Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Lombardia, Italy.
Rheumatology Division, IRCCS Policlinico San Matteo Foundation, Pavia, Lombardia, Italy.
Rheumatol Int. 2023 Sep;43(9):1637-1649. doi: 10.1007/s00296-023-05344-z. Epub 2023 Jun 14.
Idiopathic inflammatory myopathies (IIMs) confer a significant risk of disability and poor quality of life, though fatigue, an important contributing factor, remains under-reported in these individuals. We aimed to compare and analyze differences in visual analog scale (VAS) scores (0-10 cm) for fatigue (VAS-F) in patients with IIMs, non-IIM systemic autoimmune diseases (SAIDs), and healthy controls (HCs). We performed a cross-sectional analysis of the data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) international patient self-reported e-survey. The COVAD survey was circulated from December 2020 to August 2021, and details including demographics, COVID-19 history, vaccination details, SAID details, global health, and functional status were collected from adult patients having received at least one COVID-19 vaccine dose. Fatigue experienced 1 week prior to survey completion was assessed using a single-item 10 cm VAS. Determinants of fatigue were analyzed in regression models. Six thousand nine hundred and eighty-eight respondents (mean age 43.8 years, 72% female; 55% White) were included in the analysis. The overall VAS-F score was 3 (IQR 1-6). Patients with IIMs had similar fatigue scores (5, IQR 3-7) to non-IIM SAIDs [5 (IQR 2-7)], but higher compared to HCs (2, IQR 1-5; P < 0.001), regardless of disease activity. In adjusted analysis, higher VAS-F scores were seen in females (reference female; coefficient -0.17; 95%CI -0.21 to -13; P < 0.001) and Caucasians (reference Caucasians; coefficient -0.22; 95%CI -0.30 to -0.14; P < 0.001 for Asians and coefficient -0.08; 95%CI -0.13 to 0.30; P = 0.003 for Hispanics) in our cohort. Our study found that patients with IIMs exhibit considerable fatigue, similar to other SAIDs and higher than healthy individuals. Women and Caucasians experience greater fatigue scores, allowing identification of stratified groups for optimized multidisciplinary care and improve outcomes such as quality of life.
特发性炎性肌病 (IIM) 可导致显著的残疾和生活质量下降风险，尽管疲劳是一个重要的促成因素，但在这些患者中报告不足。我们旨在比较和分析 IIM 患者、非 IIM 系统性自身免疫性疾病 (SAID) 患者和健康对照者 (HC) 疲劳的视觉模拟量表 (VAS) 评分 (0-10cm) 之间的差异。我们对 COVID-19 疫苗在自身免疫性疾病中的接种 (COVAD) 国际患者自我报告电子调查的数据进行了横断面分析。COVAD 调查于 2020 年 12 月至 2021 年 8 月进行，从接受至少一剂 COVID-19 疫苗的成年患者中收集了人口统计学、COVID-19 病史、疫苗接种详细信息、SAID 详细信息、整体健康和功能状态等信息。在调查完成前 1 周评估疲劳，使用 10cm VAS 进行单项评估。在回归模型中分析了疲劳的决定因素。纳入 6988 名受访者 (平均年龄 43.8 岁，72%为女性；55%为白人) 进行分析。总体 VAS-F 评分为 3(四分位距 1-6)。IIM 患者的疲劳评分与非 IIM SAID 相似(5，四分位距 2-7)[5(四分位距 2-7)]，但高于 HCs(2，四分位距 1-5；P<0.001)，无论疾病活动度如何。在调整分析中，女性(女性参考；系数-0.17；95%CI-0.21 至-13；P<0.001)和高加索人(高加索参考；系数-0.22；95%CI-0.30 至-0.14；P<0.001)的 VAS-F 评分较高，而亚洲人(系数-0.08；95%CI-0.13 至 0.30；P=0.003)和西班牙裔(系数-0.08；95%CI-0.13 至 0.30；P=0.003)的 VAS-F 评分较高。我们的研究发现，IIM 患者表现出相当大的疲劳，与其他 SAID 相似，高于健康个体。女性和高加索人经历更大的疲劳评分，这允许为优化多学科护理和改善生活质量等结果确定分层群体。
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