Dar Waseem R, Mir Irfan A, Siddiq Summra, Nadeem Mir, Singh Gurmeet
Department of Medicine, School of Medical Science and Research, Greater Noida 201306, India.
Medicine, New Cross Hospital, Wolverhampton WV1 1JA, UK.
Clin Pract. 2022 Jul 26;12(4):591-598. doi: 10.3390/clinpract12040062.
Introduction: Rheumatoid arthritis (RA) is a common autoimmune illness that manifests mostly as chronic, symmetric, and progressive polyarthritis with a global frequency of 0.3−1.0%. RA is a disease that affects people all over the world. In India, the prevalence is estimated to be 0.7%, with around 10 million persons suffering from RA. Most people with rheumatoid arthritis experience fatigue on most days, with over 70% experiencing symptoms similar to chronic fatigue syndrome. Patients rate fatigue as a top priority and believe this unmanageable symptom is ignored by clinicians; a systematic review shows the biological agents for RA inflammation have only a small effect on fatigue. Fatigue predicts and reduces the quality of life, and it is as difficult to cope with as pain. Physicians have traditionally concentrated on the inflammatory aspects of the illness (e.g., synovitis), whereas RA patients have prioritized pain, exhaustion, sleep difficulties, and other quality-of-life issues. Aims and Objectives: The basic aim of the study was to access the incidence of fatigue in rheumatoid arthritis and evaluate its impact on the quality of life in these patients using the MAF scale (multidimensional assessment of fatigue) after prior permission for the first time in an Asian population. Results: A total of 140 subjects and 100 controls were included in the study. Age was closely matched between the study subjects and controls. Among study subjects with the disease, 94 (67%) had a disease duration ≤ 5 years, 26 (19%) had a disease duration between 6−10 years, 10 (7%) had a duration of 11−15 years and 10 (7%) had >10 years disease duration. Among the sample, 31 (25%) study subjects had a DAS score ≤ 4.0, 63 (50%) study subjects had a DAS score (disease activity score) between 4.01 and 6.0, and in the remaining 31 (25%) study subjects, the DAS score was >6.0. The mean DAS score among study subjects was 4.96, and the study subjects had a mean activity of daily living (ADL) score of 11.64; controls had a mean score of 2.42 with a statistically significant p-value. The global fatigue index was higher in study subjects, with a mean of 33.16 in contrast with a mean of 14.41 in the controls with a significant p-value. Conclusion: Our study fatigue was a persistent problem, despite treatment. The median level of fatigue experienced by study subjects with RA was high. Therefore, as persistent fatigue is associated with functional loss, fatigue in RA remains an ‘unmet need’ and continues to be ignored by clinicians.
类风湿关节炎（RA）是一种常见的自身免疫性疾病，主要表现为慢性、对称性和进行性多关节炎，全球发病率为0.3%-1.0%。RA是一种影响全球各地人群的疾病。在印度，估计患病率为0.7%，约有1000万人患有RA。大多数类风湿关节炎患者大多数日子都会感到疲劳，超过70%的患者出现类似于慢性疲劳综合征的症状。患者将疲劳列为首要问题，并认为这种难以控制的症状被临床医生忽视；一项系统评价显示，用于RA炎症的生物制剂对疲劳的影响很小。疲劳预示并降低生活质量，而且它与疼痛一样难以应对。传统上，医生专注于该疾病的炎症方面（如滑膜炎），而RA患者则将疼痛、疲惫、睡眠困难和其他生活质量问题列为优先事项。目的：本研究的基本目的是首次在亚洲人群中，在获得事先许可后，使用MAF量表（疲劳多维评估）评估类风湿关节炎患者疲劳的发生率，并评估其对这些患者生活质量的影响。结果：本研究共纳入140名受试者和100名对照。研究受试者和对照之间的年龄密切匹配。在患有该疾病的研究受试者中，94人（67%）病程≤5年，26人（19%）病程在6-10年之间，10人（7%）病程为11-15年，10人（7%）病程>10年。在样本中，31名（25%）研究受试者的疾病活动度评分（DAS）≤4.0，63名（50%）研究受试者的DAS评分在4.01至6.0之间，其余31名（25%）研究受试者的DAS评分>6.0。研究受试者的平均DAS评分为4.96，研究受试者的日常生活活动（ADL）平均评分为11.64；对照组的平均评分为2.42，p值具有统计学意义。研究受试者的总体疲劳指数较高，平均为33.16，而对照组的平均为14.41，p值显著。结论：我们的研究表明，尽管进行了治疗，但疲劳仍是一个持续存在的问题。患有RA的研究受试者经历的疲劳中位数水平较高。因此，由于持续疲劳与功能丧失相关，RA中的疲劳仍然是一个“未满足的需求”，并继续被临床医生忽视。
