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Fatigue and rheumatoid arthritis.
1Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Institut de Rhumatologie, Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. anne.mayoux-benhamou@cch.ap-hop-paris.fr
Summary
Rheumatoid arthritis (RA) fatigue is a chronic, complex condition impacting quality of life, often linked to psychosocial factors. Improved assessment and management strategies, including therapies and exercise, are crucial for patient well-being.
Area of Science:
- Rheumatology
- Clinical Medicine
- Psychosomatic Medicine
Background:
- Fatigue is a prevalent extra-articular symptom in rheumatoid arthritis (RA), significantly affecting patients' quality of life.
- RA-related fatigue is distinct from normal tiredness, characterized by chronicity, lack of relation to exertion, and poor relief with rest.
- Despite its impact, the multidimensional nature of RA-related fatigue and its consequences are often overlooked by healthcare teams.
Purpose of the Study:
- To highlight the multidimensional nature of rheumatoid arthritis (RA)-related fatigue.
- To underscore the association between RA-related fatigue and psychosocial factors.
- To emphasize the need for improved assessment and management strategies for RA-related fatigue.
Main Methods:
- Review of existing literature on fatigue assessment in RA.
- Analysis of instruments used for fatigue assessment, including self-reporting questionnaires.
- Examination of pharmacological (DMARDs, anti-TNF) and non-pharmacological (behavioral therapy, exercise) management approaches.
Main Results:
- RA-related fatigue is strongly associated with psychosocial factors, indicating a complex interplay of psychological and physiological elements.
- Disease-modifying antirheumatic drug (DMARD) therapy, particularly anti-tumor necrosis factor (anti-TNF) agents, can decrease disease activity and alleviate fatigue.
- Various self-reporting instruments exist for fatigue assessment, ranging from brief, symptom-focused questionnaires to multidimensional assessments.
Conclusions:
- Fatigue is a critical outcome measure in RA research and practice, necessitating comprehensive management strategies.
- Integrated management approaches combining pharmacological treatments, behavioral therapies, and physical exercise are essential for addressing RA-related fatigue.
- Further research and clinical attention are required to improve the recognition and effective management of fatigue in rheumatoid arthritis patients.