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Three Components Tied to PsA-Related Fatigue

Fatigue may be attributed to several factors related to the disease, such as inflammatory markers and chronic pain among patients with psoriatic arthritis (PsA), according to the findings of a recent study.

“Fatigue is one of the most significant symptoms, and an outcome of great importance, in patients with PsA, but associations between underlying components of fatigue experienced by patients in relation to the disease have been sparsely investigated,” the researchers said.

They performed a cross-sectional survey that included 1062 participants with PsA registered in the Danish nationwide Registry DANBIO from December 2013 to June 2014. Using principal component analysis, the researchers identified factors associated with fatigue.
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The principal component analysis reduced co-variables into 3 components, which explained 63% of fatigue in participants, the researchers said. Inflammatory factors, including swollen and tender joints, doctor’s global assessment, elevated CRP, and high Pain Detect Questionnaire (PDQ) Score, comprised the first component and contribute to 31% of fatigue. The second component consisted of increasing age and long disease duration, which accounted for 17% of fatigue. Lastly, the third component, which contributed to 15% of fatigue, consisted of high PDQ scores, tender joint count, increasing age, concomitant low CRP, suggestive of a chronic pain component consisting of central pain sensitization or structural joint damage, the researcher said.

"Fatigue in patients with PsA may be driven by clinical inflammatory factors, disease duration, and chronic pain in the absence of inflammation,” the researchers concluded.

Skougaard M, Jørgensen TS, Rifbjerg-Madsen S, et al. In psoriatic arthritis fatigue is driven by inflammation, disease duration, and chronic pain: An observational DANBIO registry study [published online July 15, 2019]. J Rheumatol. doi:10.3899/jrheum.181412

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