Background Persistent fatigue is a major problem for many patients with RA. Knowledge is limited regarding the contribution of inflammation, functional status and comorbidity burden on the level of fatigue, and it is unknown whether such associations vary across different RA populations.
Objectives To analyze in RA patients associations between fatigue score, disease activity, disability and comorbidities in rich and poor countries.
Methods 9,874 patients from 34 countries (16 with high gross domestic product (GDP) (>24.000 US dollars (USD) pr. capita) and 18 with low-GDP countries (<24.000 USD)) participated in the Quantitative Standard monitoring of Patients with RA (QUEST-RA) study. The prevalence of 31 comorbid conditions, fatigue (0-10 cm VAS-scale), disease activity in 28 joints (DAS28), and physical disability (Health Assessment Questionnaire score (HAQ)) were assessed. Univariate and multivariate linear regression analyses were performed to assess the association between fatigue, comorbidities, disease activity, disability and GDP.
Results The median fatigue score was 4.4. In low-GDP countries 25.4% of the patients had a high level of fatigue (>6.6) compared with 23.0% in high-GDP countries (p<0.001). In univariate analysis, fatigue increased with increase in number of comorbidities, disease activity and disability in both high- and low-GDP countries. In multivariate analysis these 3 variables explained 29.4% of the variability (table). Fatigue was overall higher in low-GDP countries, which was explained by higher disease activity. Overall, patients had a median of 2 comorbid conditions and the percentage of patients with comorbidities was higher in high-GDP countries.
Conclusions Fatigue remains a widespread problem. Regardless of GDP, comorbid burden, disease activity and disability predicted approx. 30% of the variability in fatigue.
Disclosure of Interest None Declared
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