#4-45E. Unraveling the Burden: Distinct Mechanisms of Fatigue in Sjögren’s Disease (Clin Rheumatol, 2026)

Are we utilizing a one-size-fits-all approach when managing the debilitating fatigue frequently reported by patients with Sjögren’s disease? This cross-sectional study investigates the severity and determinants of fatigue across primary Sjögren’s disease (pSjD), associated SjD, and other systemic autoimmune rheumatic diseases. Researchers discovered that while the burden of fatigue is similarly severe in both primary and associated SjD, the underlying drivers are remarkably distinct. Crucially, fatigue in pSjD is predominantly linked to non-inflammatory factors such as fibromyalgia, pain, and dryness, whereas systemic inflammation, indicated by C-reactive protein levels, is a key contributor to fatigue in associated SjD. When critically appraising this paper, it is important to note its cross-sectional, single-center design, which fundamentally limits causal inferences, alongside the lack of assessment for potentially confounding psychological factors like depression or sleep disturbances. Nevertheless, these findings are highly relevant for clinicians because they emphasize the necessity of tailored, mechanism-based management strategies; specifically, addressing central sensitization and utilizing non-pharmacological therapies for pSjD, while focusing on optimizing systemic inflammatory control for patients with associated SjD.

Citation: Jeon Hye-Ji, Kim Hyun-Sook, Lee Kyung-Ann. Fatigue in primary and associated Sjögren’s disease: similar burden, distinct determinants. Clinical Rheumatology. 2026. DOI: https://doi.org/10.1007/s10067-026-08011-3

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