Impact of treatments on fatigue in axial spondyloarthritis: a systematic review and meta-analysis.

This article systematically reviews the effects of pharmacological and non-pharmacological treatments on fatigue in patients with axial spondyloarthritis (axSpA), a chronic inflammatory disease affecting the axial skeleton. It analyzes 34 studies involving 7,351 patients, focusing on biologic disease-modifying antirheumatic drugs (bDMARDs), targeted synthetic DMARDs (tsDMARDs), and various non-drug interventions. The review finds that anti-TNF, anti-IL-17, and JAK inhibitors significantly reduce fatigue, with no clear differences between these drug classes, although the effect may be less pronounced in women and in non-radiographic axSpA. Non-pharmacological treatments, particularly physical activity and therapies such as cryotherapy and magnetotherapy, also show beneficial effects on fatigue, especially when combined with pharmacological treatments. The study highlights the need for further research on gender differences and the integration of non-pharmacological approaches to optimize fatigue management in axSpA.