Fatigue Severity Associated With Work Productivity, Quality of Life in PsA

Fatigue was common among patients with PsA and underrecognized by physicians.

Greater fatigue levels correlate with decreased physical functioning, work productivity, and health-related quality of life (HRQOL) among patients with psoriatic arthritis (PsA), according to study findings published in The Journal of Rheumatology.

Researchers conducted a real-world cross-sectional survey across the US and Europe in 2018, using data from the Adelphia Disease Specific Programme. They assessed the effect of frequency and severity of fatigue on HRQOL among patients with physician-confirmed PsA.

The survey included questions on fatigue frequency and severity, using both patient- and physician-reported measures, including the Psoriatic Arthritis Impact of Disease fatigue scale, provider-confirmed (yes/no) reports of patient fatigue, the 5-level EuroQoL 5-dimension questionnaire (EQ-5D-5L) for HRQOL, the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Work Productivity and Activity Impairment Questionnaire.

Of the 831 patients (46.9% women; mean age, 47.5 years) with PsA, 651 (78.3%) reported fatigue. Fatigue severity increased with disease duration/patient age, pain levels, PsA disease severity, the total body area affected by psoriasis, and the number of tender or swollen joints (all P <.05).

These findings highlight the importance of prioritizing fatigue in the research and management of PsA.

Multivariate analysis showed that greater fatigue levels correlated with worse physical functions, HRQOL, and work productivity (all P <.001). Anxiety and depression more commonly occurred among patients with PsA who reported higher levels of fatigue severity.

The researchers noted that physicians reported fatigue in 32% of patients with self-reported fatigue, suggesting its underreporting among patients with PsA.

Study limitations included lack of randomized samples of both patients with PsA and treating physicians that may have introduced a selection bias; recall bias in both patient- and physician-reported measures; the cross-sectional design of the study preventing conclusions about causality; lack of certain data that reduced sample size for multivariate analysis; and the inability to account for all confounding variables, such as the presence of comorbidities that may have affected fatigue severity.

“Despite many patients receiving advanced therapy, fatigue is still highly prevalent among patients with PsA and underrecognized by physicians,” the study authors said. “These findings highlight the importance of prioritizing fatigue in the research and management of PsA.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Gossec L, Walsh JA, Michaud K, et al. Effect of fatigue on health-related quality of life and work productivity in psoriatic arthritis: Findings from a real-world survey. J Rheumatol. 2022;49(11):1221-1228. doi:10.3899/jrheum.211288