In a study recently presented during the European League Against Rheumatism Annual European Congress of Rheumatology (EULAR 2015), a team of researchers found that fatigue and functional limitations remained stable during the progress of disease in systemic sclerosis patients. The new evidence suggests that SSc is not always necessarily progressive as previously thought.
The team of researchers investigated a total of 215 patients with a diagnosis of systemic sclerosis (SSc). Of these, 75.1% had limited SSc.
Systemic sclerosis (SSc) is a systemic connective tissue disease. Characteristics of systemic sclerosis include essential vasomotor disturbances; fibrosis; subsequent atrophy of the skin, subcutaneous tissue, muscles, and internal organs (eg, alimentary tract, lungs, heart, kidney, CNS); and immunologic disturbances accompany these findings.
In the study, the researchers found that at baseline SSc patients had a mean age of 56.4 years; 67.9% were women. the mean duration of the disease was 9.2 years. To identify two classifications for fatigue and two classes for functional disability the researchers performed latent class growth analysis.
To assess functional status, the researchers used The Health Assessment Questionnaire-Disability Index (HAQ-DI) and to assess fatigue the researchers used the SF-36 vitality subscale.
Based on the level of disability, the researchers classified a “stable-low” group that included 133 patients with low baseline HAQ-DI scores. This group was compared with a “stable-high” group comprising 82 patients that was classified based on baseline high disability scores.
At baseline, the researchers classified a “stable-moderate” group including 99 patients, and a “stable-severe” group comprising 116 patients, that was classified based on levels of fatigue.
During the 3 years of the study, patients of both groups had a slight but not-insignificant deterioration in their SSc clinical status. According to the researchers nearly one-third of the patients met criteria for both groups. The results revealed that patients in the stable-high disability group were more likely to experience disability and fatigue and to be women.
Patients in the stable-severe fatigue group reported less disease acceptance, were more likely to report lung involvement, and were women. The researchers also found a statistical significant association between disability and fatigue subgroups.