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Care for depression, sleep may relieve fatigue in patients with RA, axSpA

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Advanced care for depression, sleep and functional deficits may relieve persistent fatigue in patients with either rheumatoid arthritis or axial spondyloarthritis and low disease activity, according to researchers in Saint-Étienne, France.

Investigators enrolled 55 patients with rheumatoid arthritis (RA) and 45 patients with axial spondyloarthritis (axSpA) into an observational, cross-sectional study. Most of the patients in the RA group were women, and men made up 68% of the axSpA group. The mean disease duration was 11.9 years, and all patients received biologic disease-modifying anti-rheumatic drugs (DMARDs) with or without conventional DMARDs.

Researchers assessed patients using the Disease Activity Score in 28 joints (DAS28) or the bath Ankylosing Spondylitis Activity Index (BASDAI). All patients had a DAS28 of less than 3.2 and BASDAI of four or less. Researchers also assessed patients using the Pittsburgh Sleep Quality Index, the Functional Assessment of Chronic Illness Therapy (FACIT) measurement system, the Hospital Anxiety and Depression Scale and the Health Assessment Questionnaire.

Investigators found higher levels of physical activity and lower functional disabilities in patients with axSpA compared to patients with RA. Univariate statistical analysis revealed age, gender, sleep quality, anxiety, depression and functional disability were associated with FACIT-fatigue. Multiple linear regression showed age, sleep quality, depression and functional disability correlated with fatigue regardless of disease type.

Analysis of covariance revealed a stronger association between greater disability and fatigue in patients with axSpA compared to patients with RA. Higher levels of fatigue correlated with greater depression, higher age and sleep quality to a similar degree in patients with RA and axSpA.

“Our study suggests the importance of advance care of depression, sleep quality, and functional deficit in patients with low-activity RA or axSpA in order to improve their state of fatigue and consequently to increase their quality of life,” the researchers wrote. - by Shirley Pulawski

Reference:

Nizeica V, et al. Paper #2337. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosures: The researchers report no relevant financial disclosures.