Is fatigue common in patients with controlled rheumatoid arthritis?

This study investigated fatigue in patients with early-stage rheumatoid arthritis. They found that these patients commonly report fatigue and this was linked to higher depression and anxiety scores. 

The aim of rheumatoid arthritis (RA) treatment is to reduce disease activity. To achieve this, a patient will be prescribed medication to reduce inflammation. However, for some patients, reducing disease activity does not help with symptoms such as pain and fatigue.

Fatigue (tiredness) is experienced by 40-80% of patients with RA. It can have negative effects on a patient’s quality of life, work participation, and mood. It is unclear how common fatigue is among patients with early RA and how it evolves over time.

This study included 246 patients with early RA. Patients were evaluated at the beginning of the study and at 12 months. The authors analyzed disease activity and general health. Fatigue was measured using a standardized questionnaire. Patients were also asked about their level of coping, depression and anxiety symptoms.

Overall, almost half (45%) of patients reported fatigue over the initial 12 months, despite controlled RA symptoms. 77% of patients who reported fatigue at the beginning of the study, were still fatigued 12 months later. 15% of the patients who were not fatigued at the beginning of the study, became fatigued after 1 year.

Patients that reported fatigue at the beginning of the study had more active disease than non-fatigued patients. Higher depression and anxiety scores at the beginning of the study were associated with developing fatigue after 12 months.

The authors concluded that patients with controlled rheumatoid arthritis commonly report fatigue. They also found that depression was associated with developing fatigue over time.  

Fatigue may be caused by several factors. These factors include inflammation in RA, as well as mood disorders such as depression and anxiety. Further investigation is needed to determine the cause of fatigue in early RA.

If you have any concerns regarding fatigue, please consult with your physician.