Efficacy of pharmacological interventions: A systematic review informing the 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases

Farisogullari, Bayram; Santos, Eduardo José Ferreira; Dures, Emma; Geenen, Rinie; Machado, Pedro M.

Abstract

ObjectiveTo identify the best evidence on the efficacy of pharmacological interventions in reducing fatigue in people with inflammatory rheumatic and musculoskeletal diseases (I-RMDs) and to summarise their safety in the identified studies to inform European Alliance of Associations for Rheumatology recommendations for the management of fatigue in people with I-RMDs.MethodsSystematic review of adults with I-RMDs conducted according to the Cochrane Handbook. Search strategy ran in Medline, Embase, Cochrane Library, CINAHL Complete, PEDro, OTseeker and PsycINFO. Only randomised controlled trials (RCTs) or controlled clinical trials were eligible. Assessment of risk of bias, data extraction and synthesis performed by two reviewers independently and in duplicate. Data pooled in statistical meta-analyses.ResultsFrom 4151 records, 455 were selected for full-text review, 99 fulfilled the inclusion criteria and 19 RCTs were included in meta-analyses. Adalimumab was superior to placebo in reducing fatigue at 12 and 52 weeks in rheumatoid arthritis (RA) (n=3 and 2 RCTs; mean difference (MD)= -3.03, pConclusionsSeveral pharmacological interventions are efficacious and generally safe for managing fatigue in people with I-RMDs.

• Journal Article Type: Article
• Acceptance Date: Jul 14, 2023
• Online Publication Date: Dec 6, 2023
• Publication Date: Nov 1, 2023
• Deposit Date: Dec 7, 2023
• Publicly Available Date: Dec 8, 2023
• Journal: RMD open
• Electronic ISSN: 2056-5933
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 4
• Article Number: e003349
• DOI: https://doi.org/10.1136/rmdopen-2023-003349
• Keywords: Arthritis, Inflammation, Autoimmune diseases, Biological Therapy, Outcome Assessment, Health Care
• Public URL: https://uwe-repository.worktribe.com/output/11491437
• PMID: 38056919