DAY 2 - Fatigue Limits Quality of Life for Patients with Crohn’s Disease and Ulcerative Colitis

People living with Crohn’s disease (CD) or ulcerative colitis (UC) often experience disease-related fatigue, which affects their work productivity, social interactions, and many other aspects of their lives, according to a study presented at the ACG 2024 Annual Scientific Meeting in Philadelphia, Pennsylvania.

“We know that fatigue is a common yet debilitating symptom with multifactorial etiology, which significantly affects the quality of life of patients with CD and UC,“ said lead author Remo Panaccione, MD, Director of the Inflammatory Bowel Disease Clinic at the University of Calgary, in Calgary, Canada. “However, fatigue may be undertreated because of its subjective nature. Moreover, effective management strategies are lacking.”

Panaccione’s team used data from The Communicating Needs and Features of IBD Experiences (CONFIDE) Survey to analyze the burden and impact of disease-related fatigue on the productivity and quality of life of patients from five European countries and the United States. The study looked at the impact of CD- and UC-related fatigue on patients’ daily activities, including work, school, and social, physical, and sexual activities. Responses were collected from 215 U.S.-based and 547 European patients with CD, and from 200 U.S.-based and 556 European individuals with UC.
Up to 46% of the individuals with CD and UC reported ever experiencing fatigue, while up to 36% of patients reported experiencing fatigue at the time of the survey response. The respondents said they struggled with fatigue despite receiving advanced therapies for inflammatory bowel disease (IBD).

“Overall, this results in a large proportion of patients declining participation in work, school, social activities, or sports and physical exercise due to their disease-related fatigue,” Panaccione said during a presentation. The responses showed that more than 70% of patients with CD or UC who ever experienced fatigue reported an impact on their work- or school-related activities, including working fewer hours and stopping work earlier in the day than planned due to CD- or UC-related fatigue. More than half of respondents across all disease subtypes and geographic regions also reported reduced sexual activity in the previous 3 months, with a significant proportion of those attributing this finding to disease-related fatigue.

“I think we have demonstrated that fatigue is a prevalent symptom of moderate-to-severe CD and UC, which adversely affects patients’ work, school, social, physical, or sexual activities,” Panaccione concluded. “The findings indicate that most patients with CD or UC who experience fatigue stop work earlier than planned or work fewer hours, which often leads to productivity loss. This underscores the need to develop fatigue-related treatment strategies in CD and UC.”

Multiple factors may contribute to fatigue in people living with IBD. Interventions designed to improve the quality of life of people with CD or UC must effectively target common drivers of fatigue in this population, including chronic inflammation and sleep disturbance. The quest for effective management strategies remains challenging as inflammation may persist even in patients with IBD who respond to biologic therapies.