Background and aims: Pain and fatigue are prevalent and impair quality of life in people with Rheumatoid Arthritis (RA). They might be caused by multiple and overlapping mechanisms. We examined the relationship between pain and fatigue in early RA. 
Methods: Baseline data were examined from the Early Rheumatoid Arthritis Network inception cohort. Pain and fatigue were measured with normed SF36 Bodily Pain and Vitality subscales respectively. Other variables included SF36 Mental Health (MH), Health Assessment Questionnaire (HAQ), Erythrocyte Sedimentation Rate (ESR), Haemoglobin Concentration (Hb), Swollen Joint Count (SJC), Tender Joint Count (TJC), Patient's Global Assessment of Disease Activity (PGA), Seropositivity and demographics. Multiple linear regression was utilized.
Results: ERAN participants comprised 67% female with a mean age of 57y. Mean pain and fatigue scores were 34 (SD±10) and 42(SD±11) respectively, indicating worse quality of life compared to the UK population average. Worse fatigue was associated with worse pain, in unadjusted model (β = 0.56 CI, 0.52 - 0.62) and after adjusting for the effects of HAQ, PGA, TJC and MH (β = 0.20 CI, 0.13 - 0.28, Adjusted R2 = 0.48). This association was not explained by inflammatory variables e.g. ESR and Seropositivity. 
Conclusions: Fatigue is associated with pain, independent of inflammation in patients with early RA. Longitudinal studies are required to explore the temporality of this relationship. Treatments that help manage pain and fatigue, in addition to those reducing inflammation, might improve quality of life in people with RA.

PAIN AND FATIGUE IN EARLY RHEUMATOID ARTHRITIS - A CROSS-SECTIONAL STUDY