Do certain inflammatory chemicals have more impact on fatigue and mood

Another update from the recent European rheumatology conference (EULAR)...

There are many inflammatory substances that can be produced in the body. TNF (tumour necrosis factor) and IL-6 (interleukin 6) are known to be high in Rheumatoid arthritis. Biologic Treatments for rheumatoid arthritis have focused on lowering TNF or IL-6 levels. Knowing which type of treatment to use can be difficult as there are no current markers in the blood tests that will determine if one treatment may be better over another. 

One area that is being looked at is the impact that interleukin-6 elevation has on increasing fatigue, cardiovascular disease, insulin resistance and anemia of chronic disease. In one study of healthy athletes, IL-6 was given which caused a significant increase in fatigue. This was reversed when therapy that decreased IL-6 was given. It was also seen that healthy people who are deprived of sleep have an increase in IL-6, which can cause pain in people who previously had no pain.  

There are two approved biological therapies for Rheumatoid arthritis in Canada that specifically reduce IL-6. Based on research shared in this educational session, for people in which fatigue and mood changes have been a significant part of their arthritis, this may be an aspect to consider in treatment selection. 

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