Assessment of fatigue in Moroccan patients with ankylosing spondylitis

Abstract

This study aims to assess fatigue aspects in Moroccan patients with ankylosing spondylitis (AS), and its relationships with disease-specific variables of activity and severity. A cross-sectional study included patients with ankylosing spondylitis according to New York Classification criteria for the diagnosis of AS. To assess fatigue, the first item of Bath Ankylosing Spondylitis Disease Activity index (BASDAI) and the Multidimensional assessment of fatigue were used (MAF). The evaluation included the activity of the disease (BASDAI), global well-being (Bath Ankylosing Spondylitis Global Index), functional status (Bath Ankylosing Spondylitis Functional Index), enthesitis and health-related quality of life (SF-36 generic instrument). One hundred patients were included (67 men and 33 women), of average age 38.0 years ± 12.9 [18–72]. Our patients had a moderately active and a severe disease. In our data, 60% experienced severe fatigue (BASDAI fatigue ≥ 50 mm) and mean total score of ${\hbox{MAF}} = {32}.0\pm 20$. Gender, NSAID therapy and the presence of biological inflammatory syndrome did not influence the MAF scores. Higher scores of fatigue were correlated with functional disability, general well-being, disease activity, enthesitis, and the deterioration of five domains of SF-36. Multivariate regression showed strong relationship between fatigue severity and general well-being and enthesitis. Severe fatigue (MAF) was most related with the domain of physical function. This study state the importance of fatigue in AS patients. The severity of fatigue is associated with disease activity, functional disability, general well-being, and enthesitis. Fatigue influences negatively different aspects of quality of life. Fatigue is an important outcome measure that must be part of routine clinical evaluation of our AS patients.