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The following is a summary of “Characteristics and drivers of fatigue in patients with psoriasis and psoriatic arthritis: A cross sectional study,” published in the July 2024 issue of Dermatology by Nymand, et al.

Fatigue is a significant symptom experienced by patients with psoriasis and psoriatic arthritis (PsA), but the specific factors contributing to fatigue in these conditions have not been thoroughly investigated. Understanding these factors is essential for improving patient care and management strategies. For a study, researchers sought to investigate the characteristics of fatigue and identify potential drivers of fatigue among individuals with psoriasis, with or without PsA, and to compare these findings with a nonpsoriasis control group.

The study included 2,741 adults with psoriasis, 593 with PsA, and 3,788 nonpsoriasis control participants. All participants completed the Multidimensional Fatigue Inventory-20 (MFI-20) questionnaire to assess fatigue levels. Patients with psoriasis also reported their joint pain intensity, pruritus, skin pain, and sleep problems using a numerical rating scale. Linear regression models were utilized to examine the relationships between these variables and fatigue. Beta coefficients (β) for the slopes, along with 95% CIs, were calculated to assess the impact of these factors on fatigue.

The analysis revealed that PsA was associated with the highest levels of total fatigue, with a beta coefficient of 5.22 (95% CI, 3.55-6.90), indicating a significantly greater fatigue impact compared to both psoriasis (β = 2.10; 95% CI, 0.96-3.25) and the general population (P_trend < .0001). For patients with psoriasis, whether or not they had PsA, a 1-point increase in joint pain intensity was strongly associated with increased fatigue, with a β of 2.23 (95% CI, 2.03-2.44).

A notable limitation of this study was the lack of data on the effects of pharmacotherapy on fatigue, which could have provided additional insights into fatigue management. The study highlighted that fatigue in patients with psoriasis and PsA is influenced by several factors, with PsA being associated with greater fatigue than psoriasis alone. The findings suggested that a symptom-based approach addressing joint pain, pruritus, and sleep disturbances is essential for managing fatigue in patients with psoriasis, rather than relying solely on objective measures of disease severity.

Reference: jaad.org/article/S0190-9622(24)00400-6/fulltext