THE IMPACT OF FATIGUE ON THE QUALITY OF LIFE OF PATIENTS WITH RHEUMATOID ARTHRITIS: A REVIEW OF CURRENT RESEARCH

Abstract

Relevance. Rheumatoid arthritis (RA) is a systemic autoimmune rheumatic disease of unknown etiology, characterized by chronic, progressive, erosive arthritis and involvement of various organs and systems.[1] The condition can lead to pain, joint stiffness, limited physical activity, and a reduced quality of life.[2] One of the most significant symptoms for patients is chronic fatigue, which may persist even when the inflammatory process is better controlled. This fatigue can restrict daily activities, social interactions, and work capacity. Therefore, assessing fatigue - alongside clinical disease activity - is essential for the comprehensive management of patients with RA.[3]

Objective. To summarize the findings of recent randomized controlled trials concerning fatigue and quality of life in patients with rheumatoid arthritis, and to explore potential ways to improve these outcomes.

Materials and Methods. A review of five scientific publications was conducted. The studies examined the effects of physical exercise, aquatic interventions, anti-inflammatory dietary approaches, and cognitive-behavioral therapy, as well as the use of Korean red ginseng for rheumatic diseases. The study designs, outcome measures, and key findings were analyzed. Given that the assessment methods and metrics varied across the studies, a direct comparison of their results was not performed.

Results. A randomized study by Bilberg et al. (2025) involved 87 patients with rheumatoid arthritis. The study investigated the impact of a 12-week program consisting of high-intensity interval training and strength exercises on fatigue and quality of life. Compared to the control group, participants in the program showed improvements in their overall physical condition, as well as increased physical activity and motivation. These differences persisted for up to 12 months of follow-up. Furthermore, the authors noted an improvement in the patients' overall quality-of-life scores, which highlights the benefits of individually tailored physical activity.[4]

In a study by Aktaş et al. (2025), 54 patients were divided into three groups: the first group received warm saline baths for their hands and feet, the second group received warm water baths, and the third group served as a control. After a six-week study period, the groups that underwent water-based treatments showed a reduction in overall pain, decreased fatigue, and an improvement in quality of life. Significant differences between the groups were also observed regarding fatigue and quality-of-life scores related to it.[5]

The ADIRA randomized crossover study, conducted by Turesson Wadell et al. (2021), evaluated the impact of an anti-inflammatory diet on 50 patients with rheumatoid arthritis. Overall, no significant differences were found between the experimental and control groups regarding lifestyle factors, fatigue, or pain. However, specific analyses using the SF-36 scale indicated improvements in physical activity levels within the experimental group. Consequently, the findings suggest a need for further investigation through larger-scale studies to obtain reliable data and ensure accurate interpretation.[6]

Cho et al. (2024) examined the effects of Korean red ginseng on 120 patients with rheumatic diseases, including 43 patients with rheumatoid arthritis. The study followed a randomized, double-blind, placebo-controlled design. After 12 weeks, approximately 38.3% of participants in the group receiving ginseng showed improvement in fatigue-related scores on the FACIT-Fatigue scale, compared to 26.7% in the placebo group. However, no statistically significant differences were found between the two groups. Thus, the superiority of ginseng over a placebo in reducing fatigue has not been conclusively established.[7]

The RAFT study, conducted by Hewlett et al. (2019), examined the impact of group-based cognitive-behavioral programs developed by rheumatology specialists. Compared to a control group, participation in such a program helped reduce fatigue in patients with rheumatoid arthritis, with these positive changes persisting for up to two years. The study results indicate that, in addition to pharmacological treatment, psychological support and training in self-regulation strategies play an important role in managing the disease.[8]

Discussion. The studies reviewed indicate that fatigue in rheumatoid arthritis is a multifactorial issue requiring a comprehensive approach. Physical exercise and cognitive-behavioral programs have been shown to significantly reduce fatigue and improve quality of life. Conversely, research has not demonstrated clear efficacy for anti-inflammatory diets or specific dietary supplements. Variations in assessment methods and patient characteristics make it difficult to compare findings across studies. Furthermore, as not all the reviewed studies assessed quality of life as a primary outcome, the data should be interpreted with consideration for the specific objectives of each study.

Conclusion. The findings suggest that fatigue in rheumatoid arthritis is a distinct clinical issue. It leads to a decline in patients' physical and emotional activity and restricts their social engagement. The results of the reviewed studies support the inclusion of fatigue assessment as part of the comprehensive care for patients with rheumatoid arthritis. Further research, utilizing standardized fatigue assessment methods and long-term follow-up, is required to determine the most effective strategies for improving quality of life.