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Rehabilitation added to biologics improved women’s RA symptoms
Initiating a personalized rehabilitation program in combination with biologics therapy improved function and lessened fatigue in women with rheumatoid arthritis, according to recent study results.
Researchers in Italy studied 38 women with rheumatoid arthritis (RA) with high disease activity (Disease Activity Score 28 [DAS28]>5.1) being treated with disease-modifying antirheumatic drugs. A personalized 4-week rehabilitation program (twice daily) — including physical therapy and exercise to improve aerobic threshold, balance and muscle strength — was added to treatment at baseline, with patients reevaluated at 4 weeks, 3 months, 6 months and 9 months. DAS28, tender joint count, swollen joint count, global health status, health assessment questionnaire (HAQ) and Functional Assessment of Chronic Illness Therapy (FACIT) were used for clinical assessments.
Six patients were excluded from the study because of intolerance to exercise. Thirty-two patients (mean age, 62.63 years; mean disease duration, 14.87 years) completed the program. When compared with baseline, all clinical and laboratory outcomes improved at follow-up visits. Function and fatigue showed a significant improvement from baseline (HAQ, 2.42 ± 0.43; FACIT, 16.75 ± 9) to 4 weeks (HAQ, 2.13 ± 0.42; FACIT, 33 ± 9.06) to 9 months (HAQ, 2.19 ± 0.38; FACIT, 29.22 ± 10.52). DAS28 decreased from 5.98 ± 0.5 at baseline to 5.3 ± 0.69 at 9 months. Moderate disease activity also was achieved by about 30% of the patients (DAS28<5.1) at 9 months.
“Although many authors agree on the importance of exercise in RA, there is no specific therapy for rheumatoid cachexia and its major features,” the researchers concluded. “In this pilot study, we showed that in RA patients in [functional class]≥II undergoing biologics, a personalized training improves the RA features less [responsive] to traditional therapies, fatigue and function. Larger studies assessing the drivers of fatigue in established RA are needed.”