Automated LEAF Tool Useful for Fatigue Management in Patients With SLE

A free automated digital tool for managing severe fatigue in patients with systemic lupus erythematosus (SLE) was shown to address common issues such as insomnia, pain, fibromyalgia, and active disease, according to study results published in Rheumatic & Musculoskeletal Diseases Open.

Between May and November 2022, researchers conducted a cross-sectional survey study to assess the efficacy of the automated Lupus Expert System for Assessment of Fatigue (LEAF): a digital tool for managing symptoms of fatigue in patients with SLE.

In short, the LEAF tool analyzes patient-reported outcomes and offers tailored feedback on the type of fatigue, along with clinically significant factors, and provides guidance on how to effectively manage these symptoms.

Fatigue was self-evaluated with the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-Fatigue). The intensity of fatigue, disease activity, and pain were assessed using a self-reported Numerical Rating Scale (NRS; range from 0-10). The Multidimensional Fatigue Inventory was utilized to assess specific aspects of fatigue.

A total of 1250 participants were included in the final analysis, with 688 completing the entire study.

The majority of participants (95.2%) identified as female and were primarily (66.2%) of European descent; the median patient age was 43 years.

Among participants, 66.9% (n=720/1077) reported having active SLE and 69.1% (n=730/1057) reported experiencing clinically significant pain.

Of the 1250 total patients, a significant percentage (78.9%; n=987) reported experiencing fatigue, as indicated by a FACIT-Fatigue score of less than 34. The median fatigue intensity score was 7, based on the NRS scale.

The results of the univariate analysis revealed that women were at greater risk of experiencing fatigue (P =.01) and were inclined to have a positive screening for fibromyalgia (P <.0001).

Additionally, they were inclined to perceive their disease as more active and experience elevated levels of pain, anxiety, depression, insomnia, and stress (all P <.0001).

Among the participants, 93.2% reported finding LEAF beneficial, with 92.3% expressing a willingness to recommend this tool to fellow patients with SLE.

Fatigue was found to be independently associated with insomnia (odds ratio [OR], 3.31; 95% CI, 1.73-4.34; P =.0003), pain (OR, 2.83; 95% CI, 1.44-5.54; P =.002), fibromyalgia (OR, 2.50; 95% CI, 1.26-4.96; P =.008), self-reported active SLE (OR, 2.26; 95% CI, 1.17-4.40; P =.02), and stress (OR, 1.97; 95% CI, 1.01-3.83; P =.045), according to the multivariable analysis.

Study limitations included self-reported disease activity and potential selection bias.

Study authors concluded, “[Personalized] assessment and management of fatigue using digital tools can now be incorporated into the holistic management of SLE.”

Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Rheumatology Advisor