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Lessening the impact of fatigue in inflammatory rheumatic diseases: a randomised clinical trial

Fatigue is pervasive, disabling and challenging to manage across all inflammatory rheumatic diseases (IRDs). Addressing the burden of fatigue is central to Arthritis Research UK’s strategy. Their recent think tank identified a number of fundamental research priorities, several of which we now aim to investigate in this proposal.


Primarily, we seek to advance the implementation of fatigue alleviating physical activity support programmes and cognitive-behavioural treatments within health services. We will individually test these interventions against usual care across multiple, rather than single, IRDs to enable improved patient access and resource utilisation. The interventions will be delivered centrally, by either telephone or Skype, with a view to further enhancing cost-effectiveness.


The conduct of such a pragmatic trial also presents a unique opportunity to a) investigate the underlying mechanisms of fatigue in order to optimise future interventions and b) identify the moderators of physical activity and cognitive-behavioural therapy efficacy so as to inform future stratified trials and patient triage pathways.


This multi-disciplinary trial brings together many leaders of this rapidly evolving field. If successful, it has the potential to unlock widespread access to much needed therapies and will provide vital insights into this commonly neglected patient priority.