Background Rheumatoid arthritis (RA) and systemic sclerosis (SScl) are two different forms of connective tissue diseases associated with significant morbidity. While fatigue is not required for a diagnosis of RA or SScl persistent fatigue is an important clinical problem which may interfere with loss of functioning and health related quality of life (HRQoL) and contribute to the increased disease burden. Several studies compared these two diseases in terms of clinical, laboratory and imaging aspects, however level of fatigue has not been evaluated comparatively.
Objectives The aim of this study was to compare levels of fatigue in RA and SSc and to assess potential influence of fatigue on clinical variables.
Methods Patients meeting the ACR/EULAR criteria for SSc and RA with an age more than 18 were consecutively recruited. Patients with a prior diagnosis of psychiatric disorders or fibromyalgia or taking medications for these disorders, or with uncontrolled diabetes, neurological disorders or taking any kind of biologic agents were excluded. Patients were examined and evaluated for disease specific and generic outcome measures including disease activity parameters, physical functions, psychological status and health related quality of life (HRQoL) measures. Level of fatigue was assessed by Fatigue Severity Scale (FSS) and Multidimensional Assessment of Fatigue (MAF) scale. These were interviewed by the same experienced physician who was blind to clinical data.
Results Fifty patients (44 F, 6 M) with SSc and fifty-one (45 F, 6 M) with RA were included. Patients had similar age and similar gender, educational and smoking status, as well as functioning and HRQoL. However, patients with RA declared higher levels on VAS-pain (p=0.012), and higher body mass index than patients with SSc (p<0.0001) and lower distances in 6-minute walking test (p=0.002). Levels of fatigue which were assessed by VAS, FSS and MAF were quite similar between patients with RA and SSc. Levels of fatigue, measured by different scales, were significantly correlated with physical functions and HRQoL measures and psychometric variables in both groups, however the correlation coefficients were relatively higher in patients with RA.
Conclusions Fatigue is a major problem in patients with RA and SSc. This is the first report comparing these two diseases in terms of fatigue and its correlates. Patients with RA and SSc should be carefully evaluated for fatigue by using valid scales and the impact of fatigue on clinical measures should not be overlooked.
Disclosure of Interest None declared