title: Fatigue in early axial spondyloarthritis. Results from the French DESIR cohort.
abstract: BACKGROUND
  Fatigue is frequent in long-standing axial spondyloarthritis (axSpA); its frequency in early axSpA and its causes are unclear. The objective was to evaluate the magnitude of fatigue in early axSpA and to assess if fatigue appeared more strongly associated with patient- or with disease-related characteristics.
  
  
  METHODS
  Patients were assessed in DESIR, a national observational cohort of patients with recent (<3 years duration) inflammatory back pain suggestive of axSpA. Magnitude of fatigue was assessed by a numeric rating scale (0-10) over one year. Factors associated with high fatigue (≥5/10) at 12 months were assessed by univariate and multivariate logistic regression, for patients fulfilling the ASAS axSpA criteria.
  
  
  RESULTS
  Of the 708 patients, 486 fulfilled the ASAS criteria for axSpA: mean age 33±9 years; 244 (50%) males. Magnitude of fatigue was high at baseline (mean fatigue: 5.7±2.3) and decreased only slightly over the first year, and was overlapping in patients fulfilling the ASAS criteria or not. High fatigue at 12 months was well explained (variance explained: 0.84) by a higher ASDAS-CRP (odds ratio [OR]: 3.05 [95% confidence interval (CI) 2.27-4.12], P<0.0001), higher Bath Anylosing Spondylitis Patient Global (BAS-G) (OR: 3.51 [95% CI, 2.08-6.02], P<0.0001) and with borderline significance, female gender (OR: 1.65 [95% CI, 1.00-2.71], P=0.049).
  
  
  CONCLUSIONS
  Fatigue levels were high in this population, both for patients fulfilling or not, the ASAS criteria for axSpA. High fatigue was closely related to disease-related variables, indicating fatigue may be an integral part of the disease process in axSpA.
authors.affiliation: Institut Pierre-Louis d'épidémiologie et de santé publique, GRC-UPMC 08 (EEMOIS), Sorbonne Universités, UPMC Université Paris 06, 75013 Paris, France; Department of rheumatology, Pitié-Salpêtrière hospital, AP-HP, 75013 Paris, France. Electronic address: laure.gossec@aphp.fr.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.affiliation: Paris Descartes University, Rheumatology Department, Cochin Hospital, AP-HP, 75014 Paris, France; Inserm (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, 75013 Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.affiliation: Simone-Veil faculty of medicine, University of Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France; Inserm U1173, laboratoire d'excellence INFLAMEX, 78180 Montigny-le-Bretonneux, France; Rheumatology Department, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris, 92100 Boulogne-Billancourt, France.
authors.forename: Maria-Antonietta
authors.initials: MA
authors.lastname: D'Agostino
authors.affiliation: Institut Pierre-Louis d'épidémiologie et de santé publique, GRC-UPMC 08 (EEMOIS), Sorbonne Universités, UPMC Université Paris 06, 75013 Paris, France; Department of rheumatology, Pitié-Salpêtrière hospital, AP-HP, 75013 Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
mesh_terms: D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005221:Fatigue / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D025241:Spondylarthritis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D055815:Young Adult
keywords: BASDAI; Fatigue; Quality of life; Spondyloarthritis/ankylosing spondylitis