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RA patients may need specific treatment for fatigue

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Many people with rheumatoid arthritis (RA) experience persistent fatigue which may need to be treated separately, according to a recent study.

Researchers at the University of Aberdeen found that some patients are vulnerable to continued fatigue even when other symptoms have been successfully treated.

The study, published in the journal Rheumatology, is based on data from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis. Among participants with severe baseline fatigue, the researchers identified those who experienced disease remission after six months of treatment, and evaluated fatigue response according to partial or complete remission at follow-up.

Demographic, clinical and psychosocial characteristics were compared between those who responded to treatment those who did not.

Severe baseline fatigue was reported by 2,652 participants, of whom 271 (10%) achieved disease remission after six months. In total, 225 participants (83%) reported partial remission but only 37.3% of those whose RA symptoms went into remission saw their fatigue completely alleviate.

In addition to reporting clinically poorer health status, these patients tended to have a history of hypertension, depression and stroke as well as baseline treatment use of steroids and antidepressants.

The findings suggest that patients who suffer from persistent fatigue could be identified and offered a more tailored treatment approach, said Arthritis Research UK, reporting on the study.

The researchers concluded: “Despite achieving clinical remission, many RA patients do not achieve complete remission of their fatigue. Therefore, despite being important in overall disease control, reductions in disease activity are not always sufficient to ameliorate fatigue, so other symptom-specific management approaches must be considered for those for whom fatigue does not resolve.”

Richard Francis, head of research and evaluation at Arthritis Research UK, commented: “It will be extremely disheartening for those people who achieve remission to continue experiencing fatigue, which can be particularly debilitating and difficult to talk about.

“This study highlights the need for better treatments for fatigue, which can be used alongside existing medication. We need to ensure fatigue has recognition from medical professionals so people can get the care they require.”