However, people with chronic fatigue syndrome and fibromyalgia also
report high levels of fatigue but there is no evidence of inflammation
or higher levels of cytokines. This, has led some people to suggest
that in some cases fatigue may be due to depression or psychological
reasons not related to disease directly.
Yet, drugs
which alter the levels of inflammatory chemicals in the body have been
found to help fatigue. Therefore, this may provide evidence that in
an inflammatory condition, like ankylosing spondylitis, the fatigue
could be caused by the chemicals that lead to inflammation.
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What
drugs help fatigue.
Recently
it has been found that the drug anti-TNF
reduces fatigue in ankylosing spondylitis.
Other
methods of dealing with fatigue:
Low dose
amitriptyline (this is a muscle relaxant) before going to bed has been
shown help fatigue a little (an improvement of 23%). Exercise in the
pool (ie water based exercise) is reported to help fatigue.
In
summary :
Fatigue
is a major symptom for some people with ankylosing spondylitis. It is
a complicated symptom and could be caused by chemicals leading to inflammation.
To date, only a new drug called anti-TNF appears to greatly reduce fatigue.
However, research into fatigue and ankylosing spondylitis (as well as
other inflammatory conditions) is continuing.
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References
:
Jones S
et al. Fatigue in ankylosing spondylitis : its prevalence and relationship
to disease activity, sleep, and other factors. J Rheumatol 1996; 23(3):
487-90.
Sundstrom
B et al . Exercise habits among people with AS: A questionnaire based
survey in the Country of Vasterbotten,Sweden. Scand J Rheumatol 2002;
31 (3): 163-7
Van Tubergen
et al. Assessment of fatigue in patients with ankylosing spondylitis:
a psychometric analysis. Arthritis Rheum 2002; 47(1): 8-16.
Brophy
S et al . Factors associated with fatigue in AS and socio-economic implications.
Arthritis Rheum 2002.
Wei-Howe
Koh et al. Low dose amitriptyline in ankylosing spondylitis: a short
term, double blind, placebo controlled study. J Rheumatol 1997; 24(11):
2159-2161.
Gorman
J. Treatment of ankylosing spondylitis by inhibition of tumour necrosis
factor alpha. BMJ 2002; 346 (18): 1349-1356
Braun J.
Treatment of active ankylosing spondylitis with infliximab: a randomised
controlled multicentre trial. Lancet 2002; 359: 1187-93.
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