Effect of Fatigue on Health-Related Quality of Life and Work Productivity in Psoriatic Arthritis: Findings From a Real-World Survey

J Rheumatol. 2022 Nov;49(11):1221-1228. doi: 10.3899/jrheum.211288. Epub 2022 Jul 15.


Objective: To evaluate fatigue frequency and severity among patients with psoriatic arthritis (PsA) and assess the effect of fatigue severity on patient-reported outcome measures (PROMs) assessing quality of life, function, and work productivity.

Methods: Data were derived from the Adelphi Disease Specific Programme, a cross-sectional survey conducted in 2018 in the United States and Europe. Patients had physician-confirmed PsA. Fatigue was collected as a binary variable and through its severity (0-10 scale, using the 12-item Psoriatic Arthritis Impact of Disease fatigue question) from patients; physicians also reported patient fatigue (yes/no). Other PROMs included the 5-level EuroQol 5-dimension questionnaire (EQ-5D-5L) for health-related quality of life (HRQOL), Health Assessment Questionnaire-Disability Index, and Work Productivity and Activity Impairment Questionnaire. Multivariate linear regression was used to evaluate the association between fatigue severity and other PROMs.

Results: Among the 831 included patients (mean age 47.5 yrs, mean disease duration 5.3 yrs, 46.9% female, 48.1% receiving a biologic), fatigue was reported by 78.3% of patients. Patients with greater fatigue severity had greater disease duration, PsA severity, pain levels, body surface area affected by psoriasis, and swollen and tender joint counts (all P < 0.05). In multivariate analyses, patients with greater fatigue severity experienced worse physical functioning, HRQOL, and work productivity (all P < 0.001). Presence of fatigue was underreported by physicians (reported in only 32% of patients who self-reported fatigue).

Conclusion: Prevalence of patient-reported fatigue was high among patients with PsA and underrecognized by physicians. Fatigue severity was associated with altered physical functioning, work productivity, and HRQOL.

Keywords: fatigue; health-related quality of life; patient-reported outcomes; psoriatic arthritis; real-world data; work productivity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthritis, Psoriatic* / complications
  • Arthritis, Psoriatic* / diagnosis
  • Arthritis, Psoriatic* / epidemiology
  • Arthritis, Psoriatic* / physiopathology
  • Cross-Sectional Studies
  • Efficiency*
  • Europe / epidemiology
  • Fatigue* / complications
  • Fatigue* / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / complications
  • Pain / epidemiology
  • Patient Reported Outcome Measures
  • Quality of Life*
  • Self Report
  • Severity of Illness Index
  • Surveys and Questionnaires*
  • United States / epidemiology
  • Work* / psychology