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
Hauptverfasser: Phaw, Naw April, Dyson, Jessica Katharine, Mells, George, Jones, David
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creator Phaw, Naw April
Dyson, Jessica Katharine
Mells, George
Jones, David
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.
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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 &amp; 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. 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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 &amp; 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 &amp; 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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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source MEDLINE; Springer Nature - Complete Springer Journals
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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