Fatigue: The missing target in Crohn’s disease management
World Journal of Gastroenterology, cilt.32, sa.26, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 32 Sayı: 26
- Basım Tarihi: 2026
- Doi Numarası: 10.3748/wjg.v32.i26.118961
- Dergi Adı: World Journal of Gastroenterology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Anxiety, Crohn’s disease, Depression, Fatigue, Inflammatory bowel diseases
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet
Özet
Treat-to-target strategies have improved mucosal healing in inflammatory bowel disease; however, nearly half of patients in clinical remission still experience disabling fatigue. Morais et al published a study in the World Journal of Gastroenterology demonstrated that biologic treatment success does not necessarily improve patient-reported outcomes and fatigue cannot be explained solely by disease activity or conventional inflammatory biomarkers. A major strength of the study lies in its focus on fatigue as a primary clinical outcome. Although depression, anxiety, stress, and insomnia had limited predictive value individually, their combined assessment increased fatigue risk up to 45-fold. The composite psychological score demonstrated good discriminative performance, supporting its practical use in routine care. Fatigue was also associated with leukocyte alterations, such as relative neutrophilia and lymphopenia/eosinopenia, consistent with stress-related immune activation. No significant associations were found with anemia, nutritional deficiencies, thyroid function, or C-reactive protein, underscoring the multidimensional and largely inflammation-independent nature of fatigue in Crohn’s disease and highlighting the need for a more patient-centered management approach.