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Non-drug Treatments Reduce Fatigue in Patients With Inflammatory Rheumatic Disorders

In June 27, 2022, Lancet published an article titled “Remotely delivered cognitive behavioural and personalised exercise interventions for fatigue severity and impact in inflammatory rheumatic diseases (LIFT): a multicentre, randomised, controlled, open-label, parallel-group trial.”

The study found that non-drug treatments effectively reduce disabling fatigue in patients with inflammatory rheumatic disorders such as rheumatoid arthritis (RA).

The investigators from the Universities of Aberdeen and Glasgow in Scotland compared three different types of care administered to 368 patients with various inflammatory rheumatic conditions including not just RA, but also lupus and axial spondylitis. Two were found effective at reducing fatigue: personalized physical activity programs delivered via telephone and cognitive behavioral approaches.

The physical activity sessions were on average five 45-minute sessions per week over 30 weeks. The cognitive behavioral therapy group received an average of eight sessions over the same period (note, group meetings, not individual therapy). A “usual-care” cohort was given only educational pamphlets on how to manage fatigue.

Both the exercise program and the behavioral therapy program resulted in significantly lessened fatigue for patients when compared to a study group that received usual care, according to the Scottish researchers. Tangible improvements were also found in sleep and behavioral health-related quality of life. And these benefits lasted six months after treatment was completed.