Understanding Fatigue in Primary Biliary Cholangitis
Background Fatigue affects 50% of primary biliary cholangitis patients and is severe in approximately 20%, significantly affecting quality of life. The pathogenesis of fatigue in primary biliary cholangitis is poorly understood. This study aimed to explore subgroups of fatigue to support targeting o...
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Veröffentlicht in: | Digestive diseases and sciences 2021-07, Vol.66 (7), p.2380-2386 |
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description | Background
Fatigue affects 50% of primary biliary cholangitis patients and is severe in approximately 20%, significantly affecting quality of life. The pathogenesis of fatigue in primary biliary cholangitis is poorly understood. This study aimed to explore subgroups of fatigue to support targeting of selected groups in future clinical trials.
Methods
Data were derived from the UK-PBC cohort. Participants completed the PBC-40, Hospital Anxiety and Depression Score, Epworth Sleepiness Scale, and Orthostatic Grading Scale for symptoms assessment. Fatigue and cognitive symptoms were regarded as clinically significant if they exceeded the previously defined cutoff for “moderate” symptom.
Results
Of 2002, patients for whom full PBC-40, fatigue, and cognitive symptom domain scores were available, 1203 (60%) had significant fatigue and 730 (36%) had significant cognitive symptoms. Among the 1203 patients with significant fatigue, 663 (55%) also had significant cognitive symptoms (termed fatigue with cognitive symptoms) with a significant linear association between the fatigue and cognitive symptom severity. “Fatigue with cognitive symptoms” patients were younger and more likely to have severe fatigue. They also experienced greater social and emotional impact.
Conclusions
Fatigue in PBC is complex, and there has been no progress to date in identifying therapies able to improve it. One factor in slow progress may be the heterogeneity of patients describing fatigue complicating effective cohort selection for clinical trials. This study has identified potential discrete subgroups of fatigued patients with and without cognitive symptoms. The group of patients expressing “fatigue with cognitive symptoms” was homogenous and may represent a coherent cohort for clinical trials. |
doi_str_mv | 10.1007/s10620-020-06502-0 |
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Fatigue affects 50% of primary biliary cholangitis patients and is severe in approximately 20%, significantly affecting quality of life. The pathogenesis of fatigue in primary biliary cholangitis is poorly understood. This study aimed to explore subgroups of fatigue to support targeting of selected groups in future clinical trials.
Methods
Data were derived from the UK-PBC cohort. Participants completed the PBC-40, Hospital Anxiety and Depression Score, Epworth Sleepiness Scale, and Orthostatic Grading Scale for symptoms assessment. Fatigue and cognitive symptoms were regarded as clinically significant if they exceeded the previously defined cutoff for “moderate” symptom.
Results
Of 2002, patients for whom full PBC-40, fatigue, and cognitive symptom domain scores were available, 1203 (60%) had significant fatigue and 730 (36%) had significant cognitive symptoms. Among the 1203 patients with significant fatigue, 663 (55%) also had significant cognitive symptoms (termed fatigue with cognitive symptoms) with a significant linear association between the fatigue and cognitive symptom severity. “Fatigue with cognitive symptoms” patients were younger and more likely to have severe fatigue. They also experienced greater social and emotional impact.
Conclusions
Fatigue in PBC is complex, and there has been no progress to date in identifying therapies able to improve it. One factor in slow progress may be the heterogeneity of patients describing fatigue complicating effective cohort selection for clinical trials. This study has identified potential discrete subgroups of fatigued patients with and without cognitive symptoms. The group of patients expressing “fatigue with cognitive symptoms” was homogenous and may represent a coherent cohort for clinical trials.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-020-06502-0</identifier><identifier>PMID: 32851498</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Biochemistry ; Cholagogues and Choleretics - therapeutic use ; Cholangitis ; Clinical trials ; Cohort Studies ; Depression, Mental ; Fatigue ; Fatigue - etiology ; Female ; Gastroenterology ; Hepatology ; Humans ; Liver Cirrhosis, Biliary - complications ; Liver Cirrhosis, Biliary - drug therapy ; Male ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Neurophysiology ; Oncology ; Original Article ; Transplant Surgery ; Ursodeoxycholic Acid - therapeutic use</subject><ispartof>Digestive diseases and sciences, 2021-07, Vol.66 (7), p.2380-2386</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>COPYRIGHT 2021 Springer</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-110a5ed20276f6bef5213d87cd820a2256da0821a67ae2b542d130536c8ad9943</citedby><cites>FETCH-LOGICAL-c442t-110a5ed20276f6bef5213d87cd820a2256da0821a67ae2b542d130536c8ad9943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-020-06502-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-020-06502-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32851498$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Phaw, Naw April</creatorcontrib><creatorcontrib>Dyson, Jessica Katharine</creatorcontrib><creatorcontrib>Mells, George</creatorcontrib><creatorcontrib>Jones, David</creatorcontrib><title>Understanding Fatigue in Primary Biliary Cholangitis</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background
Fatigue affects 50% of primary biliary cholangitis patients and is severe in approximately 20%, significantly affecting quality of life. The pathogenesis of fatigue in primary biliary cholangitis is poorly understood. This study aimed to explore subgroups of fatigue to support targeting of selected groups in future clinical trials.
Methods
Data were derived from the UK-PBC cohort. Participants completed the PBC-40, Hospital Anxiety and Depression Score, Epworth Sleepiness Scale, and Orthostatic Grading Scale for symptoms assessment. Fatigue and cognitive symptoms were regarded as clinically significant if they exceeded the previously defined cutoff for “moderate” symptom.
Results
Of 2002, patients for whom full PBC-40, fatigue, and cognitive symptom domain scores were available, 1203 (60%) had significant fatigue and 730 (36%) had significant cognitive symptoms. Among the 1203 patients with significant fatigue, 663 (55%) also had significant cognitive symptoms (termed fatigue with cognitive symptoms) with a significant linear association between the fatigue and cognitive symptom severity. “Fatigue with cognitive symptoms” patients were younger and more likely to have severe fatigue. They also experienced greater social and emotional impact.
Conclusions
Fatigue in PBC is complex, and there has been no progress to date in identifying therapies able to improve it. One factor in slow progress may be the heterogeneity of patients describing fatigue complicating effective cohort selection for clinical trials. This study has identified potential discrete subgroups of fatigued patients with and without cognitive symptoms. The group of patients expressing “fatigue with cognitive symptoms” was homogenous and may represent a coherent cohort for clinical trials.</description><subject>Aged</subject><subject>Biochemistry</subject><subject>Cholagogues and Choleretics - therapeutic use</subject><subject>Cholangitis</subject><subject>Clinical trials</subject><subject>Cohort Studies</subject><subject>Depression, Mental</subject><subject>Fatigue</subject><subject>Fatigue - etiology</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Liver Cirrhosis, Biliary - complications</subject><subject>Liver Cirrhosis, Biliary - drug therapy</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Neurophysiology</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Transplant Surgery</subject><subject>Ursodeoxycholic Acid - therapeutic use</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtr3DAUhUVISSaPP9BFGcgmG6dXV08v0yGTFALtolkLjSU7Ch45lexF_31lnActpYjLFdJ3Lkc6hHykcEUB1OdMQSJUMJcUgBUckBUVilUopD4kK6Cy7CmVx-Qk5ycAqBWVR-SYoRaU13pF-EN0PuXRRhdit97aMXSTX4e4_p7C3qZf6y-hD3PfPA69jV0YQz4jH1rbZ3_-0k_Jw_bmx-auuv92-3VzfV81nONYUQpWeIeASrZy51uBlDmtGqcRLBaTzoJGaqWyHneCo6MMBJONtq6uOTsll8vc5zT8nHwezT7kxvfFhx-mbJAzpXmNOKMXf6FPw5RicWdQcIG65lK9U53tvQmxHcZkm3mouVYUa8a4nqmrf1BlOb8PzRB9G8r5HwJcBE0ack6-Nc_L5xkKZo7KLFEZmGuOykARfXpxPO323r1JXrMpAFuAXK5i59P7k_4z9jeLMJo4</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Phaw, Naw April</creator><creator>Dyson, Jessica Katharine</creator><creator>Mells, George</creator><creator>Jones, David</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20210701</creationdate><title>Understanding Fatigue in Primary Biliary Cholangitis</title><author>Phaw, Naw April ; Dyson, Jessica Katharine ; Mells, George ; Jones, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-110a5ed20276f6bef5213d87cd820a2256da0821a67ae2b542d130536c8ad9943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Biochemistry</topic><topic>Cholagogues and Choleretics - therapeutic use</topic><topic>Cholangitis</topic><topic>Clinical trials</topic><topic>Cohort Studies</topic><topic>Depression, Mental</topic><topic>Fatigue</topic><topic>Fatigue - etiology</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Liver Cirrhosis, Biliary - complications</topic><topic>Liver Cirrhosis, Biliary - drug therapy</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Neurophysiology</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Transplant Surgery</topic><topic>Ursodeoxycholic Acid - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Phaw, Naw April</creatorcontrib><creatorcontrib>Dyson, Jessica Katharine</creatorcontrib><creatorcontrib>Mells, George</creatorcontrib><creatorcontrib>Jones, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Phaw, Naw April</au><au>Dyson, Jessica Katharine</au><au>Mells, George</au><au>Jones, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Understanding Fatigue in Primary Biliary Cholangitis</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>66</volume><issue>7</issue><spage>2380</spage><epage>2386</epage><pages>2380-2386</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><abstract>Background
Fatigue affects 50% of primary biliary cholangitis patients and is severe in approximately 20%, significantly affecting quality of life. The pathogenesis of fatigue in primary biliary cholangitis is poorly understood. This study aimed to explore subgroups of fatigue to support targeting of selected groups in future clinical trials.
Methods
Data were derived from the UK-PBC cohort. Participants completed the PBC-40, Hospital Anxiety and Depression Score, Epworth Sleepiness Scale, and Orthostatic Grading Scale for symptoms assessment. Fatigue and cognitive symptoms were regarded as clinically significant if they exceeded the previously defined cutoff for “moderate” symptom.
Results
Of 2002, patients for whom full PBC-40, fatigue, and cognitive symptom domain scores were available, 1203 (60%) had significant fatigue and 730 (36%) had significant cognitive symptoms. Among the 1203 patients with significant fatigue, 663 (55%) also had significant cognitive symptoms (termed fatigue with cognitive symptoms) with a significant linear association between the fatigue and cognitive symptom severity. “Fatigue with cognitive symptoms” patients were younger and more likely to have severe fatigue. They also experienced greater social and emotional impact.
Conclusions
Fatigue in PBC is complex, and there has been no progress to date in identifying therapies able to improve it. One factor in slow progress may be the heterogeneity of patients describing fatigue complicating effective cohort selection for clinical trials. This study has identified potential discrete subgroups of fatigued patients with and without cognitive symptoms. The group of patients expressing “fatigue with cognitive symptoms” was homogenous and may represent a coherent cohort for clinical trials.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32851498</pmid><doi>10.1007/s10620-020-06502-0</doi><tpages>7</tpages></addata></record> |
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subjects | Aged Biochemistry Cholagogues and Choleretics - therapeutic use Cholangitis Clinical trials Cohort Studies Depression, Mental Fatigue Fatigue - etiology Female Gastroenterology Hepatology Humans Liver Cirrhosis, Biliary - complications Liver Cirrhosis, Biliary - drug therapy Male Medical research Medicine Medicine & Public Health Medicine, Experimental Middle Aged Neurophysiology Oncology Original Article Transplant Surgery Ursodeoxycholic Acid - therapeutic use |
title | Understanding Fatigue in Primary Biliary Cholangitis |
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