@article{8764450,
  abstract     = {{Background & Aims
Fatigue is highly prevalent among patients with inflammatory bowel disease (IBD), and only limited treatment options are available. Based on the hypothetical link between low serum tryptophan concentrations and fatigue, we determined the effect of 5-hydroxytryptophan supplementation on fatigue in patients with inactive IBD.

Methods
A multicenter randomized controlled trial was performed at 13 Belgian hospitals, including 166 patients with IBD in remission but experiencing fatigue, defined by a fatigue visual analog scale (fVAS) score of ≥5. Patients were treated in a crossover manner with 100 mg oral 5-hydroxytryptophan or placebo twice daily for 2 consecutive periods of 8 weeks. The primary end point was the proportion of patients reaching a ≥20% reduction in fVAS after 8 weeks of intervention. Secondary outcomes included changes in serum tryptophan metabolites, Functional Assessment of Chronic Illness Therapy Fatigue scale, and scores for depression, anxiety, and stress. The effect of the intervention on the outcomes was evaluated by linear mixed modeling.

Results
During 5-hydroxytryptophan treatment, a significant increase in serum 5-hydroxytryptophan (estimated mean difference, 52.66 ng/mL; 95% confidence interval [CI], 39.34–65.98 ng/mL; P < .001) and serotonin (3.0 ng/mL; 95 CI, 1.97–4.03 ng/mL; P < .001) levels was observed compared with placebo. The proportion of patients reaching ≥20% reduction in fVAS was similar in placebo- (37.6%) and 5-hydroxytryptophan (35.6%)-treated patients (P = .830). The fVAS reduction (−0.18; 95% CI, −0.81 to 0.46; P = .581) and Functional Assessment of Chronic Illness Therapy Fatigue scale increase (0.68; 95% CI, −2.37 to 3.73; P = .660) were both comparable between 5-hydroxytryptophan and placebo treatment as well as changes in depression, anxiety, and stress scores.

Conclusions
Despite a significant increase in serum 5-hydroxytryptophan and serotonin levels, oral 5-hydroxytryptophan did not modulate IBD-related fatigue better than placebo. (Trial Registration: Belgian Federal Agency for Medication and Health Products, EudraCT number: 2017-005059-10 and ClinicalTrials.gov: NCT03574948, https://clinicaltrials.gov/ct2/show/NCT03574948.)}},
  author       = {{Truyens, Marie and Lobatón Ortega, Triana and Ferrante, Marc and Bossuyt, Peter and Vermeire, Séverine and Pouillon, Lieven and Dewint, Pieter and Cremer, Anneline and Peeters, Harald and Lambrecht, Guy and Louis, Edouard and Rahier, Jean-François and Dewit, Olivier and Muls, Vinciane and Holvoet, Tom and Vandermeulen, Liv and Peeters, Anneleen and Gonzales, Bryan and Bos, Simon and Laukens, Debby and De Vos, Martine}},
  issn         = {{0016-5085}},
  journal      = {{GASTROENTEROLOGY}},
  keywords     = {{Gastroenterology,Hepatology,Crohn’s Disease,Ulcerative Colitis,Exhaustion,Neurobehavior}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1294--1305.e3}},
  title        = {{Effect of 5-hydroxytryptophan on fatigue in quiescent inflammatory bowel disease : a randomized controlled trial}},
  url          = {{http://doi.org/10.1053/j.gastro.2022.07.052}},
  volume       = {{163}},
  year         = {{2022}},
}

Altmetric

View in Altmetric

Web of Science

Times cited: