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Table 2 Potential risk factors of fatigue

From: Prevalence and factors associated with fatigue in patients with psoriatic arthritis: a systematic review and meta-analysis

Risk factors

Risk factor definition

Measurement of effect in odds ratioa

Other measurement of effect

Gender

With reference to female [23, 24]

OR 0.62, CI 0.32–1.20,

p-value 0.16 [23]

OR 1.81, CI 0.97–3.44,

p-value 0.06 [24]

With significant fatigue (59.2% male)

Without significant fatigue (67% male)

p-value > 0.05 [22]

Age

 

OR 1.00, CI 0.97–1.03,

p-value 0.99 [23]

OR 0.99, CI 0.97–1.02,

p-value 0.89 [24]

With significant fatigue (mean: 50.4, SD: 12.7)

Without significant fatigue (mean: 51.6, SD: 12)

p-value > 0.05 [22]

Disease duration

 

OR 1.00, CI 0.96–1.05,

p-value 0.94 [23]

OR 1.00, CI 0.97–1.03,

p-value 0.90 [24]

With significant fatigue (median: 4, IQR: 2–10)

Without significant fatigue (median: 5, IQR: 2–10)

p-value > 0.05 [22]

Education

With reference to primary school [23]

For each year less of education [24]

Middle school: OR 0.24, CI 0.10–0.59,

p-value < 0.01 [23]

High school and above: OR 0.23 CI 0.01–0.51,

p-value < 0.01 [23]

OR 1.09, CI 1.02–1.23,

p-value 0.02 [24]

 

Tender joints

For each 5 extra joints [24]

OR 1.30, CI 1.01–1.68,

p-value 0.05 [24]

 

Swollen joints

 

OR 1.04, CI 0.94–1.14,

p-value 0.43 [24]

OR 1.03, CI 0.82–1.30,

p-value 0.77 [23]

 

Skin PsO

Skin PsO > 5% of body surface [24]

OR 4.67, CI 1.05–20.72,

p-value 0.04 [24]

 

Axial involvement

Current inflammatory back pain considered related to the inflammatory rheumatism [24]

OR 0.98, CI 0.51–1.87, p-value 0.94 [24]

 

Enthesitis

Enthesitis count [23]

Current inflammatory entheseal disease considered related to the inflammatory rheumatism [24]

Leeds Enthesitis Index [22]

OR 1.04, CI 0.90–1.19, p-value 0.62 [23]

OR 1.53, CI 0.76–3.05, p-value 0.23 [24]

With significant fatigue (median: 0, IQR: 0–1)

Without significant fatigue (median: 0)

p-value > 0.05 [22]

Dactylitis

Current diffuse swelling of a digit considered related to the inflammatory rheumatism [22]

OR 0.56, CI 0.23–1.37,

p-value 0.20 [24]

With significant fatigue (median: 0, IQR: 0–3)

Without significant fatigue (median: 0, IQR: 0–1)

p-value > 0.05 [22]

DAPSA

 

OR 0.89, CI 0.76–1.14,

p-value 0.94 [23]

With significant fatigue (median: 18.3, IQR: 11.4–29.9)

Without significant fatigue (median: 11.3, IQR: 5.3–18)

p-value < 0.01 [22]

PASI

  

With significant fatigue (median: 4.2, IQR: 1.2–10.7)

Without significant fatigue (median: 2.1, IQR: 0.3–5.6)

p-value 0.04 [22]

MDA

Satisfying five out of of seven of the following: tender joint count ≤ 1,

swollen joint count ≤ 1,

enthesitis count ≤ 1,

PASI ≤ 1 or body surface area ≤ 3,

PtGA ≤ 20 mm,

patient pain VAS ≤ 15 mm,

and health assessment questionnaire ≤ 0.5 [23]

OR 1.00, CI 0.42–2.40,

p-value 0.99 [23]

 

VLDA

Satisfying seven out of of seven of the following: tender joint count ≤ 1, swollen joint count ≤ 1, enthesitis count ≤ 1, PASI ≤ 1 or body surface area ≤ 3, PtGA ≤ 20 mm, patient pain VAS ≤ 15 mm, and health assessment questionnaire ≤ 0.5 [23]

OR 0.16, CI 0.03, 0.92,

p-value 0.04 [23]

 

Medication use

Including cDMARDs, MTX, SSZ, LEF, CsA, ACT, biologics [22]

 

p-value > 0.05 [22]

PsO Duration

  

With significant fatigue (median: 12, IQR: 10–23)

Without significant fatigue (median: 14, IQR: 7–22)

p-value > 0.05 [22]

HAQ

HAQ [23]

HAQ-DI [22]

OR 2.06, CI 0.55–7.76, p-value 0.29 [23]

With significant fatigue (median: 0.75, IQR: 0.03–1.13)

Without significant fatigue (median: 0, IQR: 0 -0.38)

p-value > 0.05 [22]

Diabetes mellitus

  

With significant fatigue (diabetes mellitus: 14.3%)

Without significant fatigue (diabetes mellitus: 19.2%)

p-value > 0.05 [22]

Ischemic heart disease

  

With significant fatigue (ischemic heart disease: 4.1%)

Without significant fatigue (ischemic heart disease: 4.4%)

p-value > 0.05 [22]

Renal function

Creatinine clearance [22]

 

With significant fatigue (median: 89, IQR: 76–120)

Without significant fatigue (median: 94, IQR: 78–110)

p-value > 0.05 [22]

BMI

 

OR 0.95, CI 0.90–1.01, p-value 0.09 [23]

With significant fatigue (mean: 24.8, SD: 5.5)

Without significant fatigue (mean: 24.9, SD: 3.9)

p-value > 0.05 [22]

Inflammatory markers

CRP [23]

ESR and CRP [22]

OR 1.01, CI 0.98–1.04, p-value 0.67 [23]

ESR:

With significant fatigue (median: 18, IQR: 11–47)

Without significant fatigue (median: 20, IQR: 10–35)

p-value > 0.05 [22]

CRP:

With significant fatigue (median: 4.6, IQR: 3.1–11.1)

Without significant fatigue (median: 11.3, IQR: 3.1–9.5)

p-value > 0.05 [22]

VAS Pain

VAS, 0–100 mm [22, 23]

OR 1.02, CI 0.98–1.05, p-value 0.33 [23]

With significant fatigue (median: 50, IQR: 15–70)

Without significant fatigue (median: 10, IQR: 0–43)

p-value > 0.05 [22]

Quality of life

PsAQoL [23]

General health VAS [22]

OR 1.05, CI 0.95–1.16, p-value 0.03 [23]

With significant fatigue (median: 60, IQR: 40–80)

Without significant fatigue (median: 40, IQR: 20–60)

p-value > 0.05 [22]

Fibromyalgia

FiRST [23]

OR 1.41, CI 1.09–1.82, p-value 0.01 [23]

 

BASDAI

 

OR 1.53, CI 1.15–2.04, p-value < 0.01 [23]

 

Anxiety

HAD-A [23]

OR 1.14, CI 1.02–1.26, p-value 0.02 [23]

 
  1. aadjusted estimate
  2. OR: odds ratio; CI: confidence interval; SD: standard deviation; IQR: interquartile range; PsO: psoriasis; DAPSA: disease activity in psoriatic arthritis; PASI: psoriasis area and severity index; MDA: minimal disease activity; PtGA: patient global assessment; cDMARDs: conventional disease-modifying anti-rheumatic drugs; MTX: methotrexate; SSZ: sulphasalazine; LEF: lefluonamide; CsA: cyclosporine; ACT: acitretin; HAQ: health assessment questionnaire; HAQ-DI: health assessment questionnaire-disability index; BMI: body mass index; ESR: erythrocyte sedimentation rate; CRP: c-reactive protein; VAS: visual analogue scale; PsAQoL: psoriatic arthritis quality of life; FiRST: fibromyalgia rapid screening tool; VLDA: very low disease activity; BASDAI: bath ankylosing spondylitis disease activity index; HAD-A: hospital anxiety and depression scale-anxiety