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Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management / Sinead Brophy, Helen Davies, Michael S. Dennis, Roxanne Cooksey, Muhammad J. Husain, Elizabeth Irvine, Stefan Siebert

Seminars in Arthritis and Rheumatism, Volume: 42, Issue: 4, Pages: 361 - 367

Swansea University Author: Sinead Brophy

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Abstract

OBJECTIVES: Fatigue is an important symptom associated with ankylosing spondylitis (AS). This study examines patients' perspectives and clinical associations of fatigue to help inform potential strategies to alleviate fatigue in AS.METHODS: A mixed methods approach was taken to examine fatigue...

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Published in: Seminars in Arthritis and Rheumatism
ISSN: 00490172
Published: 2013
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URI: https://cronfa.swan.ac.uk/Record/cronfa12591
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2019-07-01T14:22:55.5253610</datestamp><bib-version>v2</bib-version><id>12591</id><entry>2012-09-07</entry><title>Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management</title><swanseaauthors><author><sid>84f5661b35a729f55047f9e793d8798b</sid><ORCID>0000-0001-7417-2858</ORCID><firstname>Sinead</firstname><surname>Brophy</surname><name>Sinead Brophy</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2012-09-07</date><deptcode>HDAT</deptcode><abstract>OBJECTIVES: Fatigue is an important symptom associated with ankylosing spondylitis (AS). This study examines patients' perspectives and clinical associations of fatigue to help inform potential strategies to alleviate fatigue in AS.METHODS: A mixed methods approach was taken to examine fatigue in a cohort of people with AS. Fatigue levels were evaluated from 3 consecutive monthly questionnaires. Open-ended questions on fatigue were analyzed using thematic analysis and logistic regression was used to examine quantitative data. In addition, fatigue levels were examined before and after treatment with anti-tumor necrosis factor (TNF) compared to nontreated controls.RESULTS: Three hundred forty-eight of 385 participants completed a fatigue questionnaire. Fatigue was reported to have significant physical, social, and psychological effects. A third of the participants reported that there was nothing they could do to reduce their fatigue, whereas other participants reported that medication, exercise, and resting helped. The main factor associated with fatigue was pain [&#x3B2;-coefficient: 0.74 (95% CI: 0.66 to 0.81)], whereas depression was much less strongly associated. However, these factors only explained 40% of the variation in fatigue levels. Starting anti-TNF therapy reduced fatigue and pain levels compared to the period of time before taking anti-TNF [difference: 14.4 (95% CI: 5.3 to 23.5) on a scale of 0-100] and this reduction was not seen in controls over the same period.CONCLUSIONS: Fatigue is not strongly associated with anxiety, motivation, and depression; instead the factor most associated with fatigue is pain. This suggests that in addition to treatments to reduce disease activity, strategies for alleviating fatigue in AS should focus on pain management techniques and actively treating inflammation.</abstract><type>Journal Article</type><journal>Seminars in Arthritis and Rheumatism</journal><volume>42</volume><journalNumber>4</journalNumber><paginationStart>361</paginationStart><paginationEnd>367</paginationEnd><publisher/><issnPrint>00490172</issnPrint><keywords/><publishedDay>28</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2013</publishedYear><publishedDate>2013-02-28</publishedDate><doi>10.1016/j.semarthrit.2012.06.002</doi><url/><notes>Epub ahead of print</notes><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2019-07-01T14:22:55.5253610</lastEdited><Created>2012-09-07T14:59:05.2456103</Created><path><level id="1">Swansea University Medical School</level><level id="2">Medicine</level></path><authors><author><firstname>Sinead</firstname><surname>Brophy</surname><orcid>0000-0001-7417-2858</orcid><order>1</order></author><author><firstname>Helen</firstname><surname>Davies</surname><order>2</order></author><author><firstname>Michael S.</firstname><surname>Dennis</surname><order>3</order></author><author><firstname>Roxanne</firstname><surname>Cooksey</surname><order>4</order></author><author><firstname>Muhammad J.</firstname><surname>Husain</surname><order>5</order></author><author><firstname>Elizabeth</firstname><surname>Irvine</surname><order>6</order></author><author><firstname>Stefan</firstname><surname>Siebert</surname><order>7</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2019-07-01T14:22:55.5253610 v2 12591 2012-09-07 Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 2012-09-07 HDAT OBJECTIVES: Fatigue is an important symptom associated with ankylosing spondylitis (AS). This study examines patients' perspectives and clinical associations of fatigue to help inform potential strategies to alleviate fatigue in AS.METHODS: A mixed methods approach was taken to examine fatigue in a cohort of people with AS. Fatigue levels were evaluated from 3 consecutive monthly questionnaires. Open-ended questions on fatigue were analyzed using thematic analysis and logistic regression was used to examine quantitative data. In addition, fatigue levels were examined before and after treatment with anti-tumor necrosis factor (TNF) compared to nontreated controls.RESULTS: Three hundred forty-eight of 385 participants completed a fatigue questionnaire. Fatigue was reported to have significant physical, social, and psychological effects. A third of the participants reported that there was nothing they could do to reduce their fatigue, whereas other participants reported that medication, exercise, and resting helped. The main factor associated with fatigue was pain [β-coefficient: 0.74 (95% CI: 0.66 to 0.81)], whereas depression was much less strongly associated. However, these factors only explained 40% of the variation in fatigue levels. Starting anti-TNF therapy reduced fatigue and pain levels compared to the period of time before taking anti-TNF [difference: 14.4 (95% CI: 5.3 to 23.5) on a scale of 0-100] and this reduction was not seen in controls over the same period.CONCLUSIONS: Fatigue is not strongly associated with anxiety, motivation, and depression; instead the factor most associated with fatigue is pain. This suggests that in addition to treatments to reduce disease activity, strategies for alleviating fatigue in AS should focus on pain management techniques and actively treating inflammation. Journal Article Seminars in Arthritis and Rheumatism 42 4 361 367 00490172 28 2 2013 2013-02-28 10.1016/j.semarthrit.2012.06.002 Epub ahead of print COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 2019-07-01T14:22:55.5253610 2012-09-07T14:59:05.2456103 Swansea University Medical School Medicine Sinead Brophy 0000-0001-7417-2858 1 Helen Davies 2 Michael S. Dennis 3 Roxanne Cooksey 4 Muhammad J. Husain 5 Elizabeth Irvine 6 Stefan Siebert 7
title Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management
spellingShingle Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management
Sinead, Brophy
title_short Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management
title_full Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management
title_fullStr Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management
title_full_unstemmed Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management
title_sort Fatigue in Ankylosing Spondylitis: Treatment Should Focus on Pain Management
author_id_str_mv 84f5661b35a729f55047f9e793d8798b
author_id_fullname_str_mv 84f5661b35a729f55047f9e793d8798b_***_Sinead, Brophy
author Sinead, Brophy
author2 Sinead Brophy
Helen Davies
Michael S. Dennis
Roxanne Cooksey
Muhammad J. Husain
Elizabeth Irvine
Stefan Siebert
format Journal article
container_title Seminars in Arthritis and Rheumatism
container_volume 42
container_issue 4
container_start_page 361
publishDate 2013
institution Swansea University
issn 00490172
doi_str_mv 10.1016/j.semarthrit.2012.06.002
college_str Swansea University Medical School
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hierarchy_top_id swanseauniversitymedicalschool
hierarchy_top_title Swansea University Medical School
hierarchy_parent_id swanseauniversitymedicalschool
hierarchy_parent_title Swansea University Medical School
department_str Medicine{{{_:::_}}}Swansea University Medical School{{{_:::_}}}Medicine
document_store_str 0
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description OBJECTIVES: Fatigue is an important symptom associated with ankylosing spondylitis (AS). This study examines patients' perspectives and clinical associations of fatigue to help inform potential strategies to alleviate fatigue in AS.METHODS: A mixed methods approach was taken to examine fatigue in a cohort of people with AS. Fatigue levels were evaluated from 3 consecutive monthly questionnaires. Open-ended questions on fatigue were analyzed using thematic analysis and logistic regression was used to examine quantitative data. In addition, fatigue levels were examined before and after treatment with anti-tumor necrosis factor (TNF) compared to nontreated controls.RESULTS: Three hundred forty-eight of 385 participants completed a fatigue questionnaire. Fatigue was reported to have significant physical, social, and psychological effects. A third of the participants reported that there was nothing they could do to reduce their fatigue, whereas other participants reported that medication, exercise, and resting helped. The main factor associated with fatigue was pain [β-coefficient: 0.74 (95% CI: 0.66 to 0.81)], whereas depression was much less strongly associated. However, these factors only explained 40% of the variation in fatigue levels. Starting anti-TNF therapy reduced fatigue and pain levels compared to the period of time before taking anti-TNF [difference: 14.4 (95% CI: 5.3 to 23.5) on a scale of 0-100] and this reduction was not seen in controls over the same period.CONCLUSIONS: Fatigue is not strongly associated with anxiety, motivation, and depression; instead the factor most associated with fatigue is pain. This suggests that in addition to treatments to reduce disease activity, strategies for alleviating fatigue in AS should focus on pain management techniques and actively treating inflammation.
published_date 2013-02-28T03:23:56Z
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