Persistent fatigue affects many with IBD, even after clinical remission

  • J Crohns Colitis
  • 26 Aug 2019

  • International Clinical Digest
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Takeaway

  • Persistent fatigue is common in real-world patients with IBD, even among those achieving clinical remission with biologic therapy.

Why this matters

  • Clinicians should assess fatigue in patients with IBD and consider concomitant psychosocial symptoms such as sleep disturbance, depression, and anxiety, during routine patient care.

Study design

  • Researchers studied patients with Crohn's disease (CD; n=206) or ulcerative colitis (UC; n=120) initiating biologic therapy with a TNF blocker (n=122), vedolizumab (n=126), or ustekinumab (n=70).
  • They measured fatigue based on a 7-point question from the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) and used multivariable regression models to examine the association between clinical remission and fatigue resolution.
  • Funding: None.

Key results

  • 61% (n=198) of patients reported fatigue at baseline, particularly women and those with depression, active IBD, or disturbed sleep (P<.001>
  • 70% (n=86) of these patients remained fatigued at 14 weeks after initiating therapy, 63% (n=55) at 30 weeks, and 61% (n=44) at 54 weeks.
  • Patients who achieved clinical remission at these intervals were less likely to have persistent fatigue, but 35%, 30%, and 28% were still affected.

Limitations

  • Researchers validated the SIBDQ fatigue question, using patients with quiescent IBD.
  • Some patients discontinued biological therapy during the study.