Effectiveness of a rehabilitative programme in improving fatigue and function in rheumatoid arthritis patients treated with biologics: a pilot study.

Objectives: To evaluate the effectiveness of a personalised rehabilitative programme in improving fatigue and function in rheumatoid arthritis (RA) female patients treated with biologic DMARDs.

Methods: Thirty-eight consecutive female RA in-patients treated with biologics, entered this prospective pilot study. All subjects were in high disease activity (DAS-28>5.1). After baseline (T0) evaluation, a personalised 4-weeks rehabilitative programme was added to standard biologic treatment and all patients were re-evaluated at the end of the rehabilitative treatment (T1), at 3 (T2), 6 (T3) and 9 (T4) month follow-up. Clinical rheumatologic assessment included the DAS-28, TJC, SJC, global health status, HAQ and FACIT.

Results: Subjects showed a mean age of 65±3.5 years and a 10±1,1 years mean disease duration. All clinical and laboratory outcomes significantly improved at the different follow-up times as compared to baseline. In particular, a significant improvement in function and fatigue indices (HAQ and FACIT) was found since T1 to T4 as compared to T0. During the follow-up, DAS-28 decreased. Accordingly, about 30% of subjects achieved a moderate disease activity (DAS-28<5.1).

Conclusions: A combined treatment biologics-rehabilitation is effective in improving function and fatigue in female patients with established RA. Fatigue results independent from disease activity.