Non-drug treatments effectively reduce disabling fatigue in patients with inflammatory rheumatic disorders such as rheumatoid arthritis, a new study finds. Investigators urge clinicians to include these therapies in patients’ treatment protocols.
Therapies are lacking for fatigue in rheumatic disease, which can remain disabling for some patients, even when other symptoms are addressed, according to the researchers. The new study aimed to find whether non-drug therapies can help to ease the problem, said investigators from the universities of Aberdeen and Glasgow in Scotland.
Two effective therapies
The investigators compared three different types of care administered to 368 patients with various inflammatory rheumatic diseases including RA, lupus and axial spondylitis. Two were found effective at reducing fatigue: personalized physical activity programs delivered via telephone and cognitive behavioral approaches.
Physical activity programs included an average of five 45-minute sessions over 30 weeks. The cognitive behavioral therapy group received an average of eight sessions over the same period. A usual-care cohort was given an educational pamphlet on how to manage fatigue.
Each therapy resulted in significantly improved fatigue for patients when compared to a study group that received usual care, the researchers found. Measurable improvements were also found in sleep and mental health-related quality of life. Benefits lasted six months after treatment was completed.
A poorly managed problem
The study presents possibilities for addressing fatigue with sustained results, especially during a pandemic, according to author Neil Basu, Ph.D., of the University of Glasgow. The problem is often poorly managed in these patients, he said.
“It has been encouraging to see that the interventions have led to improvements for participants even six months after the end of the treatment,” he said in a statement. “It’s also great to see that these steps were impactful even when delivered via telephone.”
The study is unique in that it looked at a variety of inflammatory rheumatic disorders, the researchers said. It is therefore “more aligned with the demands that would be put on a rheumatology service,” Basu and colleagues noted.
Full findings were published in the Lancet Rheumatology.
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