1. bookVolume 75 (2021): Issue 2 (April 2021)
Journal Details
License
Format
Journal
First Published
14 Sep 2008
Publication timeframe
6 times per year
Languages
English
access type Open Access

Does the Course of Disease Influence the Development of Fatigue in Rheumatoid Arthritis Patients?

Published Online: 08 May 2021
Page range: 106 - 112
Received: 22 Sep 2020
Accepted: 31 Mar 2021
Journal Details
License
Format
Journal
First Published
14 Sep 2008
Publication timeframe
6 times per year
Languages
English
Abstract

Patients with rheumatoid arthritis (RA) typically have many permanently inflamed joints. The inflammation inside the body can lead to general physical weakness, exhaustion, and drowsiness. This feeling of extreme tiredness is also called “fatigue”. Some people find this to be the worst symptom of the disease. However, the clinical significance of fatigue and its pathogenesis have not been recognised. This study aimed to determine the development of fatigue depending on activity and aggressiveness of RA. To achieve the goal, patients were interviewed and indicators of disease activity and aggressiveness were determined: rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), immunoglobulins IgA RF, IgM RF, IgG RF and anti-carbamylated protein antibodies (anti-CarP). Based on the results of the survey, RA patients were divided into two groups — with and without fatigue. In the group of RA patients with fatigue, statistically more often an increase in IgA RF, IgM RF, and IgG RF levels was observed in those with elevated RF level, higher IgM RF and IgG RF levels were associated with increase in IgA RF level, and increase in the IgG RF and anti-CarP levels with elevation in the IgM RF level. A higher IgG RF level contributed to a higher anti-CarP level increase. Significant differences in the levels of clinical and laboratory inflammatory markers were not observed between the RA patients with and without fatigue. The obtained data suggest that the aggressive course of RA, more than inflammation, may contribute to the development of fatigue in RA patients.

Keywords

Aletaha, D., Neogi, T., Silman, A. J., Funovits, J., Felson, D. T., Bingham, C. O. 3rd, Birnbaum, N. S., Burmester, G. R., Bykerk, V. P., Cohen, M. D. et al. (2010). 2010 rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum.,62 (9), 2569–2581.Search in Google Scholar

Aletaha, D., Landewe, R., Karonitsch, T., Bathon, J., Boers, M., Bombardier, C., Choi, H., Combe, B., Dougados, M. (2008). Reporting disease activity in clinical trials of patients with rheumatoid arthritis: EULAR/ACR collaborative recommendations. Ann. Rheum. Dis., 67 (10), 1360–1364.Search in Google Scholar

Andersson, M. L. E., Svensson, B., Bergman, S. (2013). Chronic widespread pain in patients with rheumatoid arthritis and the relation between pain and disease activity measures over the first 5 years. J. Rheumatol., 40 (12), 1977–1985.Search in Google Scholar

Bartlett, S. J., Hewlett, S., Bingham, C. O. 3rd, Woodworth, T. G., Alten, R., Pohl, C., Choy, E. H., Sanderson, T., Boonen, A., Bykerk, V., et al. (2012). Identifying core domains to assess flare in rheumatoid arthritis: An OMERACT international patient and provider combined Delphi consensus. Ann. Rheum. Dis., 71, 1855–1860.Search in Google Scholar

Bergman, M. J., Shahouri, S. H., Shaver, T. S., Weidensaul, D. N., Busch, R. E., Wang, S., Wolfe, F. (2009). Is fatigue an inflammatory variable in rheumatoid arthritis (RA)? Analyses of fatigue in RA, osteoarthritis, and fibromyalgia. J. Rheumatol., 36, 2788–2794.Search in Google Scholar

Bingham, C. O. III, Gutierrez, A. K., Butanis, A., Bykerk, V. P., Curtis, J. R., Leong, A., Nowell, W. B., Orbai, A. M., Bartlett, S. (2019). PROMIS Fatigue short forms are reliable and valid in adults with rheumatoid arthritis. J. Patient Rep. Outcomes, 3, 14.Search in Google Scholar

Breedveld, F. C., Han, C., Bala, M., Heijde, D. van der, Baker, D., Kavanugh, A., Maini, R., Lipsky, P. (2005). Association between baseline radiographic damage and improvement in physical function after treatment of patients with rheumatoid arthritis. Ann. Rheum. Dis., 64, 52–55.Search in Google Scholar

van Delft, M. A. M., Verheul, M. K., Burgers, L. E., Derksen, V. F. A. M., van der Helm-van Mil A. H. M., van der Woude, D., Huizinga, T. W. J., Toes, R. E. M., Trouw, L. A. (2017). The isotype and IgG subclass distribution of anti-carbamylated protein antibodies in rheumatoid arthritis patients. Arthritis Res Ther., 19, 190.Search in Google Scholar

Cappelli, L., Barlett, S. J., Jones, M., Bingharm, C. (2015). CCP Antibody negativity is associated with higher fatigue in rheumatoid arthritis (abstract). Arthritis Rheumatol.,67 (suppl 10), 2602. https://acrabstracts.org/abstract/ccp-antibody-negativity-is-associated-with-higher-fatigue-in-rheumatoid-arthritis/ (accessed 14.09.2020).Search in Google Scholar

Demmelmaier, I., Pettersson, S., Nordgren, B., Dufour, A. B., Opava, C. H. (2018). Associations between fatigue and physical capacity in people moderately affected by rheumatoid arthritis. Rheumatol. Int., 38, 2147–2155.Search in Google Scholar

Druce, K. L., Bhattacharya, Y., Jones, G. T., Macfarlane, G. J., Basu, N. (2016). Most patients who reach disease remission following anti-TNF therapy continue to report fatigue: Results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis. Rheumatology (UK), 55, 1786–1790.Search in Google Scholar

Hewlett, S., Carr, M., Ryan, S., Kirwan, J., Richards, P., Carr, A., Hughes, R. (2005). Outcomes generated by patients with rheumatoid arthritis: How important are they? Musculoskeletal Care, 3, 131–142.Search in Google Scholar

Hewlett, S., Chalder, T., Choy, E., Hewlett, S., Chalder, T., Choy, E., Cramp, F., Davis, B., Dures, E., Nicholls, C., Kirwan, J. (2011). Fatigue in rheumatoid arthritis: Time for a conceptual model. Rheumatology, 50, 1004–1006.Search in Google Scholar

Hewlett, S., Cockshott, Z., Byron, M., Kitchen, K., Tipler, S., Pope, D., Hehir, M. (2005). Patients’ perception of fatigue in rheumatoid arthritis: Overwhelming, uncontrollable, ignored. Arthritis Rheum.,53, 697–702.Search in Google Scholar

Holdren, M., Schieir, O., Bartlett, S. J., Bessette, L., Boire, G., Hazlewood, G., Hitchon, C., Keystone, E., Tin, D., Thorne, C., Bykerk, V., Pope, J. (2019). Achieving a low disease state within first 3 months in early rheumatoid arthritis results in lower fatigue over 5 years. Ann. Rheum. Dis., 78 (2), A24010.Search in Google Scholar

Hoogmoed, D. van, Fransen, J., Bleijenberg, G., Riel, P. van (2010). Physical and psychosocial correlates of severe fatigue in rheumatoid arthritis. Rheumatology (Oxford), 49, 1294–1302.Search in Google Scholar

Jonsson, T., Valdimarsson, H. (1998). What about IgA rheumatoid factor in rheumatoid arthritis? Ann. Rheum. Dis.,57, 63.Search in Google Scholar

Jensen Hansen, I. M., Asmussen Andreasen, R., van Bui Hansen, M. N., Emamifar, A. (2017). The reliability of Disease Activity Score in 28 Joints-C-Reactive Protein might be overestimated in a subgroup of rheumatoid arthritis patients, when the score is solely based on subjective parameters: A cross-sectional, exploratory study. J. Clin. Reum.,23 (2), 102–106.Search in Google Scholar

Junghaenel, D. U., Schneider, S., Stone, A. A. (2019). Do people with arthritis differ from healthy controls in their internal comparison standards for self-reports of health, fatigue, and pain? Identification and validation of clinically relevant clusters of severe fatigue in rheumatoid arthritis. J. Patient Rep. Outcomes, 3, 21.Search in Google Scholar

Katz, P. (2017). Fatigue in rheumatoid arthritis. Curr. Rheumatol. Rep., 19, 25.Search in Google Scholar

Kirwan, J. R., Minnock, P., Adebajo, A., Bresnihan, B., Choy, E., de Wit, M., Hazes, M., Ricgards, P., Saag, K., Suarez-Almazor, M., Wells, G., Hewlett, S. (2007). Patient perspective: Fatigue as a recommended patient centered outcome measure in rheumatoid arthritis. J. Rheumatol., 34, 1174–1177.Search in Google Scholar

Lacaille, D., White, M. A., Backman, C. L.. Gignac, M. A. M. (2007). Problems faced at work due to inflammatory arthritis: New insights gained from understanding patients’ perspective. Arthritis Care Res., 57, 1269–1279.Search in Google Scholar

Madsen, S. G., Danneskiold-Samsoe, B., Stockmarr, A., Bartels, E. M. (2016). Correlations between fatigue and disease duration, disease activity, and pain in patients with rheumatoid arthritis: A systematic review. Scand. J. Rheumatol., 45, 255–261.Search in Google Scholar

Minnock, P., Ringnér, A., Bresnihan, B., Veale, D., FitzGerald, O., McKee, G. (2017) Perceptions of the cause, impact and management of persistent fatigue in patients with rheumatoid arthritis following tumour necrosing factor inhibition therapy. Musculoskel. Care, 15, 23–35.Search in Google Scholar

Nikolaus, S., Bode, C., Taal, E., Laar, M. A. F. J. van der (2013). Fatigue and factors related to fatigue in rheumatoid arthritis: A systematic review. Arthritis Care Res., 65, 1128–1146.Search in Google Scholar

Pollard, L. C., Choy, E. H., Gonzalez, J., Khoshaba, B., Scott, D. L. (2006). Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatology, 45, 885–889.Search in Google Scholar

Pope, J. E. (2020). Management of fatigue in rheumatoid arthritis. Rheum. Musculoskel. Dis., Open, 6, e001084.Search in Google Scholar

Primdahl, J., Hegelund, A., Lorenzen, A. G., Loeppenthin, K., Dures, E., Esbensen, B. A. (2019). The experience of people with rheumatoid arthritis living with fatigue: A qualitative meta synthesis. Brit. Med. J. Open, 9, e02433810.Search in Google Scholar

Repping-Wuts, H., Fransen, J., van Achterberg, T., Bleijenberg, G., van Riel, P. (2007). Persistent severe fatigue in patients with rheumatoid arthritis. J. Clin. Nurs., 16 (11C), 377–383.Search in Google Scholar

Riemsma, R. P., Rasker, J. J., Taal, E., Griep, E. N., Wouters, J. M., Wiegman, O. (1998). Fatigue in rheumatoid arthritis: The role of self-efficacy and problematic social support. Brit. J. Rheumatol., 37, 1042–1046.Search in Google Scholar

Rodríguez-Muguruza, S., Combe, B., Guillemin, F., Fautrel, B., Olive, A., Marsal, S., Valero, O., Rincheval, N., Lukas, C. (2020). Predictors of fatigue and persistent fatigue in early rheumatoid arthritis: A longitudinal observational study, data from the ESPOIR cohort. Scand. J. Rheumatol.,49 (4), 259–266.Search in Google Scholar

Silva, C. F. R., Duarte, C., Ferreira, R. J. O., Santos, E., Silva, J. A. P. (2019). Depression, disability and sleep disturbance are the main explanatory factors of fatigue in rheumatoid arthritis: A path analysis model. Clin. Exp. Rheumatol., 38, 314–321.Search in Google Scholar

Shi, J., van de Stadt, L. A., Levarht, E. W., Hizinga, T. W. J., Toes, R. E. M., Trouw, L. A., Schaardenburg, D. van (2013). Anti-carbamylated protein antibodies are present in arthralgia patients and predict the development of rheumatoid arthritis. Arthritis Rheum.,65, 911–915.Search in Google Scholar

Shi, J., van de Stadt, L. A., Levarht, E. W., Huizinga, T. W., Hamann, D., Schaardenburg, D. van, Toes, R. E. M., Trouw, L. A. (2014). Anti-carbamylated protein (anti-CarP) antibodies precede the onset of rheumatoid arthritis. Ann. Rheum. Dis.,73, 780–783.Search in Google Scholar

Strand, V., Jones, T. V., Li, W., Koenig, A. S., Kotak, S. (2015). The impact of rheumatoid arthritis on work and predictors of overall work impairment from three therapeutic scenarios. Int. J. Clin. Rheumatol., 10, 317–328.Search in Google Scholar

Szady, P., Bączyk, G., Kozłowska, K. (2017). Fatigue and sleep quality in rheumatoid arthritis patients during hospital admission. Reumatologia, 55 (2), 65–72.Search in Google Scholar

Truchetet, M. E., Dublanc, S., Barnetche, T., Vittecoq, O., Mariette, X., Richez, C., Blanco, P., Mahler, M., Contin-Bordes, C., Schaeverbeke, T., Fédération Hospitalo-Universitaire ACRONIM. (2017). Association of the presence of anti-carbamylated protein antibodies in early arthritis with a poorer clinical and radiologic outcome: Data from the French ESPOIR cohort. Arthritis Rheumatol., 69, 2292–22302.Search in Google Scholar

Walsh, D. A., McWilliams, D. F. (2014). Mechanisms, impact and management of pain in rheumatoid arthritis. Nat. Rev. Rheumatol., 10, 581–592.Search in Google Scholar

Wolfe, F., Hawley, D. J., Wilson, K. (1996). The prevalence and meaning of fatigue in rheumatic disease. J. Rheumatol., 23, 1407–1417.Search in Google Scholar

Wolfe, F., Michaud, K. (2009). Predicting depression in rheumatoid arthritis: The signal importance of pain extent and fatigue, and comorbidity. Arthritis Care Res., 61, 667–673.Search in Google Scholar

Zielinski, M. R., Systrom, D. M., Rose, N. R. (2019). Fatigue, sleep and auto-immune and related disorders. Front Immunol., 10, 1827.Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo