Interventions for fatigue in inflammatory bowel disease

Farrell, Dawn; Savage, Eileen; Norton, Christine; Jelsness-Jørgensen, Lars-Petter; Czuber‐Dochan, Wladyslawa; Artom, Micol

doi:10.1002/14651858.cd012005

Cited by 18 publications

(29 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To our knowledge, no other studies on high‐dose thiamine and chronic fatigue in IBD have been published. Our findings therefore add an effective treatment option to the range of other possible interventions against chronic fatigue 5,6 …”

Section: Discussionmentioning

confidence: 79%

See 1 more Smart Citation

Randomised clinical trial: high‐dose oral thiamine versus placebo for chronic fatigue in patients with quiescent inflammatory bowel disease

Bager

Hvas

Rud

et al. 2020

Aliment Pharmacol Ther

View full text Add to dashboard Cite

SummaryBackgroundFatigue is a burdensome symptom for patients with inflammatory bowel disease (IBD). Few pharmacological interventions have documented effect on fatigue in patients with IBD. A pilot study indicated a 20‐day effect with high‐dose thiamine.AimsTo investigate the effect and safety of high‐dose oral thiamine (600‐1800 mg/d) based on gender and weight on chronic fatigue in patients with quiescent IBD.MethodsThis was a randomised, double‐blinded, placebo‐controlled crossover trial. Patients had quiescent IBD, severe chronic fatigue and no other explanation for fatigue. Patients were allocated 1:1 to either 1) high‐dose oral thiamine for 4 weeks, 4 weeks of washout, 4 weeks of oral placebo or 2) oral placebo for 4 weeks, 4 weeks of washout, 4 weeks of high‐dose oral thiamine. Fatigue was measured using the Inflammatory Bowel Disease‐Fatigue Questionnaire. The primary outcome was improvement (≥3 points) of fatigue after 4 weeks on thiamine.ResultsForty patients were enrolled between November 2018 and October 2019. Crossover analysis showed a mean reduction of 4.5 points (95% CI 2.6‐6.2) in fatigue after thiamine compared with a mean increase of 0.75 point (95% CI −1.3‐2.8; P = 0.0003) after placebo. Furthermore, 55% of group 1 and 75% of group 2 showed an improvement ≥ 3 points while on thiamine compared with 25% of group 1 and 35% of group 2 while on placebo. Only mild side effects were detected.ConclusionWe showed a significant beneficial effect of high‐dose oral thiamine on chronic fatigue in IBD. The treatment was well tolerated.Trial registration: NCT03634735.

show abstract

Section: Discussionmentioning

confidence: 79%

“…Only few interventions have documented effect of pharmacological interventions/measures to alleviate fatigue in patients with IBD 5,6 . Most interventions are of behavioural or psychological character.…”

Section: Introductionmentioning

confidence: 99%

Randomised clinical trial: high‐dose oral thiamine versus placebo for chronic fatigue in patients with quiescent inflammatory bowel disease

Bager

Hvas

Rud

et al. 2020

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…Anti‐stress management 45 and a solution‐focused therapy improved fatigue in IBD patients with a quiescent disease for a short period 21 . However, a recent Cochrane analysis 46 concluded that there exists only low evidence regarding efficacy of pharmacological or non‐pharmacological intervention in IBD. Most likely, a multi‐modal approach addressing inflammation, nutrition, psychiatric co‐morbidities and physical activity may be beneficial with specific interventions for severe cases, but the effectiveness of this approach needs to be addressed in future studies 26 …”

Section: Discussionmentioning

confidence: 99%

Fatigue in inflammatory bowel disease and its impact on daily activities

Schreiner

Rossel

Biedermann

et al. 2020

Aliment Pharmacol Ther

View full text Add to dashboard Cite

SummaryBackgroundFatigue is a common symptom of chronic inflammation, including inflammatory bowel disease (IBD), resulting in significant impairment in quality of life.AimsTo identify the prevalence of fatigue in a large IBD cohort compared to the general population, address risk factors, and evaluate its impact on daily life.MethodsWe evaluated 1208 IBD patients from the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS) and 414 healthy controls. Significant fatigue was defined as a visual analogue scale (VAS‐F, range 0‐10) score ≥ 4. Secondary endpoints were severity of fatigue and its impact on daily activities with the Fatigue Severity Scale (FSS), with a score ≥ 4 indicative of fatigue. Demographic, IBD‐related and psychiatric symptoms were assessed with a multivariate analysis of variance (MANOVA) model optimised for prediction of VAS‐F (primary outcome) and FSS scores.ResultsOverall, 672 IBD patients (55.6%) reported significant fatigue compared to 145 (35%) controls (OR 2.71; 95% CI 2.08‐3.54; P < 0.001). In IBD, fatigue also significantly affected daily activities (FSS ≥ 4; 405 (33.5%) IBD patients vs 81 (19.6%) controls, P < 0.001). In the MANOVA model, fatigue levels were associated with female gender (coefficient 0.839; 0.556 ‐ 1.123; P < 0.001), younger age at diagnosis (−0.031 per year; −0.042– −0.019; P < 0.001), shorter disease duration (−0.036 per year; −0.050– −0.022; P < 0.001), nocturnal diarrhoea (0.718; 0.295‐1.141; P = 0.001), low educational level (P = 0.034) and symptoms of depression and anxiety.ConclusionsFatigue is both more frequent and more severe in patients with IBD than in the general population.

show abstract

“…In instances where the fatigue is evidently related to a disease flare or other clinical problems, medical or surgical therapy may be beneficial. However, where there is no apparent explanation for fatigue, exploring psychosocial factors contributing to the onset and perpetuation of fatigue may be of value . It is important to regularly assess IBD patients for fatigue and to try and identify its possible cognitive–behavioural associates.…”

Section: Discussionmentioning

confidence: 99%

“…However, where there is no apparent explanation for fatigue, exploring psychosocial factors contributing to the onset and perpetuation of fatigue may be of value. 99 It is important to regularly assess IBD patients for fatigue and to try and identify its possible cognitivebehavioural associates. This could be the starting point in employing a holistic and systematic strategy for fatigue management.…”

Section: Discussionmentioning

confidence: 99%