New onset fatigue develops in 26% of patients with IBD at 6 months
The substantial impact of fatigue on patients with inflammatory bowel disease.
Fatigue is an important, disabling but understudied problem in IBD,” Ashwin N. Ananthakrishnan, MD, MPH, associate professor of medicine, Massachusetts General Hospital, told Healio Gastroenterology and Liver Disease. “Some of this is explained by active inflammation, but many continue to experience fatigue even as their inflammation-related symptoms resolve suggesting other underlying mechanisms that need to be understood.”
Ananthakrishnan and colleagues performed a prospective study of 2,429 patients with IBD who completed a questionnaire that evaluated fatigue status at baseline, and 1,057 of whom completed a second assessment at 6 months. Researchers used the validated Functional Assessment of Chronic Illness Therapy-Fatigue score to assess fatigue. Significant fatigue was a FACIT-F score less than 43. Incident fatigue (not fatigued as baseline but fatigued at 6 months) and resolved fatigue (fatigue at baseline but resolved on follow-up) were assessed.
Results showed the most common fatigue was episodic fatigue that affected 1,182 patients (57%). Persistent fatigue (at both baseline and follow-up) affected 695 patients (33.35%) compared with 196 (9.5%) patients who reported no fatigue at any time point. Investigators noted patients who reported persistent or intermittent fatigue had active disease, were younger, reported anemia, low vitamin B12 levels and had prior diagnosis of depression, anxiety or sleep disorder. At 6 months, 26% of patients who reported no fatigue at baseline developed new fatigue. Presence of sleep disturbance at baseline was the strongest predictor for new fatigue (OR = 2.45; 95% CI 0.24–1.55).
Investigators observed symptom resolution at 6 months in 12.3% of patients with fatigue at baseline. Resolution of fatigue was more common among patients with UC (P = .03), quiescent disease at baseline (P = .006), those who did not receive biologic therapy at baseline (P = .016) and absence of sleep disturbance (P < .001), anxiety (P = .002) and depressive (P = .005) symptoms at baseline, according to researchers.
Read New onset fatigue develops in 26% of patients with IBD at 6 months by Monica Jaramillo.