RMD Open (Jun 2019)
Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren’s syndrome
- Nagui Gendi,
- Costantino Pitzalis,
- Paul Emery,
- Kate L Hackett,
- Kristen Davies,
- Jessica Tarn,
- Rebecca Bragg,
- Ben Hargreaves,
- Samira Miyamoto,
- Peter McMeekin,
- Sheryl Mitchell,
- Simon Bowman,
- Elizabeth J Price,
- Colin Pease,
- Jacqueline Andrews,
- Peter Lanyon,
- John Hunter,
- Monica Gupta,
- Michele Bombardieri,
- Nurhan Sutcliffe,
- John McLaren,
- Annie Cooper,
- Marian Regan,
- Ian Giles,
- David Isenberg,
- Saravan Vadivelu,
- David Coady,
- Bhaskar Dasgupta,
- Neil McHugh,
- Steven Young-Min,
- Robert Moots,
- Mohammed Akil,
- Bridget Griffiths,
- Dennis W Lendrem,
- Wan-Fai Ng
Affiliations
- Nagui Gendi
- Department of Rheumatology, Basildon Hospital, Basildon, UK
- Costantino Pitzalis
- Queen Mary University of London – William Harvey Research Institute, Centre for Experimental Medicine and Rheumatology, London, United Kingdom
- Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Kate L Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
- Kristen Davies
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
- Jessica Tarn
- 1Newcastle University, Institute of Cellular Medicine, Newcastle upon Tyne, United Kingdom
- Rebecca Bragg
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
- Ben Hargreaves
- 3NIHR Newcastle Biomedical Research Center, Newcastle upon Tyne, United Kingdom
- Samira Miyamoto
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
- Peter McMeekin
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
- Sheryl Mitchell
- 2Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- Simon Bowman
- 9Rheumatology Department, University Hospitals Birmingham NHS Foundation Trust, National Institute for Health Research, Birmingham Biomedical Research Centre, Birmingham, United Kingdom
- Elizabeth J Price
- Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon, UK
- Colin Pease
- Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Jacqueline Andrews
- NIHR Leeds Biomedical Research Centre and Clinical Research Facility, Leeds Teaching Hospitals, Leeds, United Kingdom
- Peter Lanyon
- Rheumatology, Nottingham University Hospital, Nottingham, UK
- John Hunter
- 1 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Monica Gupta
- Department of General Medicine, Government Medical College and Hospital, Thiruvananthapuram, India
- Michele Bombardieri
- 2Queen Mary University of London, London, United Kingdom
- Nurhan Sutcliffe
- 4Barts Health NHS Trust, Department of Rheumatology, London, United Kingdom
- John McLaren
- NHS Fife, Fife Rheumatic Diseases Unit, Kirkcaldy, United Kingdom
- Annie Cooper
- Royal Hampshire County Hospital, Winchester, UK
- Marian Regan
- Royal Derby Hospital, Derby, UK
- Ian Giles
- 1University College London, London, United Kingdom
- David Isenberg
- Centre for Rheumatology, Department of Medicine, University College London, London, UK
- Saravan Vadivelu
- Queen Elizabeth Hospital, Gateshead, UK
- David Coady
- 4City Hospitals Sunderland, Sunderland, United Kingdom
- Bhaskar Dasgupta
- 2Southend University Hospital, Rheumatology, Westcliff-on-Sea, United Kingdom
- Neil McHugh
- Department of Life Sciences, University of Bath, Bath, UK
- Steven Young-Min
- Rheumatology, Portsmouth Hospitals NHS Trust, Portsmouth, UK
- Robert Moots
- Department of Rheumatology, Aintree University Hospital, Liverpool, UK
- Mohammed Akil
- Department of Rheumatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- Bridget Griffiths
- Rheumatology Department, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
- Dennis W Lendrem
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
- Wan-Fai Ng
- 2Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- DOI
- https://doi.org/10.1136/rmdopen-2018-000885
- Journal volume & issue
-
Vol. 5,
no. 1
Abstract
Objectives To report on fatigue in patients from the United Kingdom primary Sjögren’s syndrome (pSS) registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness.Methods From our cohort (n = 608), we identified those with comorbidities associated with fatigue, and those taking medications associated with drowsiness. We constructed dummy variables, permitting the contribution of these potentially assignable causes of fatigue to be assessed. Using multiple regression analysis, we modelled the relationship between Profile of Fatigue and Discomfort physical and mental fatigue scores and potentially related variables.Results Pain, depression and daytime sleepiness scores were closely associated with both physical and mental fatigue (all p ≤ 0.0001). In addition, dryness was strongly associated with physical fatigue (p ≤ 0.0001). These effects were observed even after adjustment for comorbidities associated with fatigue or medications associated with drowsiness.Conclusions These findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in patients with pSS.This finding is robust to both the effect of other comorbidities associated with fatigue and medications associated with drowsiness.
