Predictors of Fatigue in Rheumatoid Arthritis Patients in Remission or in a Low Disease Activity State
Predictors of Fatigue in Rheumatoid Arthritis Patients in Remission or in a Low Disease Activity State
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DOI：
10.1002/acr.22787
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发表时间：
2016-07-01
影响因子：
4.7
通讯作者：
Zangi, Heidi A.
中科院分区：
文献类型：
--
作者：
Olsen, Christin L.;Lie, Elisabeth;Zangi, Heidi A.
类风湿关节炎（RA）是一种常见的风湿性关节炎。我们的目的是评估RA患者报告的疲劳水平，这些患者在接受疾病缓解抗风湿药物（DMARDs）治疗6个月后达到缓解或疾病活动度低，并探讨疲劳与人口统计学、疾病活动度和该患者组其他患者报告结果之间的相关性。193例RA患者（年龄18岁）开始甲氨蝶呤（MTX）单药治疗或肿瘤坏死因子抑制剂与MTX联合治疗，从挪威疾病缓解抗风湿药物注册（NOR-DMARD）检索。在6个月随访时，699例患者（31.9%）处于缓解或低疾病活动状态。以6个月时的疲劳视觉模拟量表（VAS）为因变量，进行双变量和多变量线性回归分析。年龄、性别、病程、治疗组、红细胞沉降率（ESR）、28个关节肿胀和压痛关节计数、疼痛VAS评分和基线时和6个月时的残疾被测试为6个月时疲劳的预测因素。（第25百分位数，第75百分位数）疲劳水平为20.0 mm（6.0，43.0），27.9%的患者报告疲劳VAS评分40 mm。在多变量分析中，基线时较低的ESR和较高的疼痛是较高水平疲劳的统计学显著预测因素（P
ObjectiveFatigue is a frequently occurring symptom in patients with rheumatoid arthritis (RA). Our aims were to assess the level of reported fatigue in RA patients who had achieved remission or low disease activity after 6 months of treatment with disease-modifying antirheumatic drugs (DMARDs), and to explore associations between fatigue and demographics, disease activity, and other patient-reported outcomes in this patient group.MethodsA total of 2,193 RA patients (ages 18 years) starting either methotrexate (MTX) monotherapy or a tumor necrosis factor inhibitor in combination with MTX were retrieved from the Norwegian Disease-Modifying Antirheumatic Drugs Register (NOR-DMARD). At the 6-month followup, 699 patients (31.9%) were in remission or in a low disease activity state. Bivariate and multivariate linear regression analyses were conducted, with the fatigue visual analog scale (VAS) at 6 months as the dependent variable. Age, sex, disease duration, treatment group, erythrocyte sedimentation rate (ESR), the swollen and tender joint count in 28 joints, the pain VAS score, and disability at baseline and at 6 months were tested as predictors of fatigue at 6 months.ResultsAt 6 months, the median (25th, 75th percentile) level of fatigue was 20.0 mm (6.0, 43.0), and a fatigue VAS score of 40 mm was reported by 27.9% of patients. In the multivariate analysis, lower ESR and higher pain at baseline were statistically significant predictors of higher levels of fatigue (P