What promotes development of fatigue in rheumatoid arthritis patients?

Patients with rheumatoid arthritis (RA) typically have many permanently inflamed joints. The inflammation inside the body can lead to general physical weakness and fatigue. In this study we analysed the indicators determining the development of fatigue in RA patients. Overall 30 RA patients were included in the study, interviewed using adapted interview questions created by Minnock et.al. (2016). Disease activity and aggressiveness indices, and differences in proinflammatory cytokine levels were detected.
Based on the results, RA patients were divided into two groups - with and without fatigue. In patients with fatigue. In the patients with fatigue, more often an increase in RF IgA, RF IgM and RF IgG levels was detected. RF IgA level positively correlated with RF IgM, RF IgG and anti-CarP levels. In the fatigue group patients INF-γ level positively correlated with IL-21, IL-23 and TNF-α levels, as well as IL-2 level with IL-23 and TNF-α levels. In the non-fatigue patients, a positive association was found only between IL-17 and IL-21 and IL-6 levels, as well as between INF-γ and IL-6 levels. Our data suggest that RF IgA is more closely with fatigue development and only IL-6 do not significantly affect the development of fatigue in RA patients.