OP0201 FATIGUE IN JUVENILE IDIOPATIC ARTHRITIS AFTER 18 YEARS OF FOLLOW-UP

Background Fatigue is common in adults with rheumatic disease and has also been shown in adolescents with juvenile idiopathic arthritis (JIA). Knowledge on fatigue in JIA in long-term follow-up is limited. Objectives To study the prevalence and severity of fatigue 18 years after onset of JIA. Methods In this close to population-based cohort study from defined geographical areas of Norway, Sweden, Denmark and Finland, consecutive cases of JIA with disease onset in 1997 to 2000 were prospectively enrolled (1). At 18-year follow-up, fatigue was measured using Fatigue Severity Scale (FSS, range 0-7) (2), and severe fatigue was defined as FSS ≥4. General health status was measured with Health Assessment Questionnaire (HAQ) and 36-Item Short Form Health Survey (SF-36). Reduced health was defined as HAQ >0, and SF-36 0 = pain. Remission was defined according to the preliminary criteria described by Wallace. A Norwegian healthy cohort was used for comparison. Multivariable logistic regression analyses were performed. Results Among 434 eligible JIA participants 377 completed a Fatigue Severity Scale (FSS) measurement at the 18-year follow-up and were included. Of these 72% were girls, 53% had oligoarticular disease six months after onset, median age at onset was 5.6 (IQR 2.6-9.7) years, and age at the 18-year visit was 23.1 (IQR 20.3-27.2). Mean total FSS (±SD) was 3.2 (±1.5), and participants with active disease scored 3.6 (±1.6) compared to 2.9 (±1.4) for those in remission off medication. The highest total FSS was found in those with SF-36 PCS and/or MCS 0 (47%, OR 4.1) compared to HAQ score =0 (18%), SF-36 PCS/MCS 0 (36%, OR 3.8) compared to VAS pain =0 (13%). The proportion of severe fatigue in a healthy Norwegian control cohort was 12%. Conclusion At 18-year follow-up fatigue was a prominent symptom in JIA, and we found consistently higher fatigue burden and considerably more severe fatigue among participants with active disease, pain and self-reported health problems, compared to those without. We suggest fatigue to be measured at long-term follow-up both in clinical and research settings. References [1] Nordal E, et al. Arthritis Rheum 2011;63:2809-18 [2] Krupp LB, et al. Arch Neurol 1989;46:1121-23 Disclosure of Interests Ellen Dalen Arnstad: None declared, Mia Glerup: None declared, Veronika Rypdal: None declared, Suvi Peltoniemi: None declared, Maria Ekelund: None declared, Lillemor Berntson Consultant for: AbbVie, Speakers bureau: AbbVie, Anders Fasth: None declared, Susan Nielsen: None declared, Marek Zak: None declared, Kristiina Aalto: None declared, Ellen Nordal: None declared, Troels Herlin: None declared, Pal Richard Romundstad: None declared, Marite Rygg: None declared