Objective

To determine, in a cohort of patients with early rheumatoid arthritis (RA), factors associated with fatigue at baseline, describe its evolution over 5 years of follow-up, and determine baseline predictors of persistent fatigue.

Method

We selected patients fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA included in the ESPOIR cohort. Using bivariable and multivariable logistic regression models, we examined baseline variables associated with baseline fatigue (defined by visual analogue scale fatigue > 20) and baseline predictors of persistent fatigue (if the patient experienced fatigue at all visits during the 5 year follow-up period).

Results

We analysed 673 patients; 80.7% reported fatigue at baseline. At baseline, fatigue was associated with female gender, younger age, greater severity of morning stiffness, sleep problems, higher Health Assessment Questionnaire levels, presence of sicca symptoms, history of thyroid problems, and presence of psychological distress (depressive or anxiety symptoms). At 5 years of follow-up, the percentage of fatigued patients who reported fatigue at all time-points since baseline was 24.6% (referred to as ‘persistent fatigue’). Independent baseline predictors were presence of sicca symptoms, greater severity of morning stiffness, and psychological distress.

Conclusions

Fatigue is a frequent symptom in RA. The presence of sicca symptoms, greater severity of morning stiffness, and presence of psychological distress at baseline were associated with baseline fatigue and persistent fatigue at 5 years. We did not observe any association between baseline fatigue or persistent fatigue and the Disease Activity Score based on 28-joint count–erythrocyte sedimentation rate.

中文翻译：

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类风湿关节炎早期疲劳和持续疲劳的预测因素：一项纵向观察研究，数据来自ESPOIR研究组。

目的

为了确定一组早期类风湿关节炎（RA）患者的基线疲劳相关因素，描述其在5年随访中的演变，并确定持续疲劳的基线预测指标。

方法

我们选择了符合2010年美国风湿病学院/欧洲风湿病联盟RA资格的患者纳入ESPOIR队列。使用双变量和多变量logistic回归模型，我们检查了与基线疲劳相关的基线变量（由视觉模拟量表疲劳定义为20以上）和持续疲劳的基线预测因子（如果患者在5年随访期间的所有就诊中均经历了疲劳） 。

结果

我们分析了673例患者。80.7％的人报告基线疲劳。在基线时，疲劳与女性，年轻，早晨僵硬的严重程度，睡眠问题，较高的健康评估问卷水平，是否出现干燥症状，甲状腺疾病史以及心理困扰（抑郁或焦虑症状）有关。在随访的5年中，自基线以来在所有时间点都报告过疲劳的疲劳患者百分比为24.6％（称为“持续疲劳”）。独立的基线预测指标是出现干燥症状，早晨僵硬的严重程度和心理困扰。

结论

疲劳是RA的常见症状。干燥症状的出现，早晨僵硬的严重程度增加以及基线时的心理困扰都与基线疲劳和5年时的持续疲劳有关。我们没有观察到基线疲劳或持续性疲劳与基于28关节计数-红细胞沉降率的疾病活动评分之间的任何关联。