<p>Managing fatigue in patients with primary Sj&ouml;gren&rsquo;s syndrome: challenges and solutions</p>

Abstract

Primary Sjögren’s syndrome (pSS) patients identify fatigue as their most important symptom and the one most difficult to cope with, but there are still many challenges and few solutions to manage this debilitating symptom. Promising pharmacological treatments, such as rituximab, have failed in more stringent tests including randomized controlled trials (RCTs) and meta-analysis. While non-pharmacological interventions may be safer, less costly, and address other common comorbidities, to date only aerobic exercise seems to be effective at reducing fatigue in pSS. All interventions, pharmacological or not, need to be tested in high-quality RCTs. The aim of this review is to provide an overview of fatigue management in pSS and discuss potential opportunities for future research.

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

“…However, a multidimensional assessment may provide a more complete picture, improving understanding of the clinical associations of fatigue and potential treatment. Studies on pSS have also used many non-disease specific multi-item questionnaires (15,16) which would be most recommended when one of the study objectives is to compare fatigue across diseases. Commonly used instruments are summarized in Table 1.…”

Cross-sectional assessment of sleep and fatigue in middle-aged Japanese women with primary Sjogren syndrome or rheumatoid arthritis using self-reports and wrist actigraphy

“…The cause of fatigue in pSS patients is still unknown, and current interventions for managing fatigue are insufficient. [ 35 ] Our study and others [ 14 ] have identified associations between fatigue and sleep quality, suggesting that sleep management may be necessary for treating symptoms of fatigue. Cognitive behavioral therapy for insomnia improves sleep, fatigue, and QOL in patients with fibromyalgia, [ 36 ] suggesting that it could be effective in treating these symptoms in patients with pSS.…”

<p>Fatigue in Saudi Patients with Primary Sjögren’s Syndrome and Its Correlation with Disease Characteristics and Outcome Measures: A Cross-Sectional Study</p>

“…13 Different types of questionnaires including the multidimensional fatigue inventory, fatigue impact scale, fatigue severity scale (FSS), and visual analogue fatigue scale to be analyzed for the assessment of symptoms. 12,14 For the measure of fatigue severity in patients with systemic lupus erythematosus (SLE), and multiple sclerosis (MS), the FSS was initially developed by Krupp and his co-workers in the years of 1989, the FSS is a simple and easy to use self-reported questionnaire. It consists of nine statements that assess the seriousness of the patient's symptoms of exhaustion in terms of how these symptoms influence activities of daily living, physical function, exercise, and motivation around the day over the past week.…”

“… 11 A number of variable clinical studies have been used different existing methods and questionnaires to measure fatigue in systemic rheumatic diseases including pSS patients; however, not all of these tools are specific for pSS and it is not clear that the fatigue measurement methods will be able to understand the nature and improvement of fatigue inpatient with pSS in response to medical intervention. 12 Fatigue has been included as one of the components of the European League Against Rheumatism (EULAR) Sjogren’s syndrome patient reported index (ESSPRI) evaluated by a visual analogue scale (VAS) from 0 to 10. 13 Different types of questionnaires including the multidimensional fatigue inventory, fatigue impact scale, fatigue severity scale (FSS), and visual analogue fatigue scale to be analyzed for the assessment of symptoms.…”