OP0201 FATIGUE IN JUVENILE IDIOPATIC ARTHRITIS AFTER 18 YEARS OF FOLLOW-UP. (June 2019)

• Record Type: Journal Article
• Authors: Arnstad, Ellen Dalen; Glerup, Mia; Rypdal, Veronika; Peltoniemi, Suvi; Ekelund, Maria; Berntson, Lillemor; Fasth, Anders; Nielsen, Susan; Zak, Marek; Aalto, Kristiina; Nordal, Ellen; Herlin, Troels; Romundstad, Pål Richard; Rygg, Marite
• Is Part Of: Annals of the rheumatic diseases. Volume 78(2019)Supplement 2
• Page Start: 176
• Page End: 176
• Publication Date: 2019-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-eular.4006
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Fatigue is common in adults with rheumatic disease and has also been shown in adolescents with juvenile idiopathic arthritis (JIA). Knowledge on fatigue in JIA in long-term follow-up is limited. Objectives: To study the prevalence and severity of fatigue 18 years after onset of JIA. Methods: In this close to population-based cohort study from defined geographical areas of Norway, Sweden, Denmark and Finland, consecutive cases of JIA with disease onset in 1997 to 2000 were prospectively enrolled (1). At 18-year follow-up, fatigue was measured using Fatigue Severity Scale (FSS, range 0-7) (2), and severe fatigue was defined as FSS ≥4. General health status was measured with Health Assessment Questionnaire (HAQ) and 36-Item Short Form Health Survey (SF-36). Reduced health was defined as HAQ >0, and SF-36 <40 (according to the physical component summary score/mental component summary score (PCS/MCS)). Pain was measured with 10 cm visual analogue scale (VAS), 0 = no pain, >0 = pain. Remission was defined according to the preliminary criteria described by Wallace. A Norwegian healthy cohort was used for comparison. Multivariable logistic regression analyses were performed. Results: Among 434 eligible JIA participants 377 completed a Fatigue Severity Scale (FSS) measurement at the 18-year follow-up and were included. Of these 72% were girls, 53% had oligoarticular disease six months after onset, median age at onset was 5.6 (IQR 2.6-9.7) years, and age at the 18-year visit was 23.1 (IQR 20.3-27.2). Mean total FSS (±SD) was 3.2 (±1.5), and participants with active disease scored 3.6 (±1.6) compared to 2.9 (±1.4) for those in remission off medication. The highest total FSS was found in those with SF-36 PCS and/or MCS <40 (4.7 (±1.6) and 4.6 (±1.6), respectively). Severe fatigue was considerably more frequent in participants with active disease (36%, odds ratio (OR) 2.5) compared to those in remission off medication (19%), HAQ score >0 (47%, OR 4.1) compared to HAQ score =0 (18%), SF-36 PCS/MCS <40 (64/61%, OR 7.1/6.9) compared to SF-36 PCS/MCS ≥40 (20/19%), and VAS pain >0 (36%, OR 3.8) compared to VAS pain =0 (13%). The proportion of severe fatigue in a healthy Norwegian control cohort was 12%. Conclusion: At 18-year follow-up fatigue was a prominent symptom in JIA, and we found consistently higher fatigue burden and considerably more severe fatigue among participants with active disease, pain and self-reported health problems, compared to those without. We suggest fatigue to be measured at long-term follow-up both in clinical and research settings. References: [1] Nordal E, et al. Arthritis Rheum 2011;63:2809-18 [2] Krupp LB, et al. Arch Neurol 1989;46:1121-23 Disclosure of Interests: Ellen Dalen Arnstad: None declared, Mia Glerup: None declared, Veronika Rypdal: None declared, Suvi Peltoniemi: None declared, Maria Ekelund: None declared, Lillemor Berntson Consultant for: AbbVie, Speakers bureau: AbbVie, Anders Fasth: None declared, Susan Nielsen: None declared, Marek Zak: None declared, Kristiina Aalto: None declared, Ellen Nordal: None declared, Troels Herlin: None declared, Pål Richard Romundstad: None declared, Marite Rygg: None declared