, University of Utah and Salt Lake City Veterans Affairs Medical Centers, Salt Lake City, Utah, USA.
J Rheumatol. 2022 Nov;49(11):1221-1228. doi: 10.3899/jrheum.211288. Epub 2022 Jul 15.
To evaluate fatigue frequency and severity among patients with psoriatic arthritis (PsA) and assess the effect of fatigue severity on patient-reported outcome measures (PROMs) assessing quality of life, function, and work productivity.
Data were derived from the Adelphi Disease Specific Programme, a cross-sectional survey conducted in 2018 in the United States and Europe. Patients had physician-confirmed PsA. Fatigue was collected as a binary variable and through its severity (0-10 scale, using the 12-item Psoriatic Arthritis Impact of Disease fatigue question) from patients; physicians also reported patient fatigue (yes/no). Other PROMs included the 5-level EuroQol 5-dimension questionnaire (EQ-5D-5L) for health-related quality of life (HRQOL), Health Assessment Questionnaire-Disability Index, and Work Productivity and Activity Impairment Questionnaire. Multivariate linear regression was used to evaluate the association between fatigue severity and other PROMs.
Among the 831 included patients (mean age 47.5 yrs, mean disease duration 5.3 yrs, 46.9% female, 48.1% receiving a biologic), fatigue was reported by 78.3% of patients. Patients with greater fatigue severity had greater disease duration, PsA severity, pain levels, body surface area affected by psoriasis, and swollen and tender joint counts (all < 0.05). In multivariate analyses, patients with greater fatigue severity experienced worse physical functioning, HRQOL, and work productivity (all < 0.001). Presence of fatigue was underreported by physicians (reported in only 32% of patients who self-reported fatigue).
Prevalence of patient-reported fatigue was high among patients with PsA and underrecognized by physicians. Fatigue severity was associated with altered physical functioning, work productivity, and HRQOL.
评估银屑病关节炎（PsA）患者的疲劳频率和严重程度，并评估疲劳严重程度对评估生活质量、功能和工作效率的患者报告结局指标（PROMs）的影响。
数据来源于阿德尔菲特定疾病项目，这是一项2018年在美国和欧洲开展的横断面调查。患者经医生确诊为PsA。疲劳情况通过二元变量收集，并让患者根据疲劳严重程度（0至10分，使用12项银屑病关节炎疾病影响疲劳问卷）进行报告；医生也报告患者的疲劳情况（是/否）。其他PROMs包括用于健康相关生活质量（HRQOL）的5级欧洲五维健康量表（EQ-5D-5L）、健康评估问卷残疾指数以及工作效率和活动障碍问卷。采用多元线性回归来评估疲劳严重程度与其他PROMs之间的关联。
在纳入的831例患者中（平均年龄47.5岁，平均病程5.3年，46.9%为女性，48.1%正在接受生物制剂治疗），78.3%的患者报告有疲劳。疲劳严重程度较高的患者病程更长、PsA严重程度更高、疼痛水平更高、银屑病累及的体表面积更大，以及肿胀和压痛关节数更多（均P<0.05）。在多变量分析中，疲劳严重程度较高的患者身体功能、HRQOL和工作效率更差（均P<0.001）。医生对疲劳情况的报告不足（仅在32%自我报告有疲劳的患者中报告了疲劳）。
PsA患者中报告有疲劳的比例较高，但医生对此认识不足。疲劳严重程度与身体功能、工作效率和HRQOL的改变相关。
