Article Text

AB0686 Can Fatigue BE Used as A Unique Disease Activity Marker in Ankylosing Spondylitis Patients?
  1. C. Mogosan,
  2. C. Zainea,
  3. D. Marculescu,
  4. A. Radulescu,
  5. C. Codreanu
  1. Rheumatology, “Dr. i. Stoia” Center of Rheumatic Diseases, Bucharest, Romania


Background Fatigue is a major symptom in ankylosing spondylitis (AS). Clinical trials revealed its correlation with mental health and disease activity [1].

Objectives Evaluation of fatigue in relation with efficacy parameters in a population of AS patients treated with biologics in outpatient care.

Methods Cross – sectional study over a sample of 55 patients. Data were gathered from the medical files of the patients (outpatient department).

Results 55 patients with AS, treated with biologics, with a mean age of 43.78 yrs (±11.11), 67.3% males, 80% living in urban areas, 65.5% profesionally active, with mean AS duration of 12.24yrs (±9.48), 72.7% having peripheral arthritis. Mean duration of the TNF-alfa blockers therapy was 3.42yrs (±1.44), and the persistance time on a certain biological product was 2.13 yrs (±1.18). 45.5% of the AS patients were treated with etanercept, 30.9% infliximab, and 23.6% adalimumab. After 2 years of unchanged biological treatment, mean BASDAI score was 1.68 (±2.13), mean ASDAS score was 1.71 (±1.20). Mean ESR 17.75 (±14.95), mean CRP 9.47 (±18.59); self reporting BASDAI domains, common to ASDAS domains, on visual analog scale (VAS) were: back pain =23.27 (±26.80); peripheral pain =9.64 (±21.34); vertebral stiffness =19.45 (±25.19). Patient global-health (GH) evaluation (on a 0-10 VAS) was 2.50 (±2.59) and fatigue score was 22.55 (±27.90). There were no associations between demography characteristics, disease type, the biological product and the treatment efficacy. BASDAI has a a significant positive correlation with ESR (r =0.5, p<0.01), CRP (r =0.6, p<0.01) and ASDAS (r =0.9, p<0.01) and a negative association with treatment duration (r = - 0.4, p<0.01). Linear regression revealed that the most predictive parameter of BASDAI domains for CRP and ESR was fatigue (B=0.4, Rsquare =0.32, p<0.01, CI95%: 0.23-0.53). We proceeded into insert fatigue (from BASDAI) on GH place in a modified AS DAS score. The results were calculated using the standardized formula. Mean modified AS-DAS score was 1.68 (±1.23). There was a high significant positive association between modified AS-DAS and BASDAI (r =0.88, p<0.001), as well as with classic AS-DAS (r =0.99, p<0.001). BASDAI and modified AS-DAS have a reciprocal highly prediction value (B =1.53, R square =0.8, p<0.001, CI 95%:1.31-1.75).

Conclusions Cantitative evaluation of self-reporting fatigue (rapid and cheap test) can be used as a unique marker of disease activity, being a usefull tool in monitoring AS patients.


  1. Dagfinrud H, Vollestad NK, Loge JH et all Fatigue in patients with ankylosing spondylitis: A comparison with the general population and associations with clinical and self-reported measures. Arthritis Rheum. 2005 Feb 15;53(1):5-11

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.4767

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