Fatigue in rheumatoid arthritis; a persistent problem: a large longitudinal study.

摘要: Objective Fatigue is prevalent and disabling in rheumatoid arthritis (RA). Surprisingly, the long-term course of fatigue studied seldom it unclear to what extent influenced by inflammation. This study aimed determine during 8 years follow-up, its association with severity inflammation effect improved treatment strategies. Methods 626 patients RA included Leiden Early Arthritis Clinic cohort were 8 years. severity, measured on a 0–100 mm scale, other clinical variables assessed yearly. Patients 1993–1995, 1996–1998 1999–2007 treated delayed disease-modifying antirheumatic drugs (DMARDs), early mild DMARDs methotrexate respectively. After multiple imputation, serial measurements analysed using linear quantile mixed models. Results Median at baseline was 45 mm remained, despite treatment, rather stable thereafter. Female gender (effect size=4.4 mm), younger age (0.2 mm less fatigue/year), higher swollen tender joint counts (0.3 mm 1.0 mm more fatigue/swollen or joint) C reactive protein-levels (0.1 mm per mg/L) independently significantly (p Conclusions largest longitudinal so far demonstrated that between statistically significant but sizes are small, suggesting non-inflammatory pathways mediate as well. Improved strategies did not result severe fatigue. Therefore, remains an ‘unmet need’.