Assessment of fatigue in rheumatoid arthritis (by Functional Assessment of Chronic Illness Therapy-Fatigue score) and its relation to disease activity and anemia.

BACKGROUND: Patients with rheumatoid arthritis (RA) mention fatigue as one of their most annoying problems. Measuring fatigue, understanding its contributory factors, and treating it as a feasible target lead to better patient outcome and improved quality of life. The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System is a collection of health-related quality-of-life questionnaires targeted to the management of chronic illness.
OBJECTIVE: The objective of this study was to evaluate fatigue using FACIT-Fatigue (FACIT-F) score and its relation to disease activity (using Disease Activity Score [DAS28] and Clinical Disease Activity Index [CDAI] score) and anemia in RA patients.
METHODS: A total of 100 RA patients were evaluated for fatigue using FACIT-F score, for disease activity using DAS28 and CDAI scores, for anemia using hemoglobin levels. Correlation studies were done using Pearson test.
RESULTS: Functional Assessment of Chronic Illness Therapy-Fatigue showed positive association with DAS28 (P < 0.001; r = -0.80) and CDAI (P < 0.001; r = -0.83). Considering various components of DAS28 and CDAI, FACIT-F showed significant correlation with tender joint count (P < 0.001; r = -0.73), swollen joint count (P < 0.001; r = -0.76), patient global assessment (P < 0.001; r = -0.72), and evaluator global assessment (P < 0.001; r = -0.75). Erythrocyte sedimentation rate had no association with the fatigue (P = 0.217). No association was observed between fatigue and hemoglobin levels (P = 0.203).
CONCLUSION: The fatigue experienced by the patients with RA is strongly associated with the severity of disease activity and is independent of anemia.