AB0216 FATIGUE ASSESSMENT IN RHEUMATOID ARTHRITIS, SANTO DOMINGO, DOMINICAN REPUBLIC

Abstract

BackgroundRheumatoid arthritis (RA) is an inflammatory, systemic autoimmune disease affecting the synovial membrane of small joints.1 Wagan A. et al demonstrated that the frequency of fatigue in rheumatoid arthritis is 62%,2 Hammam et al described a higher rate of fatigue associated with higher disease activity. Fatigue is as a feeling of exhaustion, also as a reduction in physical and mental capacity,3,4 it can be measured with the scale FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue), which evaluates the last 7 days, with a score of 0-52. For the severity analysis, 4 grades are used: no or mild fatigue (40-52), moderate (27-39), severe (14-26) and extreme fatigue (0-13).2,5ObjectivesTo evaluate the frequency and degree of fatigue in rheumatoid arthritis.MethodsProspective, observational, cross-sectional study of a cohort of patients of the Rheumatology Service of the Hospital Docente Padre Billini. Patients were interviewed in July 2021. Inclusion criteria: ≥ 18 years, diagnosis of RA according to the ACR/EULAR 2010 classification criteria. Exclusion criteria: previous diagnosis of fibromyalgia, depression or anxiety, treatment with antidepressants, antihistamines, beta-blockers. Scales measured: FACIT-F, DAS28, CDAI, and HAQ-DI. Statistical analysis was performed with the Pearson correlation (rp). Data were analyzed in IBM-SPSS v23.Results597 patients met inclusion criteria. 93% female, mean age 58.5±12.4 years, mean disease duration 7.5 years. HT 73.9% (441), DM 14.2% (85), dyslipidemia 21.3% (127), obesity 17.9% (107), smoking 9.9% (59), high ESR 60.0% (358), high CRP 49.7% (297), scDMARD8 2.7% (494), bDMARDS 36.8% (218), tsDMARDS 18.1 (108). Frequency of fatigue 19.9% (119): moderate 12.9% (77), severe 7.0% (42). Correlation of FACIT-F with DAS28, CDAI and HAQ-DI: No fatigue FACIT-F 80.1% (478): DAS28 remission or low activity 84.9% (406), CDAI remission or low activity 93.5% (447), moderate 4.0% (19), high activity 2.5% (12), HAQ-DI mild 75.9% (363), moderate 16.5% (79), severe 7.5% (36). Moderate FACIT-F 12.9% (77): DAS28 remission or low activity 19.5% (15), moderate 80.5% (62), CDAI moderate 48.1% (37), high activity 51.9% (40), HAQ-DI mild 24.7% (19), moderate 63.6% (49), severe 11.7% (9). Severe FACIT-F 7.0% (42): DAS28 remission or low activity 4.8% (2), high activity 95.2% (40), CDAI low activity or remission 35.7% (15), high activity 64.3% (27), HAQ-DI mild 7.1% (3), moderate 23.8% (10), severe 69.0% (29). Correlation between FACIT-F/DAS28 (rp= .673, p< .001) and FACIT-F/CDAI (rp= .701, p < .001) were strong.ConclusionThe study showed a low frequency of fatigue; the degree of fatigue most found was moderate. The group of patients with fatigue had a statistically significant linear association with disease activity and degree of functional limitation. There were no patients with extreme fatigue.