{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T06:51:37Z","timestamp":1772347897978,"version":"3.50.1"},"reference-count":142,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"European Alliance of Associations for Rheumatology","award":["HPR052"],"award-info":[{"award-number":["HPR052"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,7,14]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To identify the best evidence on the efficacy of pharmacological interventions in reducing fatigue in people with inflammatory rheumatic and musculoskeletal diseases (I-RMDs) and to summarise their safety in the identified studies to inform European Alliance of Associations for Rheumatology recommendations for the management of fatigue in people with I-RMDs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Systematic review of adults with I-RMDs conducted according to the Cochrane Handbook. Search strategy ran in Medline, Embase, Cochrane Library, CINAHL Complete, PEDro, OTseeker and PsycINFO. Only randomised controlled trials (RCTs) or controlled clinical trials were eligible. Assessment of risk of bias, data extraction and synthesis performed by two reviewers independently and in duplicate. Data pooled in statistical meta-analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 4151 records, 455 were selected for full-text review, 99 fulfilled the inclusion criteria and 19 RCTs were included in meta-analyses. Adalimumab was superior to placebo in reducing fatigue at 12 and 52\u2009weeks in rheumatoid arthritis (RA) (n=3\u2009and 2 RCTs; mean difference (MD)= \u22123.03, p&lt;0.001; MD=\u22122.25, p=0.03, respectively). Golimumab (n=2 RCTs; 24\u2009weeks: MD=\u22125.27, p&lt;0.001), baricitinib (n=2 RCTs; 24\u2009weeks: MD=\u22124.06, p&lt;0.001), sarilumab (n=2 RCTs; 24\u2009weeks: MD=\u22123.15, p&lt;0.001), tocilizumab (n=3 RCTs; 24\u2009weeks: MD=\u22123.69, p&lt;0.001) and tofacitinib (n=3 RCTs; 12 weeks: MD=\u22124.44, p&lt;0.001) were also superior to placebo in reducing fatigue in RA. A dose\/effect relationship was observed for sarilumab, tocilizumab and tofacitinib. In spondyloarthritis (excluding psoriatic arthritis), secukinumab was superior to placebo in reducing fatigue at 16\u2009weeks (n=2 RCTs; MD=\u22124.15, p&lt;0.001), with a dose\/effect relationship also observed. The narrative results of the RCTs not included in the meta-analysis indicated that several other pharmacological interventions were efficacious in reducing fatigue, with reassuring safety results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Several pharmacological interventions are efficacious and generally safe for managing fatigue in people with I-RMDs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003349","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T12:53:40Z","timestamp":1701867220000},"page":"e003349","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Efficacy of pharmacological interventions: a systematic review informing the 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases"],"prefix":"10.1136","volume":"9","author":[{"given":"Bayram","family":"Farisogullari","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hacettepe University, Ankara, Turkey"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0557-2377","authenticated-orcid":false,"given":"Eduardo Jos\u00e9 Ferreira","family":"Santos","sequence":"additional","affiliation":[{"name":"School of Health, Polytechnic University, Viseu, Portugal"},{"name":"Health Sciences Research Unit: Nursing (UICiSA:E), Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6674-8607","authenticated-orcid":false,"given":"Emma","family":"Dures","sequence":"additional","affiliation":[{"name":"Academic Rheumatology, Bristol Royal Infirmary, Bristol, UK"},{"name":"School of Health and Social Wellbeing, University of the West of England, Bristol, UK"}]},{"given":"Rinie","family":"Geenen","sequence":"additional","affiliation":[{"name":"Department of Psychology, Utrecht University, Utrecht, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8411-7972","authenticated-orcid":false,"given":"Pedro M","family":"Machado","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK"},{"name":"National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK"}]}],"member":"239","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"2025090313392462000_9.4.e003349.1","unstructured":"WHO Scientific Group on the Burden of Musculoskeletal Conditions at the Start of the New Millennium . 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