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The burden and determinants of fatigue in incident and prevalent systemic sclerosis

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

 

  1. The University of Melbourne, Victoria, and St. Vincent’s Hospital Melbourne, Victoria, Australia. jessica.fairley@svha.org.au
  2. St. Vincent’s Hospital Melbourne, Victoria, Australia.
  3. University of Adelaide, South Australia, and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  4. Lady Davis Institute for Medical Research, Montreal, and McGill University, Montreal, Canada.
  5. Monash Health, Melbourne, Victoria, and Monash University, Melbourne, Victoria, Australia.
  6. Monash Health, Melbourne, Victoria, and Monash University, Melbourne, Victoria, Australia.
  7. Royal Adelaide Hospital, Adelaide, South Australia, and Flinders University of South Australia, Australia.
  8. Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
  9. The University of Melbourne, Victoria, and St. Vincent’s Hospital Melbourne, Victoria, Australia.
  10. St. Vincent’s Hospital Melbourne, Victoria, Australia.
  11. The University of Melbourne, Victoria, and St. Vincent’s Hospital Melbourne, Victoria, Australia.
  12. The University of Sydney School of Public Health, Sydney, New South Wales; Royal Prince Alfred Hospital Sydney, New South Wales; and SydneyMSK Research Flagship Centre, University of Sydney, Sydney, New South Wales, Australia.

CER17645
2024 Vol.42, N°8
PI 1669, PF 1674
Brief Papers

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PMID: 39152749 [PubMed]

Received: 05/03/2024
Accepted : 24/06/2024
In Press: 14/08/2024
Published: 14/08/2024

Abstract

OBJECTIVES:
To investigate the burden and clinical associations of fatigue in systemic sclerosis (SSc) as measured by FACIT-Fatigue scores.
METHODS:
Australian Scleroderma Cohort Study participants with ≥1 FACIT-Fatigue score were included. Participants were divided into those with incident SSc (≤5 years SSc duration at recruitment and FACIT-Fatigue score recorded within 5 years of disease onset) or prevalent SSc (first FACIT-Fatigue score recorded >5 years after SSc onset). Generalised estimating equations were used to model change in FACIT-Fatigue scores over time, expressed as an increasing (improving) or decreasing (worsening) score.
RESULTS:
Of 859 participants, 215 had incident SSc and 644 prevalent SSc. First-recorded FACIT-Fatigue scores were similar in those with incident (37 units, IQR 25-45.5) and prevalent SSc (36 units, IQR 23-44; p=0.17), as were lowest-ever recorded FACIT-Fatigue scores (incident 23 units; prevalent 22 units, p=0.75). In incident SSc, higher skin scores (regression coefficient (RC) -1.5 units, 95%CI -2.3 to -0.8), PAH (RC -8.2, 95%CI -16.5 to 0.1) and reduced left ventricular function (RC -10.6, 95%CI -18.3 to -2.8) were associated with more severe fatigue. In prevalent SSc, higher skin scores (RC -0.6, 95%CI -1.3 to 0), gastrointestinal symptoms (RC -6.6, 95%CI -9.0 to -4.2), hypoalbuminaemia (RC -2.8, 95%CI -5.0 to -0.7), BMI<18.5kg/m2 (RC -6.3, 95%CI -10.3 to -2.2), raised CRP (RC -3.1, 95%CI -4.7 to -1.5), and anaemia (RC -1.7, 95%CI -3.5 to 0.1) were associated with more severe fatigue.
CONCLUSIONS:
The burden of fatigue is substantial in both incident and prevalent SSc. Cardiopulmonary and gastrointestinal involvement are associated with worse fatigue.

DOI: https://doi.org/10.55563/clinexprheumatol/6528od

Rheumatology Article

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