Abstract
Fatigue is a common, disabling, and difficult-to-manage problem in rheumatic diseases. Prevalence estimates of fatigue within rheumatic diseases vary considerably. Data on the prevalence of severe fatigue across multiple rheumatic diseases using a similar instrument is missing. Our aim was to provide an overview of the prevalence of severe fatigue across a broad range of rheumatic diseases and to examine its association with clinical and demographic variables. Online questionnaires were filled out by an international sample of 6120 patients (88 % female, mean age 47) encompassing 30 different rheumatic diseases. Fatigue was measured with the RAND(SF)-36 Vitality scale. A score of ≤35 was taken as representing severe fatigue (90 % sensitivity and 81 % specificity for chronic fatigue syndrome). Severe fatigue was present in 41 to 57 % of patients with a single inflammatory rheumatic disease such as rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, Sjögren’s syndrome, psoriatic arthritis, and scleroderma. Severe fatigue was least prevalent in patients with osteoarthritis (35 %) and most prevalent in patients with fibromyalgia (82 %). In logistic regression analysis, severe fatigue was associated with having fibromyalgia, having multiple rheumatic diseases without fibromyalgia, younger age, lower education, and language (French: highest prevalence; Dutch: lowest prevalence). In conclusion, one out of every two patients with a rheumatic disease is severely fatigued. As severe fatigue is detrimental to the patient, the near environment, and society at large, unraveling the underlying mechanisms of fatigue and developing optimal treatment should be top priorities in rheumatologic research and practice.
Highlights
Fatigue is a common problem in patients with a rheumatic disease
This study in 30 rheumatic diseases shows that severe fatigue is a widespread and highly prevalent problem across rheumatic diseases
Severe fatigue was least common in patients with osteoarthritis (35 %) and most common in patients with
Summary
Fatigue is a common problem in patients with a rheumatic disease. It can be as disabling as pain, is difficult to manage, and has a substantial impact on quality of life [1,2,3,4,5,6,7,8,9,10]. In research and clinical practice, multiple instruments have been used to assess fatigue, representing disease-specific versus generic as well as unidimensional versus multidimensional definitions of fatigue [4, 11, 12]. We chose a common generic (not disease-specific), unidimensional specification of fatigue to be able to estimate the prevalence of a severe level of fatigue across multiple rheumatic diseases
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