AB0248 DISEASE ACTIVITY IS ASSOCIATED WITH FATIGUE IN THE FOLLOW-UP OF PATIENTS WITH RHEUMATOID ARTHRITIS

Background Chronic fatigue negatively impacts on quality of life in Rheumatoid Arthritis (RA) patients (1,2), does not allow optimal clinical results, being an negative predictor for clinical remission (3,4). Objectives The objective was to determine whether disease activity correlates with increased fatigue in the follow-up of a RA patients. Methods Prospective study of the RA-Almenara cohort (criteria ACR87/ACR-EULAR2010). Patients were included with at least two evaluations (half-yearly). Patients with fibromyalgia, major depression and/or anxious depressive disorder, chronic neuropathic pain or active systemic manifestations (including interstitial lung disease) were excluded. Disease activity was evaluated with SDAI (Simple Disease Activity Index) and fatigue with FACIT questionnaire (Functional Assessment of Chronic Illness Therapy-fatigue). A generalized estimation equation model was used to determine the association between SDAI and FACIT, at each visit according with two models of analyses. Model 1 considered SDAI value as a linear variable; Model 2 considered each category of SDAI (high, moderate and low) activity, using remission as reference. Multivariable analyses were adjusted by possible confounders: gender, age at diagnosis, instruction, socio-economic level (Graffar), disease duration, tobacco, ACPA level, disability (MDHAQ), use of conventional (c) and biologic(b) DMARDs and corticosteroids (current use, past or non-use). Results Four hundred and twenty patients were included, 372 (88.6%) women, age at diagnosis was 44.1 (13.2) years, disease duration 17.7 (11.6) years. At the baseline 4.2% 13.6%, 41.0% and 41.2% were in remission, low, moderate and high activity respectively; 40% were using corticosteroids, 256 (61%) cDMARDs and 25 (6%) bDMARDs. Basal SDAI was 23.7 (20.4) and FACIT 17.2 (8.8). We analyzed 1233 follow up visits [2.2 (1.2) visits per patient]. Multivariablee analysis: In model 1 were associated with FACIT: SDAI [B: -0.03 (IC95%: - 0.06- -0.01;p=0.013] and MHAQ [B: -9.55 (IC95%: - 10.55- -0.54), p = Conclusions Higher disease activity correlates with worse fatigue scores, at each follow-up visits of patients with RA Reference [1] Balsamo. Isr. Med. Assoc. J. 2014, 16, 57–60. 2. Alomari. Sci. World J. 2012:580863. doi: 10.1100/2012/580863. 3. Roodenrijs. Ann Rheum Dis. 2018 Sep 7. pii: annrheumdis-2018-213687. 4 Uhlig. J Rheumatol. 2016;43(4):716–23 Disclosure of Interests None declared