PT  - JOURNAL ARTICLE
AU  - Philippe Mertz
AU  - Aurélien Schlencker
AU  - Matthias Schneider
AU  - Pierre-Edouard Gavand
AU  - Thierry Martin
AU  - Laurent Arnaud
TI  - Towards a practical management of fatigue in systemic lupus erythematosus
AID  - 10.1136/lupus-2020-000441
DP  - 2020 Nov 01
TA  - Lupus Science & Medicine
PG  - e000441
VI  - 7
IP  - 1
4099  - http://lupus.bmj.com/content/7/1/e000441.short
4100  - http://lupus.bmj.com/content/7/1/e000441.full
SO  - Lupus Sci Med2020 Nov 01; 7
AB  - Significant fatigue is reported by two-thirds of patients with SLE and severe fatigue by one-third. The assessment and treatment of fatigue remains a major challenge in SLE, especially in patients with no disease activity. Here, we suggest a practical algorithm for the management of fatigue in SLE. First, common but non–SLE-related causes of fatigue should be ruled out based on medical history, clinical and laboratory examinations. Then, presence of SLE-related disease activity or organ damage should be assessed. In patients with active disease, remission is the most appropriate therapeutic target while symptomatic support is needed in case of damage. Both anxiety and depression are major independent predictors of fatigue in SLE and require dedicated assessment and care with psychological counselling and pharmacological intervention if needed. This practical algorithm will help in improving the management of one the most common and complex patient complaints in SLE.