Background Beside pain, fatigue is expressed as the most prominent symptom in RA [1,2] and has been described as having a greater impact on daily life than pain [2].

Persons with RA experience that their fatigue vary over time concerning duration and frequency [3]. Longitudinal studies assessing change in fatigue after a period of one year have reported relatively stable fatigue [4] or considerable variations of fatigue [5]. More knowledge is needed about how fatigue in persons with RA vary over time.

Objectives To study variations of fatigue during one year in persons with RA of working age.

Methods Sixty-five participants having RA and being of working age (20-65 years) were recruited from a rheumatology clinic in West Sweden.

Questionnaires assessing fatigue were given to the participants every other month during 1 year, in total seven times.

Fatigue was assessed using both single-item and multidimensional measures:

– VAS for global fatigue (0-100 mm) (endpoints no fatigue and worst imaginable fatigue)

– The Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire, (BRAF-MDQ) consisting a global score (Total) and four subscales (Physical, Living, Cognition, Emotion) [6-7].

Results The fatigue showed statistically significant variation over time for the outcome measures VAS fatigue (p<0.01), BRAF-MDQ Total and the subscales Living, Cognition (p<0.001) and Physical (p<0.05), when analyzed by mixed models. For the subscale Emotion (p=0.08) the variation of fatigue over time was not statistically significant. A statistically significant seasonal variation was shown for global fatigue (VAS p<0.01 and BRAF-MDQ Total p<0.001) and physical aspects of fatigue (BRAF-MDQ Physical and Living p<0.01) indicating less physical fatigue in the summer.

No statistical differences over time were seen in fatigue between women and men or between age-groups.

Conclusions This study show that fatigue in persons with RA vary significantly during one year and further acknowledges the dynamic nature of fatigue and the complexity of its different facets.

References

1. Wolfe, F., D.J. Hawley, and K. Wilson, The prevalence and meaning of fatigue in rheumatic disease. J Rheumatol, 1996. 23(8): p. 1407-17.

2. Repping-Wuts, H., et al., Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study. Int J Nurs Stud, 2008. 45(7): p. 995-1002.

3. Hewlett, S., et al., Patients' perceptions of fatigue in rheumatoid arthritis: overwhelming, uncontrollable, ignored. Arthritis Rheum, 2005. 53(5): p. 697-702.

4. Mancuso, C.A., et al., Psychosocial variables and fatigue: a longitudinal study comparing individuals with rheumatoid arthritis and healthy controls. J Rheumatol, 2006. 33(8): p. 1496-502.

5. Treharne, G.J., et al., Predictors of fatigue over 1 year among people with rheumatoid arthritis. Psychol Health Med, 2008. 13(4): p. 494-504.

6. Nicklin, J., et al., Measuring fatigue in rheumatoid arthritis: a cross-sectional study to evaluate the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional questionnaire, visual analog scales, and numerical rating scales. Arthritis Care Res (Hoboken), 2010. 62(11): p. 1559-68.

7. Dures, E.K., et al., Reliability and sensitivity to change of the Bristol Rheumatoid Arthritis Fatigue Scales. Rheumatology (Oxford), 2013.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.3502