Background/Purpose Fatigue is the most common symptom in SLE patients with a strong impact on patients’ reported quality of life. Previous studies identified possible associations with fatigue with some contradictory results. The aim of this study was to identify additional potentially reversible associations with fatigue to generate targets for future interventions.

Methods Our study population consisted of 234 consecutively recruited SLE (1997 ACR criteria) outpatients from our university hospital based lupus reference centre. We analyzed clinical and demographic data from routine visits, laboratory variables, as well as sleeping disorders, disease perception, coping, social activities and health locus of control using validated questionnaires. We captured fatigue using the Fatigue Severity Scale (FSS). A score of ≥ 4 points is considered pathological. To assess depression, we used the German CES-D depression scale (values ≥ 23/60 points are considered pathological).

Results Our predominantly Caucasian cohort (99.1%) was mostly female (87.6%), with a mean age of 45.3 years (±13.4 [SD]) and a mean disease duration of 16.2 years (±9.5). In our cohort, 50.9% of patients reached a pathological result in the FSS. Depression was significantly associated with fatigue (p<0.001). Patients with poor health conditions (including sleeping disorders, pain, disease activity and damage) showed significantly more fatigue (p<0.01). Overall, in 71.4% of our SLE patients, we could identify at least one potentially reversible association for fatigue (shown in table 1).

Conclusion We observed a high prevalence of depressive disorders in our cohort and a significant correlation of depressive status with fatigue. Therefore, we suggest that psychological wellbeing is assessed in everyday clinical practice and treating physicians should react to patients’ needs accordingly. Additionally, obesity, anaemia, hypothyroidism and vitamin D deficiency can easily be assessed. Optimizing these factors represent possible targets in order to improve fatigue in SLE patients.