Among patients with psoriatic arthritis (PsA), higher rates of annual short-term disability were observed in those with fatigue than without fatigue.

These findings were presented by Elaine Husni, MD, MPH, Cleveland Clinic, OH, at the virtual American College of Rheumatology Convergence 2021.

“Fatigue is a complex symptom affecting physiological, psychological, and social factors and is commonly seen in PsA,” explained Dr Husni and colleagues. This study aimed to evaluate the impact of fatigue on short-term disability among patients with PsA in the United States.

The IBM MarketScan Commercial and Health and Productivity Management Databases were used to screen patients eligible for short-term disability benefits between 2009 and 2019. Patients with ≥2 diagnoses for PsA ≥30 days apart were included in the study.

Patients with fatigue had ≥1 fatigue diagnosis after their initial PsA diagnosis. The index date was defined as the first fatigue diagnosis. Patients with PsA and no fatigue were used as controls and matched 1:1 with patients with fatigue based on propensity scores. Propensity scored were balanced for age, gender, year of initial PsA diagnosis, PsA treatment, related conditions, the Charlson Comorbidity Index, variables associated with PsA disease severity, vitamin D deficiency, and common infections.

Patients were enrolled from ≥6 months before their initial PsA diagnosis (baseline period) to ≥12 months after the index date (follow-up period) and had to be eligible for short-term disability benefits during the entire follow-up period. Change in short-term disability and associated costs were calculated from baseline through follow-up.

A total of 1244 patients with fatigue were matched to the control group. At baseline, the average age of patients was 46.3 years and 43% were female. Patients with fatigue missed an average of 6.9 days due to short-term disability compared to 3.4 days in the control group (P = .0013).

Average costs associated with short-term disability were $897 for patients with fatigue vs $438 for controls (P = .0011).  At least 1 short-term disability leave were reported during the follow-up period in 10.2% of patients with fatigue compared to 6.6% of patients in the control group (P = .0014).

“Higher rates of annual short-term disability were observed among patients with PsA and fatigue than without fatigue. These results highlight the substantial indirect costs and economic burden of fatigue in patients with PsA,” Dr Husni and colleagues concluded.

--Janelle Bradley

Reference:

Husni E, Peterson S, Dennis N, et al. Work Disability Associated with Fatigue in Patients with Psoriatic Arthritis – a Retrospective Study Using Claims Data, 2009-2019. Presented at: American College of Rheumatology Convergence 2021; November 5-9, 2021; virtual. Abstract 0239.