Fatigue in XXXX ; a persistent problem: a large longitudinal study.

@entity1 @entity32 @entity1295 @entity1499 @entity309 @entity1851
OBJECTIVE: Fatigue is prevalent and disabling in @entity309 ( @entity309 ). Surprisingly, the long-term course of @entity1295 is studied seldom and it is unclear to what extent it is influenced by @entity32 . This study aimed to determine the course of @entity1295 during 8   years follow-up, its association with the severity of @entity32 and the effect of improved treatment strategies. METHODS: 626 @entity1 with @entity309 included in the Leiden Early Arthritis Clinic cohort were studied during 8   years. Fatigue severity, measured on a 0-100   mm scale, and other clinical variables were assessed yearly. @entity1 included in 1993-1995, 1996-1998 and 1999-2007 were treated with delayed treatment with disease-modifying antirheumatic drugs (DMARDs), early treatment with mild DMARDs and early treatment with @entity1499 respectively. After multiple imputation, the serial measurements were analysed using linear quantile mixed models. RESULTS: Median @entity1295 severity at baseline was 45   mm and remained, despite treatment, rather stable thereafter. Female gender (effect size=4.4   mm), younger age (0.2   mm less @entity1295 /year), higher swollen and tender joint counts (0.3   mm and 1.0   mm more @entity1295 /swollen or tender joint) and @entity1851 -levels (0.1   mm more @entity1295 per mg/L) were independently and significantly (p<0.05) associated with @entity1295 severity over 8   years. Although improved treatment strategies associated with less severe radiographic progression, there was no effect on @entity1295 severity (p=0.96). CONCLUSIONS: This largest longitudinal study on @entity1295 so far demonstrated that the association between @entity32 and @entity1295 is statistically significant but effect sizes are small, suggesting that non-inflammatory pathways mediate @entity1295 as well. Improved treatment strategies did not result in less severe @entity1295 . Therefore, @entity1295 in @entity309 remains an 'unmet need'.
