The aim of this study was to assess levels, causes and effects of fatigue in patients with juvenile idiopathic arthritis (JIA). The authors concluded that fatigue is common in patients with JIA and is related to time of day, disease activity, pain, mental wellbeing, and sleep.

Juvenile idiopathic arthritis (JIA) is a form of arthritis in children under the age of 16. It can cause limited mobility, stiffness, and swelling in the joints. There is currently no curative treatment for JIA. The main goal of JIA management is to make everyday living as comfortable as possible for patients.

Symptoms of JIA can significantly affect quality of life. While pain can be managed, symptoms such as fatigue (extreme tiredness) are more difficult to measure and treat. Fatigue can have a serious negative effect on children’s performance school, social life, sports, and hobbies. 

The authors included 15 different studies on fatigue in JIA patients and combined results into a single analysis. Most studies used questionnaires to assess fatigue in JIA patients.

Overall, 60 to 76% of patients with JIA reported fatigue. 25% of these patients reported moderate to severe fatigue. Levels of fatigue were significantly higher in JIA patients than in the general population.

3 studies concluded that fatigue varied throughout the day. The highest levels of fatigue were reported in the evening and in the morning.

3 studies found that higher disease activity was related to higher levels of fatigue.

4 studies demonstrated an association between pain and fatigue. The relationship between fatigue and DA was no longer significant after controlling for pain.

2 studies showed that non-steroidal anti-inflammatory drugs (NSAIDs; taken to manage pain and inflammation) were linked to lower levels of fatigue. In contrast, disease modifying anti-rheumatic drugs (DMARDs; often the first-line treatment) were linked to higher levels of fatigue.

Several studies assessed the link between mental wellbeing and fatigue. Fluctuations in mood and stress were associated with higher levels of fatigue. Anxiety, distress, and lower quality of life also increased levels of fatigue. 

The authors concluded that fatigue is common in patients with JIA and several factors appear to affect fatigue levels in JIA patients.

The data was taken from a number of different studies. The methods for measuring fatigue and outcomes of each study varied.