SynthesisRMD open2023
Efficacy of non-pharmacological interventions: a systematic review informing the 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases.
Synthesis in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- The 2026 British Society for Rheumatology guideline for the management of children, young people and adults with systemic lupus erythematosus.Rheumatology (Oxford, England) · 2026Guideline
- Effects of physical activity on health-related outcomes in Sjögren's syndrome: a systematic review and meta-analysis of randomized controlled trials.Frontiers in immunology · 2026Pooled it
- Combined effect of underwater ultrasound and custom-made insoles in rheumatoid arthritis: a randomized controlled trial.Clinical rheumatology · 2026Trial
- High-intensity exercise improves multidimensional fatigue and health-related quality of life in rheumatoid arthritis: a randomized controlled study.Arthritis research & therapy · 2025Trial
- Evidence on the Relationships Between Total Fat Intake and Health Outcomes Other Than Unhealthy Weight Gain in Adults and Children: A Scoping Review.Cochrane evidence synthesis and methods · 2026Review
- Article
- Fatigue in Sjögren's Disease - Integrating Biomedical and Psychosocial Aspects: A Narrative Review.Rheumatology and therapy · 2026Review
- 'Pushing the change': barriers, facilitators, and implementation plan for integrating individually tailored physical activity guidance in rheumatology practice.EULAR rheumatology open · 2026Article
- Trends in research on fatigue in rheumatology: Bibliometric analysis.Rheumatology and immunology research · 2026Article
- Physical Activity or Exercise: Is there any Difference in Common Symptoms and Quality of Life Among Female Patients with Rheumatic and Musculoskeletal Diseases? A Qualitative Study.Mediterranean journal of rheumatology · 2026Article
- Baseline pain, fatigue, and sleep quality predict 12-week pain improvement in inflammatory arthritis: retrospective real-world analysis of a digital health application cohort.Rheumatology international · 2026Article
- The co-creation of a COMbined Fatigue Intervention (COMFI) for people with inflammatory arthritis: a complex intervention.EULAR rheumatology open · 2026Article
- What to do when the first TNF inhibitor fails in rheumatoid arthritis: stratified expert recommendations from a scoping review and Delphi consensus.Therapeutic advances in musculoskeletal disease · 2026Article
- Unmet needs in patients with RA judged in remission by the rheumatologist: a semi-structured interview study.Rheumatology advances in practice · 2026Article
- Clinical and Psychosocial Predictors of Physical Activity in Systemic Lupus Erythematosus: A Multicentre Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2025Article
- Rehabilitation for People with Inflammatory Arthritis: Meeting the Challenges of a Changing Healthcare Landscape.Journal of clinical medicine · 2025Article
- Global research trends in aquatic exercise therapy for musculoskeletal disorders: a bibliometric analysis.Journal of rehabilitation medicine · 2025Article
- Evaluating Meaningful Changes in Patient-Reported Outcome Measurement Information System-Fatigue Scores from Three Phase 3 Clinical Trials of Sarilumab for Patients With Rheumatoid Arthritis.ACR open rheumatology · 2025Article
- Efficacy of a cognitive-behavioral digital therapeutic on psychosocial outcomes in rheumatoid arthritis: randomized controlled trial.Npj mental health research · 2024Article
- Connecting the dots: the role of fatigue in female infertility.Reproductive biology and endocrinology : RB&E · 2024Review
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify the best evidence on the efficacy of non-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.
methodsSystematic review of randomised controlled trials (RCTs) including adults with I-RMDs conducted according to the Cochrane Handbook. Search strategy ran in Medline, Embase, Cochrane Library, CINAHL Complete, PEDro, OTseeker and PsycINFO. Assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. Data were pooled in meta-analyses.
resultsFrom a total of 4150 records, 454 were selected for full-text review, 82 fulfilled the inclusion criteria and 55 RCTs were included in meta-analyses. Physical activity or exercise was efficacious in reducing fatigue in rheumatoid arthritis (RA) (standardised mean differences (SMD)=-0.23, 95% CI=-0.37 to -0.1), systemic lupus erythematosus (SLE) (SMD=-0.54, 95% CI=-1.07 to -0.01) and spondyloarthritis (SMD=-0.94, 95% CI=-1.23 to -0.66); reduction of fatigue was not significant in Sjögren's syndrome (SMD=-0.83, 95% CI=-2.13 to 0.47) and systemic sclerosis (SMD=-0.66, 95% CI=-1.33 to 0.02). Psychoeducational interventions were efficacious in reducing fatigue in RA (SMD=-0.32, 95% CI=-0.48 to -0.16), but not in SLE (SMD=-0.19, 95% CI=-0.46 to 0.09). Follow-up models in consultations (SMD=-0.05, 95% CI=-0.29 to 0.20) and multicomponent interventions (SMD=-0.20, 95% CI=-0.53 to 0.14) did not show significant reductions of fatigue in RA. The results of RCTs not included in the meta-analysis suggest that several other non-pharmacological interventions may provide a reduction of fatigue, with reassuring safety results.
conclusionsPhysica activity or exercise and psychoeducational interventions are efficacious and safe for managing fatigue in people with I-RMDs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.