Fatigue tied to more comorbidities, pain, TNFi treatment in PsA patients

Fatigue continues to be a leading symptom following treatment with tumour necrosis factor inhibitor (TNFi), a recent study has found. It has also been linked to pain, higher baseline disease activity, and Health Assessment Questionnaire (HAQ); more comorbidities, and a higher risk of TNFi treatment discontinuation in a cohort of Danish patients with psoriatic arthritis (PsA).

In addition, a weak-to-moderate agreement exists between American College Rheumatology (ACR) and visual analogue scale (VAS) fatigue responses, suggesting heterogeneity between experienced fatigue and joint inflammation.

In this study, the investigators obtained data on patient characteristics, disease activity, and drug survival from the DANBIO database on all patients with PsA from 2006 through 2015. They also acquired information on comorbidities through linkage with the Danish National Patient Registry.

Eight hundred eighty-eight patients met the eligibility criteria for analyses. Those with upper vs lower median fatigue scores had statistically significant higher disease activity measures (Disease Activity Score in 28 joints based on C-reactive protein), pain, and HAQ scores; tender joint counts; comorbidities (Charlson Comorbidity Index ≥2); and current smoking status at baseline (p<0.05).

Notably, fewer patients in the upper median fatigue group achieved ACR responses and improvements in VAS fatigue relative to those in the lower median fatigue group. In Kaplan Meier curves, drug survival was shorter in patients in the upper vs lower median fatigue group at 6-month follow-up.