Managing fatigue in patients with primary Sjögren’s syndrome: challenges and solutions

Abstract

Samira Tatiyama Miyamoto,1 Dennis William Lendrem,2–4 Wan-Fai Ng,2–4 Katie Louise Hackett,2,4–5 Valéria Valim6,71Department of Integrated Education in Health, Universidade Federal do Espírito Santo, Vitória, Brazil; 2Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University and NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK; 3NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK; 4Newcastle upon Tyne Hospitals NHS Trust, , Newcastle upon Tyne, UK; 5Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK; 6Department of Medical Clinic, Universidade Federal do Espírito Santo, Vitória, Brazil; 7Rheumatology Outpatient Clinic, Hospital Universitário Cassiano Antônio de Moraes (HUCAM), Vitória, BrazilAbstract: 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.Keywords: primary Sjögren’s syndrome, fatigue, treatment, review

Keywords

• primary Sjögren’s syndrome
• fatigue
• treatment
• review