PMID- 31263068
OWN - NLM
STAT- MEDLINE
DCOM- 20210831
LR  - 20210831
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 47
IP  - 4
DP  - 2020 Apr
TI  - The Longitudinal Course of Fatigue in Antineutrophil Cytoplasmic 
      Antibody-associated Vasculitis.
PG  - 572-579
LID - 10.3899/jrheum.190113 [doi]
AB  - OBJECTIVE: Fatigue is common and burdensome in antineutrophil cytoplasmic 
      antibody-associated vasculitis (AAV). This study aimed to understand how fatigue 
      changes over time following treatment initiation and to determine whether 
      individuals with the poorest prognosis can be robustly identified. METHODS: One 
      hundred forty-nine patients with AAV and new-onset disease recruited to 2 
      clinical trials (RITUXVAS and MYCYC) were followed for 18 months. Fatigue was 
      measured at baseline and 6-month intervals using the vitality domain of the 
      Medical Outcomes Study Short Form-36 quality of life questionnaire and compared 
      to a cohort of 470 controls. Group-based trajectory modeling (GBTM) determined 
      trajectories of the symptom to which baseline characteristics and ongoing fatigue 
      scores were compared. RESULTS: Fatigue levels at diagnosis were worse in patients 
      than controls [median (interquartile range; IQR) 30 (10-48) vs 70 (55-80); p < 
      0.001], with 46% of patients reporting severe fatigue. Fatigue improved after 6 
      months of treatment but remained worse than in controls (p < 0.001). GBTM 
      revealed varied trajectories of fatigue: low fatigue stable (n = 23), moderate 
      baseline fatigue improvers (n = 29), high baseline fatigue improvers (n = 61), 
      and stable baseline high fatigue (n = 37). Participants who followed stable high 
      fatigue trajectories had lower vasculitis activity compared to improvers, but no 
      other demographic or clinical variables differed. CONCLUSION: This study 
      longitudinally measured fatigue levels in patients with AAV. Although most 
      patients improved following treatment, an important subgroup of patients reported 
      persistently high levels of fatigue that did not change. Few clinical or 
      laboratory markers distinguished these patients, suggesting alternative 
      interventions specific for fatigue are required. [clinicaltrialsregister.eu, 
      RITUXVAS EudraCT number: 2005-003610-15; MYCYC EudraCT number: 2006-001663-33].
FAU - O'Malley, Lucy
AU  - O'Malley L
AUID- ORCID: 0000-0002-4710-3475
AD  - From the Institute of Clinical Sciences, University of Birmingham, Birmingham; 
      Arthritis Research UK Centre for Epidemiology, University of Manchester, 
      Manchester; Department of Medicine, University of Cambridge, Cambridge; Institute 
      of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
AD  - LH, DRJ, and RJ have received research grants and speaker fees from F. 
      Hoffmann-La Roche. LH, RJ, DRJ, MDM have been involved in studies in which 
      rituximab was given free of charge by Roche and MMF was given free of charge by 
      Vifor Pharma.
AD  - L. O'Malley, MB ChB, Institute of Clinical Sciences, University of Birmingham; 
      K.L. Druce, PhD, Arthritis Research UK Centre for Epidemiology, University of 
      Manchester; D. Chanouzas, PhD, Institute of Clinical Sciences, University of 
      Birmingham; M.D. Morgan, PhD, Institute of Clinical Sciences, University of 
      Birmingham; R. Jones, MD, Department of Medicine, University of Cambridge; D.R. 
      Jayne, MD, Department of Medicine, University of Cambridge; N. Basu, PhD, 
      Institute of Infection, Immunity and Inflammation, University of Glasgow; L. 
      Harper, PhD, Institute of Clinical Sciences, University of Birmingham.
FAU - Druce, Katie L
AU  - Druce KL
AD  - From the Institute of Clinical Sciences, University of Birmingham, Birmingham; 
      Arthritis Research UK Centre for Epidemiology, University of Manchester, 
      Manchester; Department of Medicine, University of Cambridge, Cambridge; Institute 
      of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
AD  - LH, DRJ, and RJ have received research grants and speaker fees from F. 
      Hoffmann-La Roche. LH, RJ, DRJ, MDM have been involved in studies in which 
      rituximab was given free of charge by Roche and MMF was given free of charge by 
      Vifor Pharma.
AD  - L. O'Malley, MB ChB, Institute of Clinical Sciences, University of Birmingham; 
      K.L. Druce, PhD, Arthritis Research UK Centre for Epidemiology, University of 
      Manchester; D. Chanouzas, PhD, Institute of Clinical Sciences, University of 
      Birmingham; M.D. Morgan, PhD, Institute of Clinical Sciences, University of 
      Birmingham; R. Jones, MD, Department of Medicine, University of Cambridge; D.R. 
      Jayne, MD, Department of Medicine, University of Cambridge; N. Basu, PhD, 
      Institute of Infection, Immunity and Inflammation, University of Glasgow; L. 
      Harper, PhD, Institute of Clinical Sciences, University of Birmingham.
FAU - Chanouzas, Dimitrios
AU  - Chanouzas D
AD  - From the Institute of Clinical Sciences, University of Birmingham, Birmingham; 
      Arthritis Research UK Centre for Epidemiology, University of Manchester, 
      Manchester; Department of Medicine, University of Cambridge, Cambridge; Institute 
      of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
AD  - LH, DRJ, and RJ have received research grants and speaker fees from F. 
      Hoffmann-La Roche. LH, RJ, DRJ, MDM have been involved in studies in which 
      rituximab was given free of charge by Roche and MMF was given free of charge by 
      Vifor Pharma.
AD  - L. O'Malley, MB ChB, Institute of Clinical Sciences, University of Birmingham; 
      K.L. Druce, PhD, Arthritis Research UK Centre for Epidemiology, University of 
      Manchester; D. Chanouzas, PhD, Institute of Clinical Sciences, University of 
      Birmingham; M.D. Morgan, PhD, Institute of Clinical Sciences, University of 
      Birmingham; R. Jones, MD, Department of Medicine, University of Cambridge; D.R. 
      Jayne, MD, Department of Medicine, University of Cambridge; N. Basu, PhD, 
      Institute of Infection, Immunity and Inflammation, University of Glasgow; L. 
      Harper, PhD, Institute of Clinical Sciences, University of Birmingham.
FAU - Morgan, Matthew D
AU  - Morgan MD
AD  - From the Institute of Clinical Sciences, University of Birmingham, Birmingham; 
      Arthritis Research UK Centre for Epidemiology, University of Manchester, 
      Manchester; Department of Medicine, University of Cambridge, Cambridge; Institute 
      of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
AD  - LH, DRJ, and RJ have received research grants and speaker fees from F. 
      Hoffmann-La Roche. LH, RJ, DRJ, MDM have been involved in studies in which 
      rituximab was given free of charge by Roche and MMF was given free of charge by 
      Vifor Pharma.
AD  - L. O'Malley, MB ChB, Institute of Clinical Sciences, University of Birmingham; 
      K.L. Druce, PhD, Arthritis Research UK Centre for Epidemiology, University of 
      Manchester; D. Chanouzas, PhD, Institute of Clinical Sciences, University of 
      Birmingham; M.D. Morgan, PhD, Institute of Clinical Sciences, University of 
      Birmingham; R. Jones, MD, Department of Medicine, University of Cambridge; D.R. 
      Jayne, MD, Department of Medicine, University of Cambridge; N. Basu, PhD, 
      Institute of Infection, Immunity and Inflammation, University of Glasgow; L. 
      Harper, PhD, Institute of Clinical Sciences, University of Birmingham.
FAU - Jones, Rachel
AU  - Jones R
AD  - From the Institute of Clinical Sciences, University of Birmingham, Birmingham; 
      Arthritis Research UK Centre for Epidemiology, University of Manchester, 
      Manchester; Department of Medicine, University of Cambridge, Cambridge; Institute 
      of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
AD  - LH, DRJ, and RJ have received research grants and speaker fees from F. 
      Hoffmann-La Roche. LH, RJ, DRJ, MDM have been involved in studies in which 
      rituximab was given free of charge by Roche and MMF was given free of charge by 
      Vifor Pharma.
AD  - L. O'Malley, MB ChB, Institute of Clinical Sciences, University of Birmingham; 
      K.L. Druce, PhD, Arthritis Research UK Centre for Epidemiology, University of 
      Manchester; D. Chanouzas, PhD, Institute of Clinical Sciences, University of 
      Birmingham; M.D. Morgan, PhD, Institute of Clinical Sciences, University of 
      Birmingham; R. Jones, MD, Department of Medicine, University of Cambridge; D.R. 
      Jayne, MD, Department of Medicine, University of Cambridge; N. Basu, PhD, 
      Institute of Infection, Immunity and Inflammation, University of Glasgow; L. 
      Harper, PhD, Institute of Clinical Sciences, University of Birmingham.
FAU - Jayne, David R W
AU  - Jayne DRW
AD  - From the Institute of Clinical Sciences, University of Birmingham, Birmingham; 
      Arthritis Research UK Centre for Epidemiology, University of Manchester, 
      Manchester; Department of Medicine, University of Cambridge, Cambridge; Institute 
      of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
AD  - LH, DRJ, and RJ have received research grants and speaker fees from F. 
      Hoffmann-La Roche. LH, RJ, DRJ, MDM have been involved in studies in which 
      rituximab was given free of charge by Roche and MMF was given free of charge by 
      Vifor Pharma.
AD  - L. O'Malley, MB ChB, Institute of Clinical Sciences, University of Birmingham; 
      K.L. Druce, PhD, Arthritis Research UK Centre for Epidemiology, University of 
      Manchester; D. Chanouzas, PhD, Institute of Clinical Sciences, University of 
      Birmingham; M.D. Morgan, PhD, Institute of Clinical Sciences, University of 
      Birmingham; R. Jones, MD, Department of Medicine, University of Cambridge; D.R. 
      Jayne, MD, Department of Medicine, University of Cambridge; N. Basu, PhD, 
      Institute of Infection, Immunity and Inflammation, University of Glasgow; L. 
      Harper, PhD, Institute of Clinical Sciences, University of Birmingham.
FAU - Basu, Neil
AU  - Basu N
AD  - From the Institute of Clinical Sciences, University of Birmingham, Birmingham; 
      Arthritis Research UK Centre for Epidemiology, University of Manchester, 
      Manchester; Department of Medicine, University of Cambridge, Cambridge; Institute 
      of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
AD  - LH, DRJ, and RJ have received research grants and speaker fees from F. 
      Hoffmann-La Roche. LH, RJ, DRJ, MDM have been involved in studies in which 
      rituximab was given free of charge by Roche and MMF was given free of charge by 
      Vifor Pharma.
AD  - L. O'Malley, MB ChB, Institute of Clinical Sciences, University of Birmingham; 
      K.L. Druce, PhD, Arthritis Research UK Centre for Epidemiology, University of 
      Manchester; D. Chanouzas, PhD, Institute of Clinical Sciences, University of 
      Birmingham; M.D. Morgan, PhD, Institute of Clinical Sciences, University of 
      Birmingham; R. Jones, MD, Department of Medicine, University of Cambridge; D.R. 
      Jayne, MD, Department of Medicine, University of Cambridge; N. Basu, PhD, 
      Institute of Infection, Immunity and Inflammation, University of Glasgow; L. 
      Harper, PhD, Institute of Clinical Sciences, University of Birmingham.
FAU - Harper, Lorraine
AU  - Harper L
AD  - From the Institute of Clinical Sciences, University of Birmingham, Birmingham; 
      Arthritis Research UK Centre for Epidemiology, University of Manchester, 
      Manchester; Department of Medicine, University of Cambridge, Cambridge; Institute 
      of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. 
      L.Harper@bham.ac.uk.
AD  - LH, DRJ, and RJ have received research grants and speaker fees from F. 
      Hoffmann-La Roche. LH, RJ, DRJ, MDM have been involved in studies in which 
      rituximab was given free of charge by Roche and MMF was given free of charge by 
      Vifor Pharma. L.Harper@bham.ac.uk.
AD  - L. O'Malley, MB ChB, Institute of Clinical Sciences, University of Birmingham; 
      K.L. Druce, PhD, Arthritis Research UK Centre for Epidemiology, University of 
      Manchester; D. Chanouzas, PhD, Institute of Clinical Sciences, University of 
      Birmingham; M.D. Morgan, PhD, Institute of Clinical Sciences, University of 
      Birmingham; R. Jones, MD, Department of Medicine, University of Cambridge; D.R. 
      Jayne, MD, Department of Medicine, University of Cambridge; N. Basu, PhD, 
      Institute of Infection, Immunity and Inflammation, University of Glasgow; L. 
      Harper, PhD, Institute of Clinical Sciences, University of Birmingham. 
      L.Harper@bham.ac.uk.
LA  - eng
SI  - EudraCT/2005-003610-15
SI  - EudraCT/2006-001663-33
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190701
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Biomarkers)
SB  - IM
MH  - *Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications/drug 
      therapy
MH  - *Antibodies, Antineutrophil Cytoplasmic
MH  - Biomarkers
MH  - Fatigue/etiology
MH  - Humans
MH  - Quality of Life
OTO - NOTNLM
OT  - ANCA-ASSOCIATED VASCULITIS
OT  - FATIGUE
OT  - QUALITY OF LIFE
EDAT- 2019/07/03 06:00
MHDA- 2021/09/01 06:00
CRDT- 2019/07/03 06:00
PHST- 2019/06/20 00:00 [accepted]
PHST- 2019/07/03 06:00 [pubmed]
PHST- 2021/09/01 06:00 [medline]
PHST- 2019/07/03 06:00 [entrez]
AID - jrheum.190113 [pii]
AID - 10.3899/jrheum.190113 [doi]
PST - ppublish
SO  - J Rheumatol. 2020 Apr;47(4):572-579. doi: 10.3899/jrheum.190113. Epub 2019 Jul 1.