PHARMACOLOGICAL TREATMENTS FOR FATIGUE IN INFLAMMATORY BOWEL DISEASE PATIENTS: AN INTEGRATIVE REVIEW

In patients with Inflammatory Bowel Disease (IBD), fatigue is a debilitating problem and may be associated with sleep disturbance, anxiety, depression, anemia, use of systemic steroids and active phase of the disease. In addition, fatigue also affects the working conditions of these patients, as it is associated with absenteeism and is a reason for time off work, surpassing medical appointments and abdominal pain. Currently, there are no well-established pharmacological therapies for fatigue, making it a subject of growing research interest.

This study aimed to conduct an integrative review of pharmacological treatments for fatigue in patients with IBD.

Inclusion criteria included full articles published from January 1, 2017 to December 31, 2024. Eligible studies had to include fatigue assessment as a primary objective and discuss pharmacological treatments for fatigue in IBD patients.The databases used were PubMed, Lilacs, SciElo and Cochrane and the descriptors were (inflammatory bowel disease) AND (fatigue) AND (drug therapy).

Total of 294 studies were identified, of which ten met the inclusion criteria, comprising 2,935 patients (1,664 with Crohn's disease, 1,215 with ulcerative colitis, and 56 with irritable bowel syndrome). Vitamin B12 has not demonstrated efficacy in alleviating fatigue in IBD patients. High doses of oral thiamine reduce fatigue, but studies using a dose of 300 mg/day of thiamine have not shown the same effect. Fatigue symptoms have been reduced with the use of vedolizumab, upadacitinib and modafinil. Studies assessing pharmacological treatments for fatigue in IBD remain limited, and available data are still insufficient. Establishing effective pharmacological therapies for fatigue in these patients may lead to better physical and emotional well-being, enhanced social interactions and employability, and reduced financial burdens associated with fatigue management. Further randomized clinical trials and systematic reviews are necessary to advance the understanding of pharmacological interventions for fatigue in IBD.