Holistic approach to care

The impact of lifestyle intervention in RA

2024-06-15

(Press-News.org) The 16-week Plants for Joints trial investigated the effects of a multidisciplinary lifestyle intervention in people with RA, as compared to usual care. The intervention was based on a whole-food, plant-based diet – alongside physical activity and stress management. Previous reports showed this intervention significantly reduced the 28-joint disease activity score (DAS28) compared to usual care alone.2,3 To expand on this, the researchers wanted to determine the long-term effectiveness of the intervention, specifically with regards to disease activity after 2 years.

After the initial 16-week randomised period, the control group also received the intervention, and participants were followed for 2 years with biannual visits and six adherence-promoting webinars annually. People with DAS28 <2.6 also received a protocol as a suggested approach to try tapering their antirheumatic medication – under the supervision of their rheumatologist – and any treatment changes were recorded.

In total, 62% of the original trial completers also completed the 2-year follow-up. Those who discontinued most often indicated that this was because they were too busy, unreachable, or did not give permission for the second year of the extension study.

The long-term results showed that improvement in DAS28 was maintained for 2 years after completing the intervention – and was significantly lower compared to baseline. Tender joint count and general health components of the DAS28 also improved significantly, although there was no significant difference in the erythrocyte sedimentation rate and swollen joint count compared to baseline. Results were similar in people who completing the 2-year extension study versus those that discontinued prematurely.

Of the 39 participants who completed their follow-up and used disease-modifying antirheumatic medication, 44% were able to decrease or stop, 26% had stable usage, and 31% had increased medication. Of those with stable or decreased medication compared to baseline, 65% had improved DAS28.

After the 2-year follow-up, HDL-cholesterol was increased and C-reactive protein (CRP) remained significantly lower compared to baseline values – although there was no longer a significant difference in weight, waist circumference, LDL-cholesterol, or HbA1c.

These findings indicate that intensive lifestyle modifications can be effective in the long term for people with RA.

Source

Wagenaar C, et al. Long-term Effectiveness of a Lifestyle Intervention for Rheumatoid Arthritis: two-year follow-up after the “Plants for Joints” randomized clinical trial. Presented at EULAR 2024; OP0330.

Ann Rheum Dis 2024; DOI: 10.1136/annrheumdis-2024-eular.885.

References

1. Gwinnutt JM, et al. 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases. Ann Rheum Dis 2023;82:48–56.

2. Walrabenstein W, et al. The effect of a multidisciplinary lifestyle program for patients with rheumatoid arthritis, an increased risk for rheumatoid arthritis or with metabolic syndrome-associated osteoarthritis: the "Plants for Joints" randomized controlled trial protocol. Trials 2021;22(1):715.

3. Walrabenstein W, et al. A multidisciplinary lifestyle program for rheumatoid arthritis: the 'Plants for Joints' randomized controlled trial. Rheumatology 2023;62(8):2683–91.

About EULAR

EULAR is the European umbrella organisation representing scientific societies, health professional associations and organisations for people with rheumatic and musculoskeletal diseases (RMDs). EULAR aims to reduce the impact of RMDs on individuals and society, as well as improve RMD treatments, prevention, and rehabilitation. To this end, EULAR fosters excellence in rheumatology education and research, promotes the translation of research advances into daily care, and advocates for the recognition of the needs of those living with RMDs by EU institutions.

Contact

EULAR Communications, communications@eular.org

Notes to Editors

EULAR Recommendations

EULAR School of Rheumatology

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[Press-News.org] Holistic approach to care
The impact of lifestyle intervention in RA

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