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Fatigue Severity and Psoriatic Arthritis

Recent research  published in The Journal of Rheumatology showed that greater fatigue levels correlate with decreased physical functioning, work productivity, and what’s called HRQOL for health-related quality of life among patients with psoriatic arthritis (PsA).

The July of 2022 article is titled:  Impact of Fatigue on Health-Related Quality of Life and Work Productivity in Psoriatic Arthritis: Findings From a Real-World Survey (link:  https://www.jrheum.org/content/early/2022/07/29/jrheum.211288). 

Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin and nail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails. Psoriatic arthritis is similar to rheumatoid arthritis (RA) in symptoms and joint swelling (aka inflammation). But it tends to affect fewer joints than RA.

Researchers assessed the effect of frequency and severity of fatigue on HRQOL among patients with physician-confirmed PsA in the 2018 timeframe in Europe.

The survey included questions on fatigue frequency and severity, using both patient- and physician-reported measures, including the Psoriatic Arthritis Impact of Disease fatigue scale, provider-confirmed (yes/no) reports of patient fatigue, the 5-level EuroQoL 5-dimension questionnaire for HRQOL, the Health Assessment Questionnaire-Disability Index (aka HAQ-DI), and the Work Productivity and Activity Impairment Questionnaire.

Of the 831 patients with PsA, 651  or 78.3% reported fatigue. Fatigue severity increased with disease duration/patient age, pain levels, PsA disease severity, the total body area affected by psoriasis, and the number of tender or swollen joints.

Multivariate analysis indicated that greater fatigue levels correlated with worse physical functions, HRQOL, and work productivity. Depression and anxiety more commonly occurred among patients with PsA who reported higher levels of fatigue severity.

The researchers noted that physicians reported fatigue in 32% of patients with self-reported fatigue, intimating that there is underreporting among patients with PsA.

A key quote from the study authors:  “Despite many patients receiving advanced therapy, fatigue is still highly prevalent among patients with PsA and underrecognized by physicians.  These findings highlight the importance of prioritizing fatigue in the research and management of PsA.”