Abstract
Objectives
The objectives of this study were to compare fatigue in a large multinational SSc cohort with general population data and identify associated sociodemographic, lifestyle and SSc disease factors.
Methods
Scleroderma Patient-centered Intervention Network Cohort participants completed the Patient-Reported Outcomes Measurement Information System-29 v2.0 fatigue domain. T-scores were compared with the USA general population (mean = 50; s.d. = 10). Multivariable linear regression was used to assess associations with sociodemographic, lifestyle, and disease-related variables.
Results
Among the 2385 participants [mean age 54.9 (s.d. = 12.6) years, 87% female, 38% dcSSc], the mean fatigue T-score was 54.6 (s.d. = 11.0); 438 (18%) reported mild fatigue, 641 (27%) moderate fatigue, and 180 (8%) severe fatigue. Fatigue was independently associated with sociodemographic factors age [−0.10 points per year, (95% CI −0.14, −0.07)], male sex [−1.67 points, (−2.96, −0.37)], non-married status [0.97 points (0.04, 1.89)] and country [reference USA; France −2.35 points (−3.48, −1.21) and UK 2.38 points (0.80, 3.97)], and lifestyle factors smoking [4.16 points (2.52, 5.80)], alcohol consumption [−0.18 points per drink per week (−0.28, −0.07)] and BMI [0.34 points per unit (0.27, 0.42)]. Fatigue was associated with disease-related factors, including gastrointestinal involvement [4.21 points (2.99, 5.43)], digital ulcers [1.51 points, (0.25, 2.77)], moderate small joint contractures (1.41 points [0.13, 2.69]), RA [4.34 points (2.37, 6.31)] and SS [1.89 points (0.23, 3.55)]. When pain was included in the model, its association was large [2.19 points (2.03, 2.34)], and interstitial lung disease was also associated [1.21 points (0.42, 2.00)].
Conclusion
In people with SSc, fatigue scores were substantially higher than in the general population and associated with multiple disease factors, including gastrointestinal involvement, several painful disease manifestations, and lung involvement.