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. 2025 Apr 4;19(4):jjae170.
doi: 10.1093/ecco-jcc/jjae170.

Fatigue in Patients with Inflammatory Bowel Disease in Remission One Year After Diagnosis (the IBSEN III Study)

Kristina A Holten  1   2 , Tomm Bernklev  1   3 , Randi Opheim  4   5 , Bjørn C Olsen  1   6 , Trond Espen Detlie  1   7 , Vibeke Strande  1   8 , Petr Ricanek  9 , Raziye Boyar  10 , May-Bente Bengtson  11 , Tone B Aabrekk  1   11 , Øyvind Asak  12 , Svein Oskar Frigstad  13 , Vendel A Kristensen  1   5 , Milada Hagen  14 , Magne Henriksen  2 , Gert Huppertz-Hauss  6 , Marte Lie Høivik  1   5 , Lars-Petter Jelsness-Jørgensen  2   4
Affiliations

Fatigue in Patients with Inflammatory Bowel Disease in Remission One Year After Diagnosis (the IBSEN III Study)

Kristina A Holten et al. J Crohns Colitis. .

Abstract

Background and aims: Fatigue is commonly observed in Crohn's disease (CD) and ulcerative colitis (UC) but its association to achieving remission is not clearly established. In this study, we describe the odds for fatigue in patients with CD/UC 1 year after diagnosis based on different definitions of remission and identified factors associated with chronic fatigue (CF) among patients in endoscopic/radiological remission.

Methods: Patients ≥ 18 years old with CD/UC were recruited from the IBSEN III cohort. Using the Fatigue Questionnaire, and dichotomizing the score, CF was defined as the presence of substantial fatigue (SF) for ≥6 months. Remission was divided into symptomatic (CD: Harvey-Bradshaw Index score < 5/UC: SCCAI score < 3), biochemical (fecal calprotectin ≤ 250 µg/g), endoscopic/radiological (CD: normal intestinal MRI/CT combined with normal endoscopy/UC: Mayo endoscopic score 0), and histological (normal mucosal biopsies). Both the likelihood of SF/CF, depending on the definition of remission, and associations between CF and selected factors for CD/UC in endoscopic/radiological remission were evaluated using binary logistic regression analysis.

Results: In total, 711/1416 patients were included. For both CD and UC, symptomatic remission significantly reduced the odds for SF and CF. In addition, the odds for SF were significantly reduced for UC in biochemical remission. Among those in endoscopic/radiological remission (n = 181), CF was independently associated with sleep disturbances (OR = 10.40, 95%CI [3.28;32.99], p < 0.001) and current treatment with infliximab (OR = 4.31, 95%CI [1.15;16.17], p = 0.03).

Conclusions: Stricter definitions of disease remission were not associated with a decreased likelihood of fatigue. For patients in endoscopic/radiological remission, CF was independently associated with sleep disturbances and current treatment with infliximab.

Keywords: Inflammatory bowel disease; epidemiology; fatigue.

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Conflict of interest statement

TB, RO, BCO, TED, PR, MBB, TBA, MHa, ØA, RB, MHe, GHH, LPJJ, and KAH declare that they have no conflicts of interest. SOF: Personal fees from Takeda, Galapagos, Jansen-Cilag, Abbvie, Pharmacosmos, Norgine, and Bristol-Myers-Squibb. VS: Sponsored by funds from Takeda. VAK: Consultant for Janssen-Cilag, scientific advisory board, and consultant for Takeda, speaker for Thermo Fischer, advisory board for Tillotts Pharma. M.L.H: Investigator-initiated research grants from Takeda, Pfizer, Tilllotts, Ferring, and Janssen. Speaker honoraria from Takeda, Tillotts, Ferring, AbbVie, Galapagos, MSD, and Meda. Advisory board for Takeda, Galapagos, MSD, Lilly, Janssen, Pfizer, and AbbVie.

Figures

Figure 1
Figure 1
Bar graph showing the prevalence of substantial fatigue (SF) and chronic fatigue (CF) one year after diagnosis among patients with Crohn’s disease (CD) and ulcerative colitis (UC). Fatigue prevalence is expressed as a percentage with 95% confidence intervals (CI) on the Y-axis, stratified by different definitions for measurable disease activity on the X-axis. The prevalence of substantial fatigue for CD and UC are presented first, followed by prevalence of chronic fatigue for CD and UC.
See this image and copyright information in PMC

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