Prevalence and factors associated with fatigue in patients with psoriatic arthritis: a systematic review and meta-analysis

Abstract

Objectives: Fatigue is a prominent symptom in patients with psoriatic arthritis (PsA). There was a wide variety of statistics previously reported on fatigue prevalence in patients. This systematic review examined the current literature to derive the overall prevalence of fatigue and risk factors in PsA patients. Methods: A systematic review of the literature with subsequent meta-analyses was conducted. Publications assessing fatigue severity and prevalence in patients with PsA using validated measurement scores were identified from seven online databases (Cochrane, CINAHL, EMBASE, Google Scholar, MEDLINE, PubMed, and Web of Science), from inception until April 2023. Employing a random effects model, we calculated the pooled fatigue prevalence. Quality assessment of included studies was performed utilising the Joanna Briggs Critical Appraisal Tool. Results: The final analysis included 15 studies with 6482 PsA patients. Pooled fatigue prevalence was 0.51 (95% CI: 0.41, 0.61; I2 = 97.4%). There was substantial heterogenicity across the studies, with biologics use and geographical location in terms of Western versus Eastern countries being possible sources of heterogeneity. Age, disease duration, gender, tender joint count, swollen joint and enthesitis count are among the most commonly reported risk factors for fatigue in multivariate logistic regressions. Conclusions: Approximately half of the patients with PsA experienced fatigue. Biologics use and geographical location of the study were possible sources of heterogeneity in the subgroup analysis.