Relationship Between Endoscopic and Clinical Disease Activity With Fatigue in Inflammatory Bowel Disease.
Kendra J Kamp, Kindra Clark-Snustad, Mitra Barahimi and 1 others
PMID 35020629WHAT IT FOUND
Most adults with inflammatory bowel disease reported fatigue, including many with no inflammation seen on scope.
Symptoms and anxiety were more closely tied to fatigue than scope findings. Nurses should screen and assess other causes.
Key findings
01Fatigue was reported by 61% of participants.
02In the final model, only active clinical disease and anxiety remained associated with fatigue; active clinical disease was 8.5 times more likely to report fatigue than inactive clinical disease.
03Endoscopic disease activity was associated with fatigue in univariate analysis but not in the final model.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study reviewed charts from one tertiary IBD center, so it may not match community practices or disease complexity. It was retrospective, so missing chart entries could understate anxiety, depression, or other factors. Fatigue was measured with one question, so physical, emotional, and mental fatigue could not be separated. The clinic visit and endoscopy could be up to 6 months apart, and 24% had medication changes, so endoscopic disease activity may not match the time of fatigue assessment. The design cannot show whether symptoms, anxiety, and fatigue influenced each other or were recorded together. Anxiety lost significance in sensitivity analysis, so its independent role is uncertain. Small numbers for some lab abnormalities, such as low B12 (n=3) and low albumin (n=7), make those findings fragile.
Declared interests
No funding source is stated. Kendra J Kamp had no conflicts to disclose. Kindra Clark-Snustad served as a consultant for Pfizer. Mitra Barahimi had no conflicts to disclose. Scott D Lee received grant support from AbbVie, UCB Pharma, Janssen, Salix, Takeda, Calgene, Arena, and AbGenomics, and served as a consultant for UCB Pharma, Cornerstones Health, Janssen, Eli Lilly and Company, Celgene, KCRN Research, LLC, Boehringer Ingelheim Pharmaceuticals, and Bristol-Myers Squibb.
The easy way to misread this
Do not conclude that endoscopic inflammation explains fatigue or that patients in endoscopic remission should not be fatigued. Endoscopic activity was associated before other factors were considered but was not independent in the final model, and 52% of fatigued patients had inactive endoscopic disease.