Fatigue is reported as the major complaint of people with ankylosing spondylitis (AS), yet it has not been studied and measured in this form of arthritis. AS studies typically evaluate conventional symptoms, like pain, stiffness, functional impairment, range of motion and quality of life.

Researchers M. Dougados, E. Dernis-Labous and M. Messow from the Rene Descartes University AP-HP Cochin Hospital in Paris, France, organized a study to evaluate two items in people with AS:

• Fatigue as a potential independent symptom in comparison with the conventional ones.
  
• Nonsteroidal anti-inflammatory drug (NSAID) therapy’s effect on fatigue.

Study Logistics
A total of 639 study participants classified as having painful AS took part and received either an NSAID or placebo.

Researchers recorded the following variables prior to the study’s start and after six weeks of therapy:

• Pain
  
• Function
  
• Patient’s global assessment (own evaluation of what he/she feels)
  
• Inflammation (night pain)
  
• Morning stiffness
  
• Finger-to-floor measurement (touching the toes)
  
• Fatigue

Results
Fatigue was considered important in 63% (401/639) of the patients.

NSAIDs seemed to affect pain and function more than fatigue.

Fatigue should be considered as an independent symptom to be systematically evaluated in AS, according to the study’s researchers. They also believe that conventional therapy, like NSAIDs, has a lower effect on fatigue than on pain or functional impairment.

Source: Assessment of fatigue in the management of patients with ankylosing spondylitis. British Society for Rheumatology 2003; 42: 1523-1528.