Open AccessDisease activity and damage are not associated with increased levels of fatigue in systemic lupus erythematosus patients from a multiethnic cohort: LXVII
Author(s) -
Burgos Paula I.,
Alarcón Graciela S.,
McGwin Gerald,
Crews Kendra Q.,
Reveille John D.,
Vilá Luis M.
Publication year - 2009
Publication title -
arthritis care & research
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.24649
Subject(s) - medicine , cohort , learned helplessness , systemic lupus erythematosus , rheumatology , disease , ethnic group , cohort study , lupus erythematosus , immunology , clinical psychology , antibody , sociology , anthropology
Objective To determine the factors associated with increased levels of fatigue over the course of the disease in systemic lupus erythematosus (SLE) patients from LUpus in MInorities: NAture versus nurture, a longitudinal multiethnic cohort. Methods Patients with SLE (according to the American College of Rheumatology revised and updated criteria) age ≥16 years with a disease duration ≤5 years at entry into the cohort, and of Hispanic (Texan or Puerto Rican), African American, or Caucasian ethnicity were studied. The association between socioeconomic/demographic characteristics, health behaviors, behavioral and psychological, functional and clinical characteristics, and fatigue was examined using generalized estimating equations to account for the longitudinal nature of the data. Results A total of 515 patients (∼91% female) contributed 2,609 visits to these analyses. Of these patients, 93 (18.1%) were Texan‐Hispanic, 101 (19.6%) were Puerto Rican‐Hispanic, 169 (32.8%) were African Americans, and 152 (29.5%) were Caucasian. The mean ± SD patient age and followup time were 37.2 ± 12.6 years and 4.7 ± 3.2 years, respectively. Variables associated with increased levels of fatigue in the multivariable analyses were Caucasian ethnicity, the presence of constitutional symptoms (fever, weight loss), and higher levels of pain, abnormal illness‐related behaviors, and helplessness ( P values between 0.0018 and <0.0001). Conclusion The presence of pain, abnormal illness‐related behaviors, helplessness, and constitutional manifestations were associated with increased levels of fatigue. However, SLE‐specific measures, such as disease activity and damage, were not. Interventions aimed at decreasing fatigue need to take into account these findings.