Predictors of fatigue severity in early systemic sclerosis

A prospective longitudinal study of the GENISOS cohort

Shervin Assassi, Astrud L. Leyva, Maureen D. Mayes, Roozbeh Sharif, Deepthi K. Nair, Michael Fischbach, Ngan Nguyen, John D. Reveille, Emilio Gonzalez, Terry A. McNearney

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objectives: Longitudinal studies examining the baseline predictors of fatigue in SSc have not been reported. Our objectives were to examine the course of fatigue severity over time and to identify baseline clinical, demographic, and psychosocial predictors of sequentially obtained fatigue scores in early SSc. We also examined baseline predictors of change in fatigue severity over time. Methods: We analyzed 1090 longitudinal Fatigue Severity Scale (FSS) scores belonging to 256 patients who were enrolled in the Genetics versus Environment in Scleroderma Outcomes Study (GENISOS). Predictive significance of baseline variables for sequentially obtained FSS scores was examined with generalized linear mixed models. Predictors of change in FSS over time were examined by adding an interaction term between the baseline variable and time-in-study to the model. Results: The patients' mean age was 48.6 years, 47% were Caucasians, and 59% had diffuse cutaneous involvement. The mean disease duration at enrollment was 2.5 years. The FSS was obtained at enrollment and follow-up visits (mean follow-up time = 3.8 years). Average baseline FSS score was 4.7(±0.96). The FSS was relatively stable and did not show a consistent trend for change over time (p = 0.221). In a multivariable model of objective clinical variables, higher Medsger Gastrointestinal (p = 0.006) and Joint (p = 0.024) Severity Indices, and anti-U1-RNP antibodies (p = 0.024) were independent predictors of higher FSS. In the final model, ineffective coping skills captured by higher Illness Behavior Questionnaire scores (p<0.001), higher self-reported pain (p = 0.006), and higher Medsger Gastrointestinal Severity Index (p = 0.009) at enrollment were independent predictors of higher longitudinal FSS scores. Baseline DLco % predicted was the only independent variable that significantly predicted a change in FSS scores over time (p = 0.013), with lower DLco levels predicting an increase in FSS over time. Conclusions: This study identified potentially modifiable clinical and psychological factors that predict longitudinal fatigue severity in early SSc.

Original languageEnglish (US)
Article numbere26061
JournalPLoS One
Volume6
Issue number10
DOIs
StatePublished - 2011

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Systemic Scleroderma
sclerosis
longitudinal studies
cohort studies
Fatigue
Longitudinal Studies
Outcome Assessment (Health Care)
Fatigue of materials
Prospective Studies
coping strategies
psychosocial factors
pain
demographic statistics
questionnaires
antibodies
duration
Genetics
Illness Behavior
Psychological Adaptation
methodology

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Assassi, S., Leyva, A. L., Mayes, M. D., Sharif, R., Nair, D. K., Fischbach, M., ... McNearney, T. A. (2011). Predictors of fatigue severity in early systemic sclerosis: A prospective longitudinal study of the GENISOS cohort. PLoS One, 6(10), [e26061]. https://doi.org/10.1371/journal.pone.0026061

Predictors of fatigue severity in early systemic sclerosis : A prospective longitudinal study of the GENISOS cohort. / Assassi, Shervin; Leyva, Astrud L.; Mayes, Maureen D.; Sharif, Roozbeh; Nair, Deepthi K.; Fischbach, Michael; Nguyen, Ngan; Reveille, John D.; Gonzalez, Emilio; McNearney, Terry A.

In: PLoS One, Vol. 6, No. 10, e26061, 2011.

Research output: Contribution to journalArticle

Assassi, S, Leyva, AL, Mayes, MD, Sharif, R, Nair, DK, Fischbach, M, Nguyen, N, Reveille, JD, Gonzalez, E & McNearney, TA 2011, 'Predictors of fatigue severity in early systemic sclerosis: A prospective longitudinal study of the GENISOS cohort', PLoS One, vol. 6, no. 10, e26061. https://doi.org/10.1371/journal.pone.0026061
Assassi, Shervin ; Leyva, Astrud L. ; Mayes, Maureen D. ; Sharif, Roozbeh ; Nair, Deepthi K. ; Fischbach, Michael ; Nguyen, Ngan ; Reveille, John D. ; Gonzalez, Emilio ; McNearney, Terry A. / Predictors of fatigue severity in early systemic sclerosis : A prospective longitudinal study of the GENISOS cohort. In: PLoS One. 2011 ; Vol. 6, No. 10.
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abstract = "Objectives: Longitudinal studies examining the baseline predictors of fatigue in SSc have not been reported. Our objectives were to examine the course of fatigue severity over time and to identify baseline clinical, demographic, and psychosocial predictors of sequentially obtained fatigue scores in early SSc. We also examined baseline predictors of change in fatigue severity over time. Methods: We analyzed 1090 longitudinal Fatigue Severity Scale (FSS) scores belonging to 256 patients who were enrolled in the Genetics versus Environment in Scleroderma Outcomes Study (GENISOS). Predictive significance of baseline variables for sequentially obtained FSS scores was examined with generalized linear mixed models. Predictors of change in FSS over time were examined by adding an interaction term between the baseline variable and time-in-study to the model. Results: The patients' mean age was 48.6 years, 47{\%} were Caucasians, and 59{\%} had diffuse cutaneous involvement. The mean disease duration at enrollment was 2.5 years. The FSS was obtained at enrollment and follow-up visits (mean follow-up time = 3.8 years). Average baseline FSS score was 4.7(±0.96). The FSS was relatively stable and did not show a consistent trend for change over time (p = 0.221). In a multivariable model of objective clinical variables, higher Medsger Gastrointestinal (p = 0.006) and Joint (p = 0.024) Severity Indices, and anti-U1-RNP antibodies (p = 0.024) were independent predictors of higher FSS. In the final model, ineffective coping skills captured by higher Illness Behavior Questionnaire scores (p<0.001), higher self-reported pain (p = 0.006), and higher Medsger Gastrointestinal Severity Index (p = 0.009) at enrollment were independent predictors of higher longitudinal FSS scores. Baseline DLco {\%} predicted was the only independent variable that significantly predicted a change in FSS scores over time (p = 0.013), with lower DLco levels predicting an increase in FSS over time. Conclusions: This study identified potentially modifiable clinical and psychological factors that predict longitudinal fatigue severity in early SSc.",
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T2 - A prospective longitudinal study of the GENISOS cohort

AU - Assassi, Shervin

AU - Leyva, Astrud L.

AU - Mayes, Maureen D.

AU - Sharif, Roozbeh

AU - Nair, Deepthi K.

AU - Fischbach, Michael

AU - Nguyen, Ngan

AU - Reveille, John D.

AU - Gonzalez, Emilio

AU - McNearney, Terry A.

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N2 - Objectives: Longitudinal studies examining the baseline predictors of fatigue in SSc have not been reported. Our objectives were to examine the course of fatigue severity over time and to identify baseline clinical, demographic, and psychosocial predictors of sequentially obtained fatigue scores in early SSc. We also examined baseline predictors of change in fatigue severity over time. Methods: We analyzed 1090 longitudinal Fatigue Severity Scale (FSS) scores belonging to 256 patients who were enrolled in the Genetics versus Environment in Scleroderma Outcomes Study (GENISOS). Predictive significance of baseline variables for sequentially obtained FSS scores was examined with generalized linear mixed models. Predictors of change in FSS over time were examined by adding an interaction term between the baseline variable and time-in-study to the model. Results: The patients' mean age was 48.6 years, 47% were Caucasians, and 59% had diffuse cutaneous involvement. The mean disease duration at enrollment was 2.5 years. The FSS was obtained at enrollment and follow-up visits (mean follow-up time = 3.8 years). Average baseline FSS score was 4.7(±0.96). The FSS was relatively stable and did not show a consistent trend for change over time (p = 0.221). In a multivariable model of objective clinical variables, higher Medsger Gastrointestinal (p = 0.006) and Joint (p = 0.024) Severity Indices, and anti-U1-RNP antibodies (p = 0.024) were independent predictors of higher FSS. In the final model, ineffective coping skills captured by higher Illness Behavior Questionnaire scores (p<0.001), higher self-reported pain (p = 0.006), and higher Medsger Gastrointestinal Severity Index (p = 0.009) at enrollment were independent predictors of higher longitudinal FSS scores. Baseline DLco % predicted was the only independent variable that significantly predicted a change in FSS scores over time (p = 0.013), with lower DLco levels predicting an increase in FSS over time. Conclusions: This study identified potentially modifiable clinical and psychological factors that predict longitudinal fatigue severity in early SSc.

AB - Objectives: Longitudinal studies examining the baseline predictors of fatigue in SSc have not been reported. Our objectives were to examine the course of fatigue severity over time and to identify baseline clinical, demographic, and psychosocial predictors of sequentially obtained fatigue scores in early SSc. We also examined baseline predictors of change in fatigue severity over time. Methods: We analyzed 1090 longitudinal Fatigue Severity Scale (FSS) scores belonging to 256 patients who were enrolled in the Genetics versus Environment in Scleroderma Outcomes Study (GENISOS). Predictive significance of baseline variables for sequentially obtained FSS scores was examined with generalized linear mixed models. Predictors of change in FSS over time were examined by adding an interaction term between the baseline variable and time-in-study to the model. Results: The patients' mean age was 48.6 years, 47% were Caucasians, and 59% had diffuse cutaneous involvement. The mean disease duration at enrollment was 2.5 years. The FSS was obtained at enrollment and follow-up visits (mean follow-up time = 3.8 years). Average baseline FSS score was 4.7(±0.96). The FSS was relatively stable and did not show a consistent trend for change over time (p = 0.221). In a multivariable model of objective clinical variables, higher Medsger Gastrointestinal (p = 0.006) and Joint (p = 0.024) Severity Indices, and anti-U1-RNP antibodies (p = 0.024) were independent predictors of higher FSS. In the final model, ineffective coping skills captured by higher Illness Behavior Questionnaire scores (p<0.001), higher self-reported pain (p = 0.006), and higher Medsger Gastrointestinal Severity Index (p = 0.009) at enrollment were independent predictors of higher longitudinal FSS scores. Baseline DLco % predicted was the only independent variable that significantly predicted a change in FSS scores over time (p = 0.013), with lower DLco levels predicting an increase in FSS over time. Conclusions: This study identified potentially modifiable clinical and psychological factors that predict longitudinal fatigue severity in early SSc.

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