Fatigue in rheumatic diseases

Sandıkçı, Sevinç Can; Özbalkan, Zeynep

doi:10.5152/eurjrheum.2015.0029

Cited by 22 publications

(8 citation statements)

References 101 publications

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“…Our findings have important clinical implications. Firstly, clinicians can reassure their fatigued ANS patients that their fatigue does not indicate that they are at increased risk for imminent progression; secondly, the presence of significant fatigue should not prompt initiation of treatment with DMARDs; and thirdly, our findings suggest that treatments that have been shown to improve fatigue, such as exercise programs, promotion of good sleep hygiene, addressing life stressors and depression [54], or drug therapy for fibromyalgia, may be more appropriate therapies for these individuals.…”

Section: Discussionmentioning

confidence: 99%

Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease

et al. 2019

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BackgroundFatigue is a common symptom of systemic autoimmune rheumatic disease (SARD). Patients with SARD have a protracted pre-clinical phase during which progressive immunologic derangements occur culminating in disease. In this study, we sought to determine when fatigue develops and whether its presence correlates with inflammatory factors or predicts disease progression.MethodsAnti-nuclear antibody (ANA)-negative healthy controls (HCs) and ANA-positive participants with no criteria, at least one clinical criteria (undifferentiated connective tissue disease, UCTD), or meeting SARD classification criteria were recruited. Fatigue was assessed using a modified version of the FACIT-F questionnaire and the presence of fibromyalgia determined using a questionnaire based on the modified 2010 ACR criteria. Peripheral blood expression of five IFN-induced genes was quantified by NanoString and the levels of IL-1β, IL-6, or TNF-α by ELISA.ResultsFatigue was as prevalent and severe in individuals lacking SARD criteria as it was in UCTD and SARD. Overall, ~ 1/3 of ANA+ subjects met fibromyalgia criteria, with no differences between sub-groups. Although fatigue was more severe in these individuals, those lacking fibromyalgia remained significantly more fatigued than ANA− HC. However, even in these subjects, fatigue correlated with the widespread pain index and symptom severity scores on the fibromyalgia questionnaire. Fatigue was not associated with elevated cytokine levels in any of the ANA+ sub-groups and did not predict imminent disease progression.ConclusionsFatigue is common in ANA+ individuals lacking sufficient criteria for a SARD diagnosis, correlates with fibromyalgia-related symptoms, and is not associated with inflammation or predictive of disease progression.

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Section: Discussionmentioning

confidence: 99%

Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease

et al. 2019

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“…The precise biologic mechanism that leads to fatigue in RA remains unknown, but it is likely multifactorial, involving complex pathways [7]. Inflammation has been implicated in the pathobiology of fatigue since it is a common symptom in many chronic inflammatory diseases [8]. Therefore, reducing inflammation may reduce fatigue.…”

Section: Introductionmentioning

confidence: 99%

Effect of biologics and targeted synthetic disease-modifying anti-rheumatic drugs on fatigue in rheumatoid arthritis

Choy

2019

Rheumatology

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Fatigue is a common and debilitating symptom in patients with RA. Since 2007, fatigue has been included as one of the core outcome measures in RA. Clinical trials of biologic DMARDs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) have included fatigue as a secondary endpoint. A Cochrane review in 2016 concluded that the bDMARDs have a moderate effect on improving fatigue in RA. More recent clinical trials of the new biologic agent sarilumab and the Janus kinase inhibitors tofacitinib and baricitinib showed similar benefits. It remains unclear whether the effect of bDMARDs and tsDMARDs on fatigue is mediated by direct effects or through a reduction in inflammation. As fatigue was a secondary endpoint, many analyses did not adjust for potential confounding factors, including pain, mood and anaemia, which is a significant limitation.

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“…Other symptoms include body fatigue, cognitive dysfunction and sleep disturbance. [17][18][19][20][21] Fibromyalgia has been described in association with infectious, inflammatory and autoimmune diseases, with no clear consensus on its pathophysiology. The clinical presentation is often misleading, with no rigid criteria for diagnosis or treatment.…”

Section: Discussionmentioning

confidence: 99%

Risk of fibromyalgia in patients with primary muscle tension dysphonia: a possible local manifestation of a musculoskeletal systemic disorder

et al. 2023

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Objective. To investigate the risk of fibromyalgia in patients with primary muscle tension dysphonia. Methods. A retrospective review was conducted of patients with primary muscle tension dysphonia, diagnosed based on history of dysphonia with evidence of laryngeal muscle tension on examination. Fibromyalgia was assessed using the Fibromyalgia Rapid Screening Tool ('FiRST').Results. Fifty patients were enrolled: 25 with primary muscle tension dysphonia (study group) and 25 matched controls. The mean age of the study group was 50.7 ± 15.2 years versus 49.5 ± 18.6 years for the controls, with a male to female ratio of 3:2 for both groups. Fiftysix per cent tested positive for fibromyalgia in the study group versus 4 per cent in the controls ( p < 0.001). The mean Voice Handicap Index 10 score in the study group was significantly higher for those who screened positive for fibromyalgia compared to those who screened negative. There was a positive, strong point-biserial correlation between Fibromyalgia Rapid Screening Tool and Voice Handicap Index 10 scores (r = 0.39; p = 0.09). Conclusion. These results suggest that fibromyalgia is a significant co-morbid condition in primary muscle tension dysphonia.

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Fatigue in rheumatic diseases

Cited by 22 publications

References 101 publications

Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease

Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease

Effect of biologics and targeted synthetic disease-modifying anti-rheumatic drugs on fatigue in rheumatoid arthritis

Risk of fibromyalgia in patients with primary muscle tension dysphonia: a possible local manifestation of a musculoskeletal systemic disorder

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