ArticleJoint bone spine2022
The course of fatigue during the development of rheumatoid arthritis and its relation with inflammation: a longitudinal study.
Article in Joint bone spine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- The natural course of health-related quality of life in patients with clinically suspect arthralgia: a longitudinal study in progressors and non-progressors to rheumatoid arthritis.Rheumatology international · 2025Article
- Validation, Reliability, and Clinical Significance of the Arabic Version of Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire.Current rheumatology reviews · 2025Article
- Fatigue in rheumatoid arthritis patients: The status, independent risk factors, and consistency of multiple scales.Immunity, inflammation and disease · 2024Article
- Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveFatigue is a prominent and disabling symptom in patients with rheumatoid arthritis (RA), that is only partially explained by inflammation and responds poorly to DMARD-therapy. We hypothesized that inflammation explains fatigue to a larger extent in the phase of clinically suspect arthralgia (CSA), when persistent clinical arthritis is still absent and fatigue has not yet become chronic. We therefore studied the course of fatigue in CSA during progression to RA and the association with inflammation at CSA-onset and at RA-diagnosis.
methods600 consecutive CSA-patients were followed for RA-development. Additionally, 710 early RA-patients were studied at diagnosis. Fatigue was assessed every study visit and expressed on a 0-100 scale. Inflammation was measured with the DAS44-CRP, with and without including subclinical inflammation. The course of fatigue over time was studied with linear mixed models. Associations between fatigue and inflammation were studied with linear regression. Analyses were stratified by ACPA-status.
resultsIn 88 CSA-patients who developed RA, pre-arthritis fatigue-levels increased gradually with 7 points/year, towards 48 (95%CI=41-55) at RA-development (P=ns). Fatigue decreased in CSA-patients who did not develop RA (4 points/year, P<0.001). At CSA-onset, inflammation was associated with fatigue (β=18, meaning 18 points more fatigue per point increase DAS-score, P<0.01). This association was stronger than at RA-diagnosis (β=5, P<0.001). Fatigue-levels were lower in ACPA-positive pre-RA, but its association with inflammation was stronger compared to ACPA-negative pre-RA.
conclusionFatigue increased gradually during progression from arthralgia to clinical arthritis, and fatigue was better explained by inflammation in CSA than in RA. This implies a 'phase-dependent relation' between inflammation and fatigue.
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