Fatigue in SLE Save

An NIH lupus cohort study looked at fatigue in SLE and found associations with organ damage, obesity, but does not correlate with disease activity in systemic lupus erythematosus (SLE) patients.

Previous studies have shown that fatigue is commonly reported in SLE and is related to with various SLE and non-SLE-related factors. An Open-Evidence analysis of fatigue in SLE suggests  the strongest independent contributors are psychosocial and pain-related factors rather than disease activity itself.  In 67–90% of patients, fatigue is ranked as a most bothersome symptom. Strongest factors are depression and anxiety, psychological stress, and pain (lets not forget poor sleep).

The current study was a prospective, observational, outpatient study of 183 consecutive SLE patients who were assessed with a standard set of activity, damage and outcome measures. Fatigue was measured using the Fatigue Severity Scale (FSS), and a score of ≥4 was used to define clinically significant fatigue. 

The overall FSS score was mean (±SD) 4±1.8 and SELENA-SLEDAI score of 3±2.6. The group reporting significant FSS scores ≥4 (N=95) included a higher proportion of White patients, more organ damage (SLICC/ACR DI score mean of 1.9, higher body mass index (mean 29.6). Organ damage associations were lead by pulmonary fibrosis and neuropathy. 

SLE patients with FSS scores <4 (N=85), had more Black patients (p=0.034), lower SLICC/ACR DI scores (1.1)and BMI (27.6; p=0.03).

. Mechanistic studies are needed to better understand pathogenesis of fatigue in SLE.