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Assessment of fatigue and its relationships with disease-related parameters in patients with Systemic sclerosis

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Abstract

We aimed to assess the prevalence and severity of fatigue in Moroccan patients with systemic sclerosis (SSc) and its relationship with disease-related parameters of activity and severity and quality of life (QoL). Patients with SSc according to the American College of Rheumatology criteria (diffuse disease) and/or the LeRoy and Medsger criteria (limited disease) for SSc were recruited. The multidimensional assessment of fatigue (MAF), a self-administered questionnaire developed to measure five dimensions of fatigue with a total score ranged from 0 (no fatigue) to 50 (severe fatigue), was used to assess fatigue. The activity of disease was assessed by evaluating the severity of skin involvement, vascular manifestations, pulmonary involvement, joint and/or muscle involvement, and the erythrocyte sedimentation rate. Functional disability was assessed by using the scleroderma health assessment questionnaire. QoL was assessed using the SF-36 generic instrument. Sixty-four patients (91% women) were included. The mean age of patients was 49.5 ± 12.4 years. Fifty-nine patients (92.1%) had diffuse SSc and 5 (7.8%) had limited disease. Among our patients, 89% experienced severe fatigue with a VAS fatigue ≥50 mm. The mean total score of the MAF was 28 ± 8.6 (10–44.8) and all domains of fatigue were affected. In univariate and multivariate analysis, fatigue was correlated with severe joint involvement, pain intensity, low vital capacity, high level of ESR, and with functional disability (for all p ≤ 0.01). There were statistically significant correlations between fatigue and the deterioration of all domains of SF-36. Fatigue is a disabling symptom in our SSc patients and is associated with poor QoL. Pain, joint involvement, functional impairment, and pulmonary involvement seem to be the most important factors that predict severe fatigue. Large studies are necessary in order to confirm those findings.

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References

  1. Rannou F, Poiraudeau S, Berezné A, Baubet T, Le-Guern V, Cabane J, Guillevin L, Revel M, Fermanian J, Mouthon L (2007) Assessing disability and quality of life in systemic sclerosis: construct validities of the Cochin Hand Function Scale, Health Assessment Questionnaire (HAQ), Systemic Sclerosis HAQ, and Medical Outcomes Study 36-Item Short Form Health Survey. Arthritis Rheum 57(1):94–102

    Article  PubMed  Google Scholar 

  2. Clements PJ, Roth MD, Elashoff R, Tashkin DP, Goldin J, Silver RM, Sterz M, Seibold JR, Schraufnagel D, Simms RW, Bolster M, Wise RA, Steen V, Mayes MD, Connelly K, Metersky M, Furst DE, Scleroderma Lung Study Group (2007) Scleroderma lung study (SLS): differences in the presentation and course of patients with limited versus diffuse systemic sclerosis. Ann Rheum Dis 66(12):1641–1647

    Article  PubMed  Google Scholar 

  3. Hudson M, Thombs BD, Steele R, Panopalis P, Newton E, Baron M, Canadian Scleroderma Research Group (2009) Health-related quality of life in systemic sclerosis: a systematic review. Arthritis Rheum 61(8):1112–1120

    Article  PubMed  Google Scholar 

  4. Sandusky SB, McGuire L, Smith MT, Wigley FM, Haythornthwaite JA (2009) Fatigue: an overlooked determinant of physical function in scleroderma. Rheumatol (Oxford) 48(2):165–169

    Article  CAS  Google Scholar 

  5. Danieli E, Airò P, Bettoni L, Cinquini M, Antonioli CM, Cavazzana I, Franceschini F, Cattaneo R (2005) Health-related quality of life measured by the Short Form 36 (SF-36) in systemic sclerosis: correlations with indexes of disease activity and severity, disability, and depressive symptoms. Clin Rheumatol 24(1):48–54

    Article  PubMed  Google Scholar 

  6. Georges C, Chassany O, Toledano C, Mouthon L, Tiev K, Meyer O, Ilie D, Rambeloarisoa J, Marjanovic Z, Cabane J, Sereni D, Pouchot J, Farge D (2006) Impact of pain in health related quality of life of patients with systemic sclerosis. Rheumatol (Oxford) 45(10):1298–1302

    Article  CAS  Google Scholar 

  7. Sandqvist G, Scheja A, Hesselstrand R (2010) Pain, fatigue and hand function closely correlated to work ability and employment status in systemic sclerosis. Rheumatol (Oxford) 49(9):1739–1746

    Article  Google Scholar 

  8. Neuberger GB (2003) Measures of fatigue. Arthritis Rheum 49:175–183

    Article  Google Scholar 

  9. Masi AT, Subcommittee for Scleroderma Criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590

    Article  Google Scholar 

  10. LeRoy EC, Medsger TA Jr (2001) Criteria for the classification of early systemic sclerosis. J Rheumatol 28:1573–1576

    PubMed  CAS  Google Scholar 

  11. Medsger TA, Bombardieri S, Czirjak L, Scorza R, Della Rossa A, Bencivelli W et al (2003) Assessment of disease severity and prognosis. Clin Exp Rheumatol 21:42–46

    Google Scholar 

  12. Minier T, Nagy Z, Bálint Z, Farkas H, Radics J, Kumánovics G, Czömpöly T, Simon D, Varjú C, Németh P, Czirják L (2010) Construct validity evaluation of the European Scleroderma Study Group activity index, and investigation of possible new disease activity markers in systemic sclerosis. Rheumatol 49(6):1133–1145

    Article  Google Scholar 

  13. Georges C, Chassany C, Mouthon L, Tiev K, Toledano C, Meyer O et al (2005) Validation of French version of the scleroderma Health Assessment Questionnaire (SSc HAQ). Clin Rheumatol 24:3–10

    Article  PubMed  CAS  Google Scholar 

  14. Khoudri I, Ali Zeggwagh A, Abidi K, Madani N, Abouqal R (2007) Measurement properties of the short form 36 and health-related quality of life after intensive care in Morocco. Acta Anaesthesiol Scand 51(2):189–197

    Article  PubMed  CAS  Google Scholar 

  15. Richards HL, Herrick AL, Griffin K, Gwilliam PD, Loukes J, Fortune DG (2003) Systemic sclerosis: patients’ perceptions of their condition. Arthritis Rheum 49:689–696

    Article  PubMed  Google Scholar 

  16. Suarez-Almazor ME, Kallen MA, Roundtree AK, Mayes M (2007) Disease and symptom burden in systemic sclerosis: a patient perspective. J Rheumatol 34:1718–1726

    PubMed  Google Scholar 

  17. Rupp I, Boshuizen HC, Jacobi CE, Dinant HJ, van den Bos GA (2004) Impact of fatigue on health-related quality of life in rheumatoid arthritis. Arthritis Rheum 51(4):578–585

    Article  PubMed  Google Scholar 

  18. Pollard LC, Choy EH, Gonzalez J, Khoshaba B, Scott DL (2006) Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatol (Oxford) 45(7):885–889

    Article  CAS  Google Scholar 

  19. Hyphantis TN, Tsifetaki N, Pappa C, Voulgari PV, Siafaka V, Bai M, Alamanos Y, Drosos AA, Mavreas V (2007) Clinical features and personality traits associated with psychological distress in systemic sclerosis patients. J Psychosom Res 62(1):47–56

    Article  PubMed  Google Scholar 

  20. Hudson M, Thombs BD, Steele R, Watterson R, Taillefer S, Baron M, Canadian Scleroderma Research Group Investigators (2008) Clinical correlates of quality of life in systemic sclerosis measured with the World Health Organization Disability Assessment Schedule II. Arthritis Rheum 59(2):279–284

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Rheumatology (Pr N Hajjaj-Hassouni), El Ayachi Hospital, University Hospital of Rabat-Sale, 11000, Sale, Morocco

    Yousra Ibn Yacoub, Bouchra Amine, Rachida Bensabbah & Najia Hajjaj-Hassouni

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  1. Yousra Ibn Yacoub
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  2. Bouchra Amine
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  3. Rachida Bensabbah
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  4. Najia Hajjaj-Hassouni
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Correspondence to Yousra Ibn Yacoub.

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Ibn Yacoub, Y., Amine, B., Bensabbah, R. et al. Assessment of fatigue and its relationships with disease-related parameters in patients with Systemic sclerosis. Clin Rheumatol 31, 655–660 (2012). https://doi.org/10.1007/s10067-011-1906-z

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  • DOI: https://doi.org/10.1007/s10067-011-1906-z

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