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
Authors' conclusion
Several pharmacological interventions are efficacious and generally safe for managing fatigue in people with I-RMDs.
Study context
- Population
- Adults with inflammatory rheumatic and musculoskeletal diseases (I-RMDs)99 studies
- Comparison
- Pharmacological interventions vs placebo for fatigue
- Outcome
- Reduction in fatigue
Methodological detailsconducted according to the Cochrane Handbook, randomised controlled trials (RCTs) or controlled clinical trials eligible, risk of bias, data extraction and synthesis by two reviewers independently and in duplicate
- Conducted according to the Cochrane Handbook
- RCTs or controlled clinical trials eligible
- Risk of bias, data extraction and synthesis by two reviewers independently and in duplicate
Pooled result
As reported in the abstract
Fatigue reduction vs placebo in rheumatoid arthritis (RA)
- Adalimumab · 12 weeks; n=3 RCTs
- MD −3.03; P < 0.001
- Adalimumab · 52 weeks; 2 RCTs
- MD −2.25; P = 0.03
- Golimumab · 24 weeks; n=2 RCTs
- MD −5.27; P < 0.001
- Baricitinib · 24 weeks; n=2 RCTs
- MD −4.06; P < 0.001
- Sarilumab · 24 weeks; n=2 RCTs
- MD −3.15; P < 0.001
- Tocilizumab · 24 weeks; n=3 RCTs
- MD −3.69; P < 0.001
- Tofacitinib · 12 weeks; n=3 RCTs
- MD −4.44; P < 0.001
Further pooled results
| Outcome | MD | P value |
|---|---|---|
| Fatigue reduction vs placebo in SpA (excluding PsA) · 16 weeksn=2 RCTs | −4.15 | P < 0.001 |
Fatigue reduction vs placebo in SpA (excluding PsA) · 16 weeks
- Dose/effect relationship also observed
Narrative results of RCTs not meta-analysed
- Several other pharmacological interventions efficacious in reducing fatigue
Original publication
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. RMD Open. Published 6 December 2023. doi:10.
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