Professor Wan-Fai Ng has worked with colleagues to produce a review on fatigue as a symptom of inflammatory rheumatic diseases.

The review highlights current knowledge and what needs to be done to help move forward and help patients manage this symptom.

Fatigue is a serious and debilitating symptom of rheumatic conditions such as rheumatoid arthritis, psoriatic arthritis, primary Sjogren’s Syndromes, and systemic lupus erythematosus.

The mechanisms of fatigue are not fully understood, but possibly involve biological, physiological, psychosocial, and behavioural factors. These factors may vary over time and presently differently between each person.

Professor Fai Ng and colleagues propose that fatigue may reflect the body’s resource management strategy in response to chronic stressors, favouring rationing and storage over expenditure.

Research into fatigue

The review, written by Professor Fai Ng, Deputy Theme Lead for NIHR Newcastle BRC’s Musculoskeletal Disease, and colleagues from Newcastle Hospitals, Bristol Royal Infirmary and the University of the West of England, highlights that studying fatigue is challenging. There is no agreed consensus on a study framework for fatigue research, and a multidisciplinary approach is essential. Lastly, the review suggests that the best way to tackle the challenge of fatigue as a symptom, is to deliver a personalised and holistic approach to each individual.

Professor Ng comments:

This review consolidates our knowledge around fatigue, bringing in research, clinical perspectives and, most importantly, the accounts of so many people living with the symptoms of fatigue.

It provides a springboard for the next steps in how we can streamline this knowledge to identify the best areas to focus our research efforts.

Next steps

Prof Ng and colleagues are currently coordinating an EU Public-Private Partnership Consortium – IDEA-FAST. The aim is to find the best way to objectively measure fatigue, to complement the conventional questionnaire approach in patients with inflammatory rheumatic conditions as well as inflammatory bowel disease, Parkinson’s disease and Huntington’s disease.

The project proposes using a range of digital technologies to measure different biological, physiological and neurocognitive performance. The study will make a step change to our understanding of the disabling symptom that affects so many people with different chronic conditions.

Professor Ng and Dr Mark Baker were also recently awarded over £600,000 from the NIHR to find new treatments for patients with Long-COVID, entitled PAuSing-Post-COVID Fatigue.

Reference:

Davies, K., Dures, E. & Ng, WF. Fatigue in inflammatory rheumatic diseases: current knowledge and areas for future research. Nat Rev Rheumatol (2021).

https://doi.org/10.1038/s41584-021-00692-1