RT Journal Article
SR Electronic
T1 Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus
JF RMD Open
JO RMD Open
FD EULAR
SP e002395
DO 10.1136/rmdopen-2022-002395
VO 8
IS 2
A1 Philippe Mertz
A1 Matteo Piga
A1 Elisabetta Chessa
A1 Zahir Amoura
A1 Reinhard E Voll
A1 Andreas Schwarting
A1 Francois Maurier
A1 Gilles Blaison
A1 Bernard Bonnotte
A1 Vincent Poindron
A1 Christoph Fiehn
A1 Hanns-Martin Lorenz
A1 Anne-Sophie Korganow
A1 Jean Sibilia
A1 Thierry Martin
A1 Laurent Arnaud
YR 2022
UL http://rmdopen.bmj.com/content/8/2/e002395.abstract
AB Objectives To analyse whether reported fatigue, one of the most challenging manifestations of systemic lupus erythematosus (SLE), may bias the assessment of disease activity in SLE according to the Physician Global Assessment (PGA).Methods Patients from the Lupus BioBank of the upper Rhein database, a cross-sectional multicentre collection of detailed clinical and biological data from patients with SLE, were included. Patients had to fulfil the 1997 American College of Rheumatology criteria for SLE and the PGA (0–3 scale) at the time of inclusion had to be available. Fatigue was assessed according to the Fatigue Scale for Motor and Cognitive Functions. Univariate and multivariate regression models were built to determine which variables were associated with the PGA.Results A total of 350 patients (89% female; median age: 42 years, IQR: 34–52) were included. The median Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score was 4 (IQR: 2–6). Of these 350 patients, 257 (73%) reported significant fatigue. The PGA (p=0.004) but not the SELENA-SLEDAI (p=0.43) was significantly associated with fatigue. Both fatigue and SELENA-SLEDAI were independently associated with the PGA in two different multivariate models.Conclusion Fatigue is independently associated with disease activity assessed using the PGA but not the SLEDAI. These findings highlight the fact that the PGA should capture only objectively active disease manifestations in order to improve its reliability.Data are available upon reasonable request.