Background Systemic Lupus Erythematosus (SLE) is a multifactorial autoimmune disease characterized by a wide range of clinical manifestations. Fatigue represents a frequent symptom reported by SLE patients, mainly at the disease onset, with impact on the quality of life. The assessment of fatigue could be difficult. The Functional Assessment of Chronic Illness version 4 Therapy (FACIT-F) questionnaire has been validated in chronic diseases to assess fatigue in adult patients.
Objectives We aimed at assessing the fatigue, by using FACIT-F questionnaire, in a monocentric cohort of SLE patients. Moreover, we evaluated possible associations with others clinical manifestations, laboratory parameters, disease activity and chronicity indices, and, general health (GH) index.
Methods In 1 month period, we enrolled consecutive SLE patients, fulfilled the 1997 American College of Rheumatology (ACR) revised criteria. Clinical and laboratory data were collected in a standardized, computerized and electronically filled form, which included demographics, past medical history with date of diagnosis, comorbidities, and previous and concomitant treatments. We assessed the disease activity and chronic damage by using SLEDAI-2K and SDI, respectively. The GH (range 0-100) was assessed. Finally, all the patients completed the FACIT-F, a 13-item questionnaire that assesses self-reported tiredness, weakness, and difficulty conducting usual activities due to fatigue. A five-point intensity type of rating scale (from “not at all” to “very much”) is used. Final scores are the sum of responses and range from 0 to 52; higher scores indicated less fatigue.
Results One hundred-nine SLE patients (11M/98F; mean ± SD age 40.7±11.5 years; mean disease duration 130.2±93.5 months) were evaluated. We obtained a mean SLEDAI-2K of 1.9±2.9 and a mean SDI of 0.4±0.7; moreover, the GH was 64.6±19.2. The assessment of FACIT-F showed a mean value of 34.6±11.8; all the patients showed the involvement of at least one item. The item more frequently involved in this cohort was the tiredness, identified in 91.7/% of the patients. A significant correlation between the FACIT-F values and GH was identified (P<0.0001; R=0.65). No significant associations have been identified between FACIT-F and SLEDAI-2K or SDI. Moreover, SLE patients with joint involvement showed a mean FACIT-F values lower than patients without (30.6±11.1 versus 35.4±11.8, P=0.05).
Conclusions In the present study the use of FACIT-F demonstrated the presence of involvement of at least one items in all the evaluated patients, with the item related to the tiredness involved in up to 90% of patients. Moreover, the fatigue was significantly associated with the health status, evaluated by GH. The absence of correlation with disease activity suggest the need to evaluate this specific finding also in patients without signs of active disease.
Disclosure of Interest None declared