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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Treating Fatigue in Sarcoidosis—A Phenotype-Based, Treatable-Traits Approach

  1. 1Department of Pneumology, Medical University of Lodz, Kopcińskiego 22, 90-153 Lodz, Poland

Abstract

Fatigue is one of the most prevalent and debilitating symptoms in sarcoidosis, yet its mechanisms remain poorly defined and therapeutic responses are often unsatisfactory. Given its multifactorial nature and the limitations of uniform treatment strategies, there is a need for more structured and clinically actionable approaches. This narrative review summarizes current evidence on biological, behavioral, treatment-related and comorbidity-related contributors to sarcoidosis-associated fatigue and proposes an author-developed framework informed by the treatable-traits concept. Rather than defining mutually exclusive categories, the framework describes clinically recognizable fatigue patterns, including active inflammatory fatigue; treatment-related fatigue; comorbidity-related fatigue; sleep-related fatigue; neuropsychiatric, cognitive, pain and small-fiber neuropathy-related fatigue; deconditioning and lifestyle-related fatigue; and residual/post-sarcoidosis fatigue. The proposed approach emphasizes systematic identification and prioritization of one or more relevant treatable traits, followed by targeted intervention and reassessment. It is intended to support clinical reasoning rather than to serve as a validated classification. The framework integrates previously recognized contributors to fatigue into a structured clinical pathway and highlights areas in which direct evidence for fatigue-specific interventions remains limited. Prospective validation is required to determine its reproducibility, clinical utility and ability to identify patients who may benefit from trait-matched interventions.

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BibTeX
@article{baczek2026treating,
  title = {{Treating Fatigue in Sarcoidosis—A Phenotype-Based, Treatable-Traits Approach}},
  author = {Karol Bączek and Adam J. Białas and Wojciech J. Piotrowski},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218346},
  url = {https://www.mdpi.com/2077-0383/15/21/8346},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Treating Fatigue in Sarcoidosis—A Phenotype-Based, Treatable-Traits Approach
AU  - Karol Bączek
AU  - Adam J. Białas
AU  - Wojciech J. Piotrowski
PY  - 2026
DA  - 2026/10/27
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218346
UR  - https://www.mdpi.com/2077-0383/15/21/8346
AB  - Fatigue is one of the most prevalent and debilitating symptoms in sarcoidosis, yet its mechanisms remain poorly defined and therapeutic responses are often unsatisfactory. Given its multifactorial nature and the limitations of uniform treatment strategies, there is a need for more structured and clinically actionable approaches. This narrative review summarizes current evidence on biological, behavioral, treatment-related and comorbidity-related contributors to sarcoidosis-associated fatigue and proposes an author-developed framework informed by the treatable-traits concept. Rather than defining mutually exclusive categories, the framework describes clinically recognizable fatigue patterns, including active inflammatory fatigue; treatment-related fatigue; comorbidity-related fatigue; sleep-related fatigue; neuropsychiatric, cognitive, pain and small-fiber neuropathy-related fatigue; deconditioning and lifestyle-related fatigue; and residual/post-sarcoidosis fatigue. The proposed approach emphasizes systematic identification and prioritization of one or more relevant treatable traits, followed by targeted intervention and reassessment. It is intended to support clinical reasoning rather than to serve as a validated classification. The framework integrates previously recognized contributors to fatigue into a structured clinical pathway and highlights areas in which direct evidence for fatigue-specific interventions remains limited. Prospective validation is required to determine its reproducibility, clinical utility and ability to identify patients who may benefit from trait-matched interventions.
SN  - 2077-0383
ER  -