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Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy

OBJECTIVES: To define fatigue trajectories in patients with rheumatoid arthritis (RA) who initiate biological DMARD (bDMARD) treatment, and explore baseline predictors for a trajectory of continued fatigue. METHODS: One-hundred and eighty-four patients with RA initiating bDMARDs were assessed at 0,...

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Autores principales: Provan, Sella Aarrestad, Michelsen, Brigitte, Sexton, Joseph, Uhlig, Tillmann, Hammer, Hilde Berner
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856128/
https://www.ncbi.nlm.nih.gov/pubmed/33214326
http://dx.doi.org/10.1136/rmdopen-2020-001372
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author Provan, Sella Aarrestad
Michelsen, Brigitte
Sexton, Joseph
Uhlig, Tillmann
Hammer, Hilde Berner
author_facet Provan, Sella Aarrestad
Michelsen, Brigitte
Sexton, Joseph
Uhlig, Tillmann
Hammer, Hilde Berner
author_sort Provan, Sella Aarrestad
collection PubMed
description OBJECTIVES: To define fatigue trajectories in patients with rheumatoid arthritis (RA) who initiate biological DMARD (bDMARD) treatment, and explore baseline predictors for a trajectory of continued fatigue. METHODS: One-hundred and eighty-four patients with RA initiating bDMARDs were assessed at 0, 1, 2, 3, 6 and 12 months. Swollen and tender joint counts, patient reported outcomes (PROMs), blood samples and ultrasound examinations were collected at each time point. Fatigue was assessed by the fatigue Numeric Rating Scale (0–10) from the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire. Clinically significant fatigue was predefined as fatigue ≥4. Three trajectories of interest were defined according to level of RAID fatigue: no fatigue (≤3 at 5/6 visits), improved fatigue (≥4 at start, but ≤3 at follow-up) and continued fatigue (≥4 at 5/6 visits). Baseline variables were compared between groups by bivariate analyses, and logistic regression models were used to explore baseline predictors of continued vs improved fatigue. RESULTS: The majority of patients starting bDMARD therapy followed one of three fatigue trajectories, (no fatigue; n=61, improved; n=33 and continued fatigue; n=53). Patients with continued fatigue were more likely to be anti–citrullinated protein antibody and/or rheumatoid factor positive and had higher baseline PROMs compared to the other groups, while there were no differences between the groups for variables of inflammation including. Patient global, tender joint count and anxiety were predictors for the continued fatigue trajectory. DISCUSSION: A trajectory of continued fatigue was determined by PROMs and not by inflammatory RA disease activity.
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spelling pubmed-78561282021-02-11 Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy Provan, Sella Aarrestad Michelsen, Brigitte Sexton, Joseph Uhlig, Tillmann Hammer, Hilde Berner RMD Open Rheumatoid Arthritis OBJECTIVES: To define fatigue trajectories in patients with rheumatoid arthritis (RA) who initiate biological DMARD (bDMARD) treatment, and explore baseline predictors for a trajectory of continued fatigue. METHODS: One-hundred and eighty-four patients with RA initiating bDMARDs were assessed at 0, 1, 2, 3, 6 and 12 months. Swollen and tender joint counts, patient reported outcomes (PROMs), blood samples and ultrasound examinations were collected at each time point. Fatigue was assessed by the fatigue Numeric Rating Scale (0–10) from the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire. Clinically significant fatigue was predefined as fatigue ≥4. Three trajectories of interest were defined according to level of RAID fatigue: no fatigue (≤3 at 5/6 visits), improved fatigue (≥4 at start, but ≤3 at follow-up) and continued fatigue (≥4 at 5/6 visits). Baseline variables were compared between groups by bivariate analyses, and logistic regression models were used to explore baseline predictors of continued vs improved fatigue. RESULTS: The majority of patients starting bDMARD therapy followed one of three fatigue trajectories, (no fatigue; n=61, improved; n=33 and continued fatigue; n=53). Patients with continued fatigue were more likely to be anti–citrullinated protein antibody and/or rheumatoid factor positive and had higher baseline PROMs compared to the other groups, while there were no differences between the groups for variables of inflammation including. Patient global, tender joint count and anxiety were predictors for the continued fatigue trajectory. DISCUSSION: A trajectory of continued fatigue was determined by PROMs and not by inflammatory RA disease activity. BMJ Publishing Group 2020-11-19 /pmc/articles/PMC7856128/ /pubmed/33214326 http://dx.doi.org/10.1136/rmdopen-2020-001372 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Rheumatoid Arthritis
Provan, Sella Aarrestad
Michelsen, Brigitte
Sexton, Joseph
Uhlig, Tillmann
Hammer, Hilde Berner
Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy
title Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy
title_full Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy
title_fullStr Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy
title_full_unstemmed Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy
title_short Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy
title_sort trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic dmard therapy
topic Rheumatoid Arthritis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856128/
https://www.ncbi.nlm.nih.gov/pubmed/33214326
http://dx.doi.org/10.1136/rmdopen-2020-001372
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