Assessment of Fatigue in Undifferentiated Spondyloarthritis (USpA)

Berat Meryem Alkan, Fatma Fidan, Sevgi Atalay, Şükran Erten, Sinem Bozkurt, Özge Ardıçoğlu

Ataturk Education and Research Hospital, PMR Clinic, Ankara, Turkey.
Yildirim Beyazit University, PMR Clinic, Ankara, Turkey.

DOI: 10.4236/ojra.2014.43022                

Abstract

Objectives: This study aimed to evaluate the fatigue in patients with undifferentiated spondyloarthritis [USpA], and its relationship with disease-specific variables, spinal mobility measures and healthy related quality of life [HRQOL]. Methods: Eighty patients with USpA and forty healthy subjects were included in this study. The multidimensional assessment of fatigue [MAF] and the generic instrument Short Form 36 [SF 36] were used in patient and control groups to assess fatigue and [HRQOL]. Fatigue was also assessed with the Bath ankylosing spondylitis disease activity index [BASDAI] fatigue item. The evaluation included the activity of the disease [BASDAI], functional status [Bath ankylosing spondylitis functional index], and visual analog scale [VAS] of axial and joint pain. Demographics and disease-related data were obtained. Results: Patients with USpA had higher scores in MAF total and in all MAF subgroup scales than controls. All SF-36 subgroups scores were also found to be significantly lower in patients. Severe fatigue experienced 60% in patients. MAF total scores were found to be significantly correlated with morning stiffness, BASDAI, Bath ankylosing spondylitis functional index (BASFI), BASDAI fatigue, VAS-axial, and SF-36 subgroups scores in patients [p < 0.05]. Conclusions: The patients with USpA defined significantly more fatigue and lower HRQOL when compared with healthy persons. MAF was found to be related with the clinical and functional status and health-related quality of life of patients with USpA.

Keywords

Undifferentiated Spondyloarthritis, MAF, HRQOL

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Dougados, M., Linden, S., Juhlin, R., et al. (1991) The European Spondyloarthropathy Study Group Preliminary Criteria for the Classification Spondyloarthropathy. Arthritis & Rheumatism, 34, 1218-1227. http://dx.doi.org/10.1002/art.1780341003
[2]	Lin, Z., Gu, J., He, P., et al. (2011) Multicenter Validation of the Value of BASFI and BASDAI in Chinese Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy Patients. Rheumatology International, 3, 233-238. http://dx.doi.org/10.1007/s00296-009-1313-9
[3]	Spoorenberg, A., Heijde, D., Klerk, E., et al. (1999) A Comparative Study of the Usefulness of the Bath Ankylosing spondylitis Functional Index and the Dougados Functional Index in the Assessment of Ankylosing Spondylitis. The Journal of Rheumatology, 26, 961-965.
[4]	Claudepierre, P., Sibila, J., Goupille, P., et al. (1997) Evaluation of a French Version of the Bath Ankylosing spondylitis Disease Activity Index in Patients with Spondylarthropathy. Journal of Rheumatology, 24, 1954-1958.
[5]	Keikkila, S., Vitanen, J.V., Kautiainen, H., et al. (2002) Functional Long Term Changes in Patients with Spondyloarthropathy. Clinical Rheumatology, 21, 119-122. http://dx.doi.org/10.1007/s10067-002-8270-y
[6]	Van Tubergen, A., Coenen, J., Landewé, R., et al. (2002) Assessment of Fatigue in Patients with Ankylosing Spondylitis: Apsychometric Analysis. Arthritis Care & Research, 47, 8-16. http://dx.doi.org/10.1002/art1.10179
[7]	Neuberger, G.B. (2003) Measures of Fatigue. Arthritis Care & Research, 49, 175-183. http://dx.doi.org/10.1002/art.11405
[8]	Akkoc, Y., Karatepe, A.G., Akar, S., et al. (2005) A Turkish Version of the Bath Ankylosing Spondylitis Disease Activity index: Reliability and Validity. Rheumatology International, 25, 280-284. http://dx.doi.org/10.1007/s00296-003-0432-y
[9]	Garrett, S.L., Jenkinson, T.R., Kennedy, L.G., et al. (1994) A New Approach to Defining Disease Status in Ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. The Journal of Rheumatology, 21, 2286-2291.
[10]	Calin, A., Garrett, S.L., Whitelock, H.C., et al. (1994) A New Approach to Defining Functional Ability in Ankylosing Spondylitis: The Development of the Bath Ankylosing Spondylitis Functional Index (BASFI). The Journal of Rheumatology, 21, 2281-2285.
[11]	Yanik, B., Gursel, Y.K., Kutlay, S., et al. (2005) Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish Population, Its Reliability and Validity: Functional Assessment in AS. Clinical Rheumatology, 24, 41-47. http://dx.doi.org/10.1007/s10067-004-0968-6
[12]	Ware Jr., J.E. (2000) SF-36 Health Survey Update. Spine, 25, 3130-3139. http://dx.doi.org/10.1097/00007632-200012150-00008
[13]	Kocyigit, H., Aydemir, O., Fisek, G., et al. (1999) Kisa Form 36’nin Türkce Versiyonunun Güvenilirligi ve Gecerliligi. Ilacve Tedavi Dergisi, 12, 102-106.
[14]	Aissaoui, N., Rostom, S., Hakkou, J., et al. (2012) Fatigue in Patients with Ankylosing Spondylitis: Prevalence and Relationships with Disease-Specific Variables, Psychological Status, and sleep Disturbance. Rheumatology International, 32, 2117-2124. http://dx.doi.org/10.1007/s00296-011-1928-5
[15]	Da Costa, D., Dritsa, M., Ring, A., et al. (2004) Mental Health Status and Leisure-Time Physical Activity Contribute to Fatigue Intensity in Patients With Spondylarthropathy. Arthritis & Rheumatism (Arthritis Care & Research), 51, 1004-1008. http://dx.doi.org/10.1002/art.20841
[16]	Calin, A., Edmunds, L., Kennedy. L.G. (1993) Fatigue in Ankylosing Spondylitis: Why Is It Ignored? The Journal of Rheumatology, 20, 991-995.
[17]	Jones, S.D., Koh, W.H., Steiner, A., et al. (1996) Fatigue in Ankylosing Spondylitis: Its Prevalence and Relationship to Disease Activity, Sleep, and Other Factors. The Journal of Rheumatology, 23, 487-490.
[18]	Roussou, E. and Sultana, S. (2010) The Bath Ankylosing Spondylitis Activity and Function Indices (BASDAI and BASFI) and Their Correlation with Main Symptoms Experienced by Patients with Spondyloarthritis. Clinical Rheumatology, 29, 869-874. http://dx.doi.org/10.1007/s10067-010-1411-9
[19]	Turan, Y., Duruoz, M.T., Bal, S., et al. (2007) Assessment of Fatigue in Patients with Ankylosing Spondylitis. Rheumatology International, 27, 847-852. http://dx.doi.org/10.1007/s00296-007-0313-x
[20]	Dernis-Labous, E., Messow, M. and Dougados, M. (2003) Assessment of Fatigue in the Management of Patients with Ankylosing Spondylitis. Rheumatology (Oxford), 42, 1523-1528. http://dx.doi.org/10.1093/rheumatology/keg421
[21]	Wolfe, F., Michaud, K. and Pincus T. (2004) Fatigue, Rheumatoid Arthritis, and Anti-Tumor Necrosis Factor Therapy: An Investigation in 24831 Patients. The Journal of Rheumatology, 31, 2115-2120.
[22]	Dagfinrud, H., Vollestad, N.K., Loge, J.H., et al. (2005) Fatigue in Patients with Ankylosing Spondylitis: A Comparison with the General Population and Associations with Clinical and seLf-Reported Measures. Arthritis Care & Research, 53, 5-11. Http://Dx.Doi.Org/10.1002/Art.20910
[23]	Yacoub, Y., Amine, B., Laatiris, A., et al. (2010) Assessment of Fatigue in Moroccan Patients with Ankylosing Spondylitis. Clinical Rheumatology, 29, 1295-1299. http://dx.doi.org/10.1007/s10067-010-1558-4
[24]	Burgos-Vargas, R. and Casasola-Vargas, J.C. (2010) From Retrospective Analysis of Patients with Undifferentiated Spondyloarthritis (SpA) to Analysis of Prospective Cohorts and Detection of Axial and Peripheral SpA. The Journal of Rheumatology, 37, 1091-1095. http://dx.doi.org/10.3899/jrheum.100413