Non-biologic pharmaceutical interventions for fatigue in rheumatoid arthritis (original) (raw)
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Rheumatology, 2019
Non-pharmacological interventions may be beneficial in the management of rheumatoid arthritis related fatigue. A narrative review was undertaken, with a focus upon research published in the past 6 years. Seven studies were identified, four focusing upon physical activity, two on psychosocial interventions and one that investigated aromatherapy and reflexology. Findings supported previous evidence that physical activity and psychosocial interventions have potential to produce small to moderate reductions in fatigue related to rheumatoid arthritis. Reflexology and aromatherapy interventions also appeared promising. Limitations to the evidence included lack of consistency in fatigue measurement, and minimal data on long-term outcomes and cost effectiveness. The wide range of physical activity interventions prevent specific recommendations. For psychosocial interventions the strongest evidence is for group-based cognitive behavioural approaches. There was lack of consideration given to ...
Clinical Rheumatology, 2008
To describe rheumatologists' knowledge, attitude and current management of fatigue in patients with rheumatoid arthritis (RA), a postal questionnaire was sent to all rheumatologists (N=204) and trainees (N=49), members of the Dutch Society of Rheumatology. The overall response rate was 44% (N =110). In general, rheumatologists' knowledge about RA-related fatigue was in accordance with the literature but they perceive a lack of their own knowledge about aetiology and evidence-based interventions to prevent and treat fatigue. The majority of the rheumatologists believe that fatigue is a multi-disciplinary diagnosis and is preferably managed by the nurse specialist (34%). Assuming that the patient will raise the issue, most of the rheumatologists pay attention to fatigue during the first consultation and less often during follow-up consultations. There is a need for knowledge about causes and treatments for RA-related fatigue to ensure that patient outcomes are improved.
The Assessment of Fatigue in Rheumatoid Arthritis Patients and Its Impact on Their Quality of Life
Clinics and Practice
Introduction: Rheumatoid arthritis (RA) is a common autoimmune illness that manifests mostly as chronic, symmetric, and progressive polyarthritis with a global frequency of 0.3–1.0%. RA is a disease that affects people all over the world. In India, the prevalence is estimated to be 0.7%, with around 10 million persons suffering from RA. Most people with rheumatoid arthritis experience fatigue on most days, with over 70% experiencing symptoms similar to chronic fatigue syndrome. Patients rate fatigue as a top priority and believe this unmanageable symptom is ignored by clinicians; a systematic review shows the biological agents for RA inflammation have only a small effect on fatigue. Fatigue predicts and reduces the quality of life, and it is as difficult to cope with as pain. Physicians have traditionally concentrated on the inflammatory aspects of the illness (e.g., synovitis), whereas RA patients have prioritized pain, exhaustion, sleep difficulties, and other quality-of-life issu...
Fatigue in persons with rheumatoid arthritis
2015
Fatigue is a prominent symptom in persons with rheumatoid arthritis (RA) with great impact on daily life. Despite the improvement in pharmacological treatment of RA over the last decades, a large number of persons with RA experience consequences from fatigue. From a patient perspective, fatigue is established as one of the most important symptoms to address in rheumatology. The overall aim of this thesis was to search for deeper knowledge about fatigue in persons with RA of working age and to evaluate a person-centered physical therapy treatment to reduce fatigue and its consequences on daily life. Specific aims of the studies included in the thesis were: To describe how persons with RA experience and manage their fatigue in daily life. To investigate variations in fatigue levels reported by persons with RA at seven different time-points during the four seasons. To investigate how disease-related aspects contribute to the variation in general fatigue and multiple aspects of fatigue ...
Fatigue and factors related to fatigue in rheumatoid arthritis: a systematic review
2012
ABSTRACT Objective Patients with rheumatoid arthritis (RA) complain about fatigue. However, little is still known about causes and consequences of fatigue. A fully developed theoretical model explaining the experience of fatigue in RA is lacking. Goal of this study was to systematically review studies in RA that examined factors related to fatigue and differences in fatigue between RA patients and other patient groups, to gain more insight in possible causes and consequences of fatigue in RA.
Persistent severe fatigue in patients with rheumatoid arthritis
Journal of Clinical Nursing, 2007
2AE83, respectively] in this group of rheumatoid arthritis patients with a low-tomoderate level of disease activity and disability. Conclusion. The data show that severe fatigue is not resolved spontaneously in rheumatoid arthritis patients, and persistent severe fatigue is mainly predicted by general health and disability. The relation with inflammation or a low level of haemoglobin, which is often assumed in clinical practice, was not found. Relevance to clinical practice. Fatigue in patients with rheumatoid arthritis has to be considered as a symptom that needs to be addressed by professionals in the same way as pain and disability. In current care, fatigue is insufficiently addressed.
Rheumatology and therapy, 2017
A post hoc analysis of three randomized controlled trials of abatacept in rheumatoid arthritis (RA) was conducted to explore the effect of abatacept on fatigue in RA and its correlation with other outcomes. In this analysis of AGREE (early RA) and AIM and ATTAIN (established RA), changes in baseline fatigue (0-100 mm scale), pain, sleep (AIM and ATTAIN only) and Disease Activity Score (DAS) 28 (C-reactive protein; CRP) were calculated at days 29, 85, and 169. Agreement between improvements ≥minimum clinically important differences (MCID) in fatigue and other outcomes were evaluated using agreement statistics (kappa) in each study and at each time point. Of 1536 patients (mean disease duration: 6.2 months [AGREE], 8.5 years [AIM], 12.2 years [ATTAIN]), mean (SE) decreases in fatigue from baseline to day 169 with abatacept were 28.9 (1.7), 25.3 (1.2), and 21.9 (1.6) in AGREE, AIM, and ATTAIN, respectively, with corresponding decreases of 16.0, 13.7, and 13.4 at day 29. Most patients (...