Evidence map›Paper›PMID 32337555›Full record

SynthesisRheumatology (Oxford, England)2020

Quantifying and predicting the effect of anti-TNF therapy on axSpA-related fatigue: results from the BSRBR-AS registry and meta-analysis.

Joanna Shim, Linda E Dean, Maira Karabayas, Gareth T Jones, Gary J Macfarlane, Neil Basu

Open access · hybridAbstract readMeta-Analysis
In one paragraph

Synthesis in Rheumatology (Oxford, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Fatigue in Inflammatory Joint Diseases.International journal of molecular sciences · 2023
    Review
  4. Recurring Fatigue After Biologic Administration: Patient-Reported Data from the Dutch Biologic Monitor.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2023
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Joanna ShimEpidemiology Group, School of Medicine, Medical Sciences and Nutrition.
Linda E DeanEpidemiology Group, School of Medicine, Medical Sciences and Nutrition.
Maira KarabayasDepartment of Rheumatology, Aberdeen Royal Infirmary, Aberdeen.
Gareth T JonesEpidemiology Group, School of Medicine, Medical Sciences and Nutrition.
Gary J MacfarlaneEpidemiology Group, School of Medicine, Medical Sciences and Nutrition.
Neil BasuInstitute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
Arthritis UK · GBAberdeen Royal Infirmary · GBUniversity of Glasgow · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEffective management of axial spondyloarthritis (axSpA)-related fatigue is a major unmet clinical need. Anti-TNF therapy may reduce fatigue levels, although any effect has yet to be definitively quantified and predictors of any such improvements are unknown.

methodsThe British Society of Rheumatology Register in Axial Spondyloarthritis (BSRBR-AS) prospectively recruited axSpA patients across the UK. Changes in fatigue levels (measured using the Chalder Fatigue Scale) >1 year were compared between those starting anti-TNF therapy at the time of recruitment and those not. Differences between treatment groups were adjusted using propensity score matching. Results were meta-analysed with the extant literature to calculate pooled estimates. Then, among those BSRBR-AS anti-TNF commencers with clinically relevant fatigue, baseline predictors of response were investigated.

resultsOf the 998 BSRBR-AS recruits with complete fatigue data, 310 were anti-TNF commencers. At 1-year follow-up, the former group reported a mean fatigue change of -2.6 (95% CI -4.1, -1.9) points while the latter reported a mean worsening of fatigue by 0.2 points. Following propensity score adjustment, those commencing anti-TNF therapy reduced fatigue by 3.0 points compared with those not. Of those with significant fatigue and commencing anti-TNF, poor sleep quality at baseline predicted fatigue improvement. In the meta-analysis, including 1109 subjects, treatment with anti-TNF therapy resulted in a significant improvement in fatigue [Standardized mean difference (SMD) = 0.36, 95% CI 0.15, 1.56].

conclusionAnti-TNF therapy results in a significant but modest reduction in fatigue amongst axSpA patients, with those reporting poor sleep quality most likely to report improvement. Effective management will likely require additional approaches.

Indexed as

FatigueFemaleHumansMaleMiddle AgedPrognosisPropensity ScoreRegistriesSleepSpondylarthropathiesTreatment OutcomeTumor Necrosis Factor InhibitorsUnited KingdomTumor Necrosis Factor Inhibitorsanti-tumour necrosis factoraxial spondylarthritisfatiguemeta-analysisregistrysleep

Identifiers

PMID32337555
PMCPMC7590410
OpenAlexW3010114990

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.