Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology Ankara, Turkey
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Emma Dures1, Bayram Farisogullari2, Eduardo Santos3, Anna Molto4, Caroline Feldthusen5, Claire Harris6, Corinna Elling-Audersch7, Deirdre Conolly8, Elena Elefante9, Fernando Estévez-López10, Ilaria Bini11, Jette Primdahl12, Kirsten Hoeper13, Marie Urban14, Mart van de Laar15, Marta Redondo16, Peter Böhm17, Raj Amarnani18, Rhys Hayward6, Rinie Geenen19, Simona Rednic20, Susanne Pettersson21, Tanja Thomsen22, Till Uhlig23, Valentin Ritschl24 and Pedro Machado25, 1Academic Rheumatology, Bristol Royal Infirmary; and Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom, 2Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey, 3Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal, 4HOPITAL COCHIN AP-HP, Service de Rhumatologie, Paris, France, 5Institute of Neuroscience and Physiology, University of Gothenburg, Department of Health and Rehabilitation, Unit of Physiotherapy, Sahlgrenska Academy, Gothenburg, Sweden, 6Northwick Park Hospital, London North West University Healthcare NHS Trust, Department of Rheumatology, London, United Kingdom, 7Deutsche Rheuma-Liga Bundesverband e.V., Patient Research Partner, Bonn, Germany, 8School of Medicine, Trinity College Dublin, Discipline of Occupational Therapy, Dublin, Ireland, 9Rheumatology Unit, Department of clinical and experimental medicine, University of Pisa, Pisa, Italy, 10Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, 11Anmar, Young, Rome, Italy, Rome, Italy, 12University Hospital of Southern Denmark, Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark, 13Hannover Medical School, Department of Rheumatology and Immunology, Hannover, Germany, 14University Hospitals Bristol, Research Design Service, Bristol, United Kingdom, 15University of Twente, Department of Psychology, Health and Technology, Enschede, Netherlands, 16Camilo José Cela University, Faculty of Heath Sciences, Madrid, Spain, 17German League against rheumatism, Forschungspartner, Bonn, Germany, 18Barts Health NHS Trust, Barts Health Rheumatology Service, London, United Kingdom, 19Utrecht University, Vorstenbosch, Netherlands, 20Prof Dr Simona Rednic, Cluj, Romania, 21Karolinska Institute, Division of Rheumatology, Department of Medicine Solna, Stockholm, Sweden, 22University of Copenhagen, Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases VRR, Rigshospitalet, Copenhagen, Denmark, 23Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway, 24Medical University of Vienna, Vienna, Austria, 25Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK. Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS trust, London, UK., London, United Kingdom
Background/Purpose: Fatigue is prevalent in people with inflammatory rheumatic and musculoskeletal diseases (I-RMDs) and recognized as one of the most challenging symptoms to manage (1). The existence of multiple factors that are correlated with fatigue, the lack of clarity around causal pathways and the evidence about what helps has led to a multifaceted approach to symptom management. However, there are no recommendations for fatigue management in people with I-RMDs. This lack of guidance is difficult for those living with fatigue and for healthcare professionals delivering clinical care.
Methods: A multi-disciplinary taskforce comprising 26 members from 14 European countries was convened and two systematic reviews (SRs) were conducted. The taskforce developed the recommendations based on the SR evidence and taskforce members' personal and professional experience of fatigue in I-RMDs.
Results: Four overarching principles and four recommendations were developed, which include health professionals' awareness that fatigue should be monitored and assessed, and people with I-RMDs should be offered management options. Shared decisions about fatigue management should consider the individual's needs and preferences, as well as their clinical disease activity, comorbidities and other psychosocial and contextual factors (Table).
Conclusion: These 2023 EULAR recommendations provide consensus and up-to-date guidance on the management of fatigue in people with I-RMDs.
E. Dures: None; B. Farisogullari: None; E. Santos: None; A. Molto: None; C. Feldthusen: None; C. Harris: None; C. Elling-Audersch: None; D. Conolly: None; E. Elefante: None; F. Estévez-López: None; I. Bini: None; J. Primdahl: None; K. Hoeper: None; M. Urban: None; M. van de Laar: Eli Lilly, 5, 6; M. Redondo: None; P. Böhm: None; R. Amarnani: None; R. Hayward: AbbVie/Abbott, 6; R. Geenen: None; S. Rednic: None; S. Pettersson: None; T. Thomsen: None; T. Uhlig: Galapagos, 2, 6, Lilly, 2, 6, Novartis, 2, 6, Pfizer, 2, 6, UCB, 2, 6; V. Ritschl: None; P. Machado: AbbVie/Abbott, 2, 6, Bristol-Myers Squibb(BMS), 2, 6, Celgene, 2, 6, Eli Lilly, 2, 6, Galapagos, 2, 6, Janssen, 2, 6, Merck/MSD, 2, 6, Novartis, 2, 6, Orphazyme, 2, 6, Pfizer, 2, 6, Roche, 2, 6, UCB, 2, 6.