2023 EULAR Recommendations for the Management of Fatigue in People with Inflammatory Rheumatic and Musculoskeletal Diseases

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

Meeting: ACR Convergence 2023

Keywords: autoimmune diseases, exercise, Fatigue, Health policy, Tumor necrosis factor (TNF)

Session Information

Date: Tuesday, November 14, 2023

Title: (2019–2038) Patient Outcomes, Preferences, & Attitudes Poster III

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

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.

Disclosures: 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.

To cite this abstract in AMA style:

Dures E, Farisogullari B, Santos E, Molto A, Feldthusen C, Harris C, Elling-Audersch C, Conolly D, Elefante E, Estévez-López F, Bini I, Primdahl J, Hoeper K, Urban M, van de Laar M, Redondo M, Böhm P, Amarnani R, Hayward R, Geenen R, Rednic S, Pettersson S, Thomsen T, Uhlig T, Ritschl V, Machado P. 2023 EULAR Recommendations for the Management of Fatigue in People with Inflammatory Rheumatic and Musculoskeletal Diseases [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/2023-eular-recommendations-for-the-management-of-fatigue-in-people-with-inflammatory-rheumatic-and-musculoskeletal-diseases/. Accessed .

« Back to ACR Convergence 2023

ACR Meeting Abstracts - https://acrabstracts.org/abstract/2023-eular-recommendations-for-the-management-of-fatigue-in-people-with-inflammatory-rheumatic-and-musculoskeletal-diseases/