The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale in patients with axial spondyloarthritis: psychometric properties and clinically meaningful thresholds for interpretation

Study on FACIT-Fatigue in Axial Spondyloarthritis Patients

Key Findings and Practical Solutions

Fatigue is a significant symptom for axial spondyloarthritis (axSpA) patients. The FACIT-Fatigue scale, a 13-item patient-reported outcome, was evaluated for its effectiveness in measuring fatigue severity and impact on daily activities in axSpA patients, including those with non-radiographic axSpA (nr-axSpA) and radiographic axSpA (r-axSpA).

The study found that the FACIT-Fatigue scale demonstrated good internal consistency, validity, and sensitivity to change across the entire axSpA spectrum. It was determined that a 5-11 point increase in FACIT-Fatigue score represents a meaningful within-patient change, with an 8-point increase identified as the responder definition. Additionally, a 2.14-5.34-point difference in FACIT-Fatigue score change over a 16-week period was considered a meaningful between-group difference. Severity bands for FACIT-Fatigue scores were defined as none or minimal (>40), mild (>30 to ≤40), moderate (>21 to ≤30), and severe (≤21).

Value and Implications

These findings support the use of the FACIT-Fatigue scale as an effective measure to evaluate fatigue-related treatment benefit in axSpA clinical trials. The proposed score estimates and thresholds provide guidance for interpreting FACIT-Fatigue scores across the axSpA spectrum.

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Practical Solutions and Benefits

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