Trends in fatigue in inflammatory rheumatic diseases: Annual data and trajectory analysis of the German National Database 2007-2023
Authors' conclusion
Fatigue affected a large proportion of both women and men across diagnoses. Fatigue trajectories reflect complex interplay of clinical and psychosocial factors.
Study context
- Population
- Patients with inflammatory rheumatic diseases (arthritides, SpA, connective tissue diseases, vasculitides), German National Database, 2007–2023per year
- Participants
- ≈9,300 patients
- Outcome
- Fatigue (NRS 0-10; >2 present, >6 severe)
Methodological detailsannual data, trajectory analysis over three consecutive visits
- Annual data
- Trajectory analysis over three consecutive visits
Main finding
As reported in the abstract
Fatigue prevalence across diagnoses
- Fatigue, AOSD (lowest)
- 55 %
- Fatigue, SSc (highest)
- 67 %
- Severe fatigue, up to (SSc)
- 26 %
- Moderate-to-severe fatigue, women
- 47-61 %
- Moderate-to-severe fatigue, men
- 35-52 %
Observational data: associations, not effects.
Further findings
Changes in inflammation-responsive outcomes and employment, 2007-2023
- CRP
- −40 %
- Tender joints
- −50 %
- Physician disease activity
- −42 %
- Employment
- 52 %→70 %
Fatigue trajectory clusters · three consecutive visits
%
- Persistent low
- 35
- Persistent high
- 23
- Worsening
- 24
- Improving
- 19
- Tender joints and morning stiffness discriminated persistent high vs low fatigue clusters
- Emotional well-being, physical functioning, coping and sleep quality more strongly associated with trajectories than inflammatory markers
- Differences across fatigue clusters substantially exceeded those between diagnostic groups
Original publication
Trends in fatigue in inflammatory rheumatic diseases: Annual data and trajectory analysis of the German National Database 2007-2023. Semin Arthritis Rheum. Published 11 December 2025. doi:10.
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