Sarcoidosis-Associated Symptoms Improve With Mindfulness-Based Cognitive Therapy

Vivienne Kahlmann, MD

New research assessed the impact that 12 weeks of online mindfulness-based cognitive therapy (eMBCT) had on patients experiencing fatigue due to sarcoidosis.

Fatigue is a prevalent and burdensome symptom for those living with sarcoidosis, and managing this symptom is particularly challenging partially because of the lack of evidence-based therapies.

This motivated Vivienne Kahlmann, MD, Center of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus Medical Center-University Medical Center Rotterdam, and a team of investigators to evaluate this cognitive therapy and its effectiveness to mitigate the negative symptoms experienced by adults with sarcoidosis.

Can Cognitive Therapy Manage Chronic Symptoms?

For the TIRED prospective, open-label, multicenter, randomized controlled trial, investigators recruited patients from 3 centers in the Netherlands who were 18 years or older, with stable sarcoidosis, and a score higher than 21 on the Fatigue Assessment Scale (FAS).

Participating patients were randomized into the eMBCT group or the control group and completed patient-reported outcome measures at baseline, after intervention, and then 12 weeks following the completion of eMBCT.

Investigators looked for a change in FAS score at the first follow up to compare the intervention and control groups for the primary outcome. The secondary outcomes were within-group difference in FAS score at both follow ups, between-group difference in FAS score at final follow up, and the changes in Hospital Anxiety and Depression Scale, the Freiburg Mindfulness Inventory-Short Form, and the Kings Sarcoidosis Questionnaire.

Mindfulness for Sarcoidosis Symptoms

A total of 99 patients were randomized for the trial between June 2019-October 2021, however, 6 patients withdrew before beginning intervention. At baseline, the FAS score was similar, with a score of 34.57 in the eMBCT group (n=46), and 35.51 in the control group (n=47).

Based on the mean changes in FAS score after intervention, the intervention group demonstrated a significant improvement compared with the control group. The mean change of the eMBCT group was -4.53 and -1.28 in the control group.

In addition to the benefits of sarcoidosis-associated fatigue, the eMBCT group showed a significant improvement in anxiety, depressive symptoms, mindfulness, and general health status at the post-intervention follow up. This led investigators to conclude that implementing 12 weeks of eMBCT can improve fatigue, anxiety, depression, mindfulness, and health status in patients with sarcoidosis-associated fatigue.

The study "Online mindfulness-based cognitive therapy for fatigue in patients with sarcoidosis (TIRED): a randomised controlled trial" was published in The Lancet Respiratory Medicine.