Fatigue in young adults with juvenile idiopathic arthritis 18 years after disease onset: data from the prospective Nordic JIA cohort

Pediatric Rheumatology

Marite Rygg¹  Troels Herlin²  Mia Glerup²  Anders Fasth³  Ellen Dalen Arnstad⁴  Susan Nielsen⁵  Marek Zak⁵  Ellen Nordal⁶  Veronika Rypdal⁶  Pål Richard Romundstad⁷  Lillemor Berntson⁸  Suvi Peltoniemi⁹  Kristiina Aalto⁹ 

[1] Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway;Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway;Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark;Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Pb 333, 7601, Levanger, Norway;Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway;Department of Pediatrics, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark;Department of Pediatrics, University Hospital of North Norway and Department of Clinical Medicine, UIT the Arctic University of Norway, Tromsø, Norway;Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway;Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden;New Children’s Hospital, Helsinki University Hospital, Pediatric Research Center, University of Helsinki, Helsinki, Finland;

关键词: Juvenile idiopathic arthritis (JIA);    Fatigue;    Patient-reported outcomes;    Health-related quality of life (HRQoL);    Young adults;    Long-term outcomes;   

DOI  :  10.1186/s12969-021-00499-0

来源: Springer

【 摘 要 】

BackgroundTo study fatigue in young adults with juvenile idiopathic arthritis (JIA) 18 years after disease onset, and to compare with controls.MethodsConsecutive children with onset of JIA between 1997 and 2000, from geographically defined areas of Norway, Sweden, Denmark and Finland were followed for 18 years in a close to population-based prospective cohort study. Clinical features, demographic and patient-reported data were collected. Inclusion criteria in the present study were a baseline visit 6 months after disease onset, followed by an 18-year follow-up with available self-reported fatigue score (Fatigue Severity Scale (FSS), 1–7). Severe fatigue was defined as FSS ≥4. For comparison, Norwegian age and sex matched controls were used.ResultsAmong 377 young adults with JIA, 26% reported severe fatigue, compared to 12% among controls. We found higher burden of fatigue among participants with sleep problems, pain, poor health, reduced participation in school/work, physical disability, active disease, or use of disease-modifying anti-rheumatic drugs (DMARDs)/biologics/systemic steroids. In contrast, participants without these challenges, had fatigue scores similar to controls. Active disease assessed at all three time points (baseline, 8-year and 18-year follow-up) was associated with higher mean fatigue score and higher percentage of severe fatigue compared to disease courses characterized by periods of inactive disease. Predictors of fatigue at the 18-year follow-up were female sex and diagnostic delay of ≥6 months at baseline, and also pain, self-reported poor health, active disease, and previous/ongoing use of DMARDs/biologics at 8 years.ConclusionsFatigue is a prominent symptom in young adults with JIA, with higher fatigue burden among participants with poor sleep, pain, self-reported health problems, active disease, or use of DMARDs/biologics. Participants without these challenges have results similar to controls. Patient- and physician-reported variables at baseline and during disease course predicted fatigue at 18-year follow-up.

【 授权许可】

CC BY