Fatigue in IBD Patients One Year Post-Diagnosis: IBSEN III Study Insights
Overview
This study evaluated fatigue prevalence in Crohn’s disease (CD) and ulcerative colitis (UC) patients one year after diagnosis, using multiple remission definitions. Symptomatic remission significantly reduced odds of substantial and chronic fatigue, while stricter remission definitions did not further decrease fatigue likelihood. Among patients in endoscopic/radiological remission, chronic fatigue was strongly associated with sleep disturbances and infliximab treatment.
Background
Inflammatory bowel diseases (IBD), including CD and UC, are chronic gastrointestinal disorders characterized by alternating periods of remission and relapse. Fatigue is a common and debilitating symptom in IBD, often persisting even during remission. Previous studies have rarely used precise diagnostic tools such as endoscopy and radiology to define remission when assessing fatigue. This study aims to clarify the relationship between fatigue and different remission definitions one year after IBD diagnosis.
Data Highlights
Remission Definition
Fatigue Outcome
Odds Ratio (OR)
95% Confidence Interval
Significance (p-value)
Symptomatic remission (CD/UC)
Reduced substantial and chronic fatigue
Significant reduction
Not specified
<0.05
Biochemical remission (UC)
Reduced substantial fatigue
Significant reduction
Not specified
<0.05
Endoscopic/radiological remission
Chronic fatigue associated with sleep disturbances
10.40
3.28–32.99
<0.001
Endoscopic/radiological remission
Chronic fatigue associated with infliximab treatment
4.31
1.15–16.17
0.03
Key Findings
Symptomatic remission significantly reduces odds of both substantial and chronic fatigue in CD and UC patients one year post-diagnosis.
Biochemical remission significantly reduces odds of substantial fatigue in UC patients but not in CD.
Stricter remission definitions (endoscopic/radiological and histological) do not further reduce fatigue likelihood.
Among patients in endoscopic/radiological remission, chronic fatigue is independently associated with sleep disturbances (OR 10.40, p < 0.001).
Current treatment with infliximab is independently associated with chronic fatigue in patients in endoscopic/radiological remission (OR 4.31, p = 0.03).
Clinical Implications
Clinicians should recognize that fatigue may persist in IBD patients despite achieving endoscopic or histological remission, highlighting the importance of assessing symptomatic remission. Addressing sleep disturbances may be a key intervention target for managing chronic fatigue in patients in remission. Additionally, awareness of the association between infliximab treatment and fatigue could inform patient management and counseling.
Conclusion
Fatigue remains a significant symptom in IBD patients one year after diagnosis, even among those with strict remission criteria. Symptomatic remission is most strongly associated with reduced fatigue, while sleep disturbances and infliximab treatment are important factors linked to chronic fatigue in patients with endoscopic/radiological remission.
References
IBSEN III Study Group 2024 -- Evaluating Fatigue Levels in Inflammatory Bowel Disease Patients in Remission One Year Post-Diagnosis
by Kristina A Holten, Tomm Bernklev, Randi Opheim, Bjørn C Olsen, Trond Espen Detlie, Vibeke Strande, Petr Ricanek, Raziye Boyar, May-Bente Bengtson, Tone B Aabrekk, Øyvind Asak, Svein Oskar Frigstad, Vendel A Kristensen, Milada Hagen, Magne Henriksen, Gert Huppertz-Hauss, Marte Lie Høivik, Lars-Petter Jelsness-Jørgensen
