ArticleCrohn's & colitis 3602026
Fatigue burden and patient attribution across remission states in inflammatory bowel disease: a longitudinal cohort study.
Article in Crohn's & colitis 360, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and aims: Fatigue is common in inflammatory bowel disease (IBD), but prior work has largely focused on symptomatic disease activity rather than progressively objective remission states. We evaluated the relationship between fatigue and hierarchical remission depth, repeated changes in remission status, and patients' attribution of fatigue to IBD. Methods: Adults with confirmed IBD completed PROMIS Fatigue surveys at 2 tertiary-care centers. PROMIS Fatigue was analyzed continuously and as clinically significant fatigue (T-score ≥55). Remission was classified hierarchically as no remission, physician-global-assessment (PGA)-defined clinical remission, endoscopic remission, or histologic remission. Visit-level repeated measures were analyzed using a linear mixed-effects model. First-visit logistic regression evaluated clinically significant fatigue after adjustment for anxiety, depression, anemia, and IBD subtype; corticosteroid exposure was added in a sensitivity model. Attribution analyses included only explicit Yes or No responses. Results: We surveyed 481 patients, contributing 900 surveys. PGA-defined clinical, endoscopic, and histologic remission remained associated with lower mean PROMIS Fatigue T-scores than no remission (adjusted differences -3.68, -3.45, and -3.27 points; all Conclusion: Remission was associated with lower fatigue burden, and patients in objective remission were less likely to attribute fatigue to IBD. These observational findings support assessing inflammatory disease control early in the evaluation of fatigue while also evaluating sleep, mood, anemia, pain, medications, and other non-inflammatory contributors.
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