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Published on: July 14, 2023

Disease activity and fatigue in juvenile idiopathic arthritis

Sarah Ringold1, Teresa M Ward, Carol A Wallace

  • 1Seattle Children's Hospital, Seattle, Washington 98015, USA. Sarah.Ringold@seattlechildrens.org

Arthritis Care & Research
|July 19, 2012
PubMed

Insights

In juvenile idiopathic arthritis (JIA), functional ability measured by the Childhood Health Assessment Questionnaire (C-HAQ) is linked to fatigue. Pain significantly confounds the relationship between fatigue and disease activity in children with JIA.

Area of Science:

  • Pediatric Rheumatology
  • Childhood Arthritis Research
  • Juvenile Idiopathic Arthritis (JIA) Studies

Background:

  • Fatigue is a common symptom in children with juvenile idiopathic arthritis (JIA).
  • Understanding the relationship between fatigue, disease activity, and functional status is crucial for managing JIA.
  • Previous studies have not fully elucidated the interplay between parent/proxy- and child-reported fatigue and objective/subjective measures of disease activity.

Purpose of the Study:

  • To investigate the association between parent/proxy- and child-reported fatigue and disease activity in children with polyarticular, extended oligoarticular, and persistent oligoarticular JIA.
  • To identify factors influencing the relationship between fatigue and disease activity in pediatric JIA patients.

Main Methods:

  • A cross-sectional cohort of 309 children with JIA was recruited from a pediatric rheumatology clinic.
  • Parent/proxy and child self-report measures included the PedsQL Multidimensional Fatigue Scales and pain assessments.
  • Disease activity was assessed using joint counts, the Childhood Health Assessment Questionnaire (C-HAQ), and the Juvenile Arthritis Disease Activity Score (JADAS); linear regression was employed.

Main Results:

  • Fatigue was significantly associated with functional ability (C-HAQ) and parent/child-reported disease activity.
  • After adjusting for pain, only the C-HAQ remained significantly associated with fatigue in multivariable models.
  • Pain was identified as a significant confounder, impacting the observed associations between fatigue and disease activity.

Conclusions:

  • Functional ability, assessed by the C-HAQ, is a key correlate of fatigue in children with JIA.
  • Pain is a critical confounding factor that must be considered when evaluating fatigue and disease activity in JIA.
  • Future JIA research should routinely incorporate assessments of both pain and fatigue to better understand their complex relationships.
Abstract

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