title: Fatigue in rheumatoid arthritis: association with severity of pain, disease activity and functional status.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic symmetric polyarthritis causing progressive joint destruction and disability. Major patient complaints are pain, disability and fatigue. The aim of this study is to assess fatigue and its association with disease-specific variables (severity of pain, disease activity, and functional status) in patients with RA.
  
  
  METHODS
  A total of 160 RA patients were included in the study. Fatigue was measured by using Fatigue Symptom Inventory (FSI). The quadrivariate Disease Activity Score-28 (DAS28) was used for evaluating disease activity and Health Assessment Questionnaire (HAQ) for determining functional status. Severity of pain was measured by using 10 cm Visual Analog Scale-Pain (VAS-pain).
  
  
  RESULTS
  Intensity items of FSI (most fatigue, least fatigue, average fatigue, current fatigue) were strongly correlated with DAS28, HAQ, and VAS pain (p=0.000). When the correlation coefficients were analyzed, current fatigue showed the highest correlation with VAS-pain (r: 0.96). This was followed by DAS28 and HAQ, respectively (r: 0.77 and 0.70) (p=0.000). Duration items of FSI (number of days fatigued, amount of time fatigued) were significantly correlated with DAS28, HAQ, and VAS pain (p=0.000). Also there were significant positive correlations between interference scale of FSI and DAS28, HAQ, and VAS-pain (r: 0.68, 0.61 and 0.67, respectively) (p=0.000). None of FSI subgroups showed statistically significant correlation with di­sease duration.
  
  
  CONCLUSIONS
  Fatigue is strongly associated with severity of pain, disease activity and functional status. Fatigue should be included in clinical practice and clinical trials as a RA outcome measure.
authors.affiliation: Numune Training and Research Hospital, Physical Medicine and Rehabilitation Department, Samanpazari, Ankara, Turkey. dryesimgarip@gmail.com
authors.forename: Yesim
authors.initials: Y
authors.lastname: Garip
authors.forename: Filiz
authors.initials: F
authors.lastname: Eser
authors.forename: Lale Akbulut
authors.initials: LA
authors.lastname: Aktekin
authors.forename: Hatice
authors.initials: H
authors.lastname: Bodur
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000503:physiopathology; D004185:Disability Evaluation; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012720:Severity of Illness Index; D055815:Young Adult