Assessment of Fatigue in Rheumatoid Arthritis (by Functional Assessment of Chronic Illness Therapy–Fatigue Score) and Its Relation to Disease Activity and Anemia

Abstract

Patients with rheumatoid arthritis (RA) mention fatigue as one of their most annoying problems. Measuring fatigue, understanding its contributory factors, and treating it as a feasible target lead to better patient outcome and improved quality of life. The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System is a collection of health-related quality-of-life questionnaires targeted to the management of chronic illness. The objective of this study was to evaluate fatigue using FACIT-Fatigue (FACIT-F) score and its relation to disease activity (using Disease Activity Score [DAS28] and Clinical Disease Activity Index [CDAI] score) and anemia in RA patients. A total of 100 RA patients were evaluated for fatigue using FACIT-F score, for disease activity using DAS28 and CDAI scores, for anemia using hemoglobin levels. Correlation studies were done using Pearson test. Functional Assessment of Chronic Illness Therapy-Fatigue showed positive association with DAS28 (P < 0.001; r = -0.80) and CDAI (P < 0.001; r = -0.83). Considering various components of DAS28 and CDAI, FACIT-F showed significant correlation with tender joint count (P < 0.001; r = -0.73), swollen joint count (P < 0.001; r = -0.76), patient global assessment (P < 0.001; r = -0.72), and evaluator global assessment (P < 0.001; r = -0.75). Erythrocyte sedimentation rate had no association with the fatigue (P = 0.217). No association was observed between fatigue and hemoglobin levels (P = 0.203). The fatigue experienced by the patients with RA is strongly associated with the severity of disease activity and is independent of anemia.