TY - JOUR
T1 - A multidisciplinary lifestyle program for rheumatoid arthritis
T2 - the 'Plants for Joints' randomized controlled trial
AU - Walrabenstein, Wendy
AU - Wagenaar, Carlijn A.
AU - van der Leeden, Marike
AU - Turkstra, Franktien
AU - Twisk, Jos W. R.
AU - Boers, Maarten
AU - van Middendorp, Henriët
AU - Weijs, Peter J. M.
AU - van Schaardenburg, Dirkjan
N1 - Funding Information:
The RCT is funded by Reade (Amsterdam, The Netherlands), Reade Foundation (Amsterdam, The Netherlands), Stichting Vermeer 14 (private foundation, Amsterdam, The Netherlands) and W.M. de Hoop Stichting (private foundation, Bussum, The Netherlands). The appointment of C.A.W. is funded by The Netherlands Organisation for Health Research and Development (ZonMw) no. 555003210. The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication.
Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - OBJECTIVE: To determine the effect of a multidisciplinary lifestyle program in patients with RA with low-moderate disease activity. METHODS: In the 'Plants for Joints' (PFJ) parallel-arm, assessor-blind randomized controlled trial, patients with RA and 28-joint DAS (DAS28) ≥2.6 and ≤5.1 were randomized to the PFJ or control group. The PFJ group followed a 16-week lifestyle program based on a whole-food plant-based diet, physical activity and stress management. The control group received usual care. Medication was kept stable 3 months before and during the trial whenever possible. We hypothesized that PFJ would lower disease activity (DAS28). Secondary outcomes included anthropometric, metabolic and patient-reported measures. An intention-to-treat analysis with a linear mixed model adjusted for baseline values was used to analyse between-group differences. RESULTS: Of the 83 people randomized, 77 completed the study. Participants were 92% female with mean (s.d.) age of 55 (12) years, BMI of 26 (4) kg/m2 and mean DAS28 of 3.8 (0.7). After 16 weeks the PFJ group had a mean 0.9-point greater improvement of DAS28 vs the control group (95% CI 0.4, 1.3; P < 0.0001). The PFJ intervention led to greater decreases in body weight (difference -3.9 kg), fat mass (-2.8 kg), waist circumference (-3 cm), HbA1c (-1.3 mmol/mol) and low-density lipoprotein (-0.32 mmol/l), whereas patient-reported outcome measures, blood pressure, glucose and other lipids did not change. CONCLUSION: The 16-week PFJ multidisciplinary lifestyle program substantially decreased disease activity and improved metabolic status in people with RA with low-moderate disease activity. TRIAL REGISTRATION: International Clinical Trials Registry Platform; https://www.who.int/clinical-trials-registry-platform; NL7800.
AB - OBJECTIVE: To determine the effect of a multidisciplinary lifestyle program in patients with RA with low-moderate disease activity. METHODS: In the 'Plants for Joints' (PFJ) parallel-arm, assessor-blind randomized controlled trial, patients with RA and 28-joint DAS (DAS28) ≥2.6 and ≤5.1 were randomized to the PFJ or control group. The PFJ group followed a 16-week lifestyle program based on a whole-food plant-based diet, physical activity and stress management. The control group received usual care. Medication was kept stable 3 months before and during the trial whenever possible. We hypothesized that PFJ would lower disease activity (DAS28). Secondary outcomes included anthropometric, metabolic and patient-reported measures. An intention-to-treat analysis with a linear mixed model adjusted for baseline values was used to analyse between-group differences. RESULTS: Of the 83 people randomized, 77 completed the study. Participants were 92% female with mean (s.d.) age of 55 (12) years, BMI of 26 (4) kg/m2 and mean DAS28 of 3.8 (0.7). After 16 weeks the PFJ group had a mean 0.9-point greater improvement of DAS28 vs the control group (95% CI 0.4, 1.3; P < 0.0001). The PFJ intervention led to greater decreases in body weight (difference -3.9 kg), fat mass (-2.8 kg), waist circumference (-3 cm), HbA1c (-1.3 mmol/mol) and low-density lipoprotein (-0.32 mmol/l), whereas patient-reported outcome measures, blood pressure, glucose and other lipids did not change. CONCLUSION: The 16-week PFJ multidisciplinary lifestyle program substantially decreased disease activity and improved metabolic status in people with RA with low-moderate disease activity. TRIAL REGISTRATION: International Clinical Trials Registry Platform; https://www.who.int/clinical-trials-registry-platform; NL7800.
KW - RA
KW - diet
KW - physical activity
KW - stress management
UR - https://www.scopus.com/pages/publications/85166442017
U2 - 10.1093/rheumatology/keac693
DO - 10.1093/rheumatology/keac693
M3 - Article
C2 - 36617162
SN - 1462-0324
VL - 62
SP - 2683
EP - 2691
JO - Rheumatology (Oxford, England)
JF - Rheumatology (Oxford, England)
IS - 8
ER -