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

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DOI

  • Ellen Dalen Arnstad, Nord-Trøndelag Hospital Trust, Norwegian University of Science and Technology
  • ,
  • Mia Glerup
  • Veronika Rypdal, University Hospital of North Norway, UiT The Arctic University of Norway
  • ,
  • Suvi Peltoniemi, University of Helsinki
  • ,
  • Anders Fasth, University of Gothenburg
  • ,
  • Susan Nielsen, Rigshospitalet
  • ,
  • Marek Zak, Rigshospitalet
  • ,
  • Kristiina Aalto, University of Helsinki
  • ,
  • Lillemor Berntson, Uppsala University
  • ,
  • Ellen Nordal, University Hospital of North Norway, UiT The Arctic University of Norway
  • ,
  • Troels Herlin
  • Pål Richard Romundstad, Norwegian University of Science and Technology
  • ,
  • Marite Rygg, Norwegian University of Science and Technology, St Olavs Hospital
  • ,
  • on behalf of the Nordic Study Group of Pediatric Rheumatology (NoSPeR)

Background: To study fatigue in young adults with juvenile idiopathic arthritis (JIA) 18 years after disease onset, and to compare with controls. Methods: Consecutive 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. Results: Among 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. Conclusions: Fatigue 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.

OriginalsprogEngelsk
Artikelnummer33
TidsskriftPediatric Rheumatology
Vol/bind19
Nummer1
Antal sider12
ISSN1546-0096
DOI
StatusUdgivet - 2021

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