Abstract
Background:Fatigue is one of the core domains to be measured in all clinical trials for psoriatic arthritis (PsA). Studies of fatigue in PsA in Asia are scarce.Objectives:To describe the prevalence and evaluate the factors associated with fatigue in PsA patients within a multi-ethnic Asian population.Methods:We used data from the PRESPOND registry for PsA patients attending an outpatient clinic of a tertiary institution in Singapore. Demographics data and disease characteristics were evaluated. Fatigue was assessed by question 1 of BASDAI (BASDAI-F) and the vitality domain of SF-36 (SF-36 VT).Results:131 patients (50.4% men, 63.4% Chinese, median PsA duration 1.78 years) with completed data for fatigue were included. The median (IQR) tender and swollen joint count was 2 (5) and 1 (3) respectively. 45 patients (34%) experienced high fatigue (defined by BASDAI-F ≥ 6/101,2). 5 clusters of factors were identified using principal component analysis that explained 66.2% of the variance of all factors, which mapped to disease activity, disease chronicity, demographics (ethnicity and gender), and BMI (Figure 1). Of these, disease activity and chronicity were significantly associated with BASDAI-F and SF-36 VT. In a multivariate analysis, back pain, peripheral joint pain and patient global assessment were associated with BASDAI-F, whereas peripheral joint pain, HAQ-DI, age and BMI were associated with SF-36 VT (Table 1).Table 1.Multivariable analysis for variables associated with fatigueBASDAI-FSF-36 VTb95% CIβpb95% CIβpBack pain (0-10)0.335(0.180, 0.490)0.356<0.001----Peripheral joint pain (0-10)0.027(0.012, 0.042)0.2680.001-2.296(-3.410, -1.182)-0.320<0.001PGA (0-100)0.211(0.061, 0.361)0.2360.006----HAQ-DI (0-3)-----12.74(-17.97, -7.51)-0.386<0.001Age, y----0.260(0.065, 0.456)0.1790.009BMI, kg/m2-----0.644(-1.183, -0.105)-0.1650.020Figure 1.Principal component analysis with 5 components and residuals (in dotted lines). Only factor loadings with magnitudes greater than 0.40 are shown.Conclusion:PsA-associated fatigue is prevalent in this Asian PsA cohort and is associated with disease activity and chronicity.
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