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Only 30% of RA patients report dietary supplement use to physicians
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Although nearly half of patients with RA use natural dietary supplements, just 30% of these patients inform their physician about their use, according to findings published in Arthritis Care & Research.
“Conventional RA therapy includes early and ongoing treatment with disease modifying anti-rheumatic drugs and biologic therapies with established efficacy in reducing disease activity that are also associated with well-documented risks, such as life-threatening infections, malignancies and major-organ dysfunction and a high annualized cost ($26,000 USD),” Janel C. DeSalvo, MD, of the University of Arizona, and colleagues wrote. “These potential risks of conventional therapy, when coupled with the perceived safety of [natural-product dietary supplements], could increase the prevalence of [natural-product dietary supplements] use for RA symptom management, a practice that could place RA patients at a higher risk of adverse side effects if coupled with intensive pharmacological management.”
To analyze the population-based patterns of the use of natural-product dietary supplements — defined as nonmineral, nonvitamin natural product-derived substances that are ingested — for RA self-management, the researchers conducted a literature review. Using the Cochrane Library, Embase, Ovid/Medline, Web of Science and other databases, the researchers identified studies in which at least 50% of participants had a diagnosis of RA, and reported on the prevalence or patterns of natural-product dietary supplements.
Of the 3,597 unique articles initially identified, all but 72 were excluded due to irrelevance. DeSalvo and colleagues ultimately focused on 23 studies, published between 1980 and 2015, that met all the inclusion criteria. Among the 23 included studies, conducted in 11 countries, were six studies that were only available as conference abstracts.
According to the researchers, the overall prevalence of the use of natural-product dietary supplements among patients with RA was 47%, with the most common supplements being marine oils, glucosamine, vinegar and chondroitin. This figure did not differ by geographic region. Of those who used them, an average of 47% of patients found natural-product dietary supplements to be effective, while 13% reported experiencing adverse effects. Only 30% had informed their physician that they used such supplements. In a majority of cases, the use of supplements was concomitant with conventional RA pharmaceuticals.
“Because the significant communication gap between patients and their providers regarding [natural-product dietary supplements] use could potentially expose patients to increased risk of harm, up-to-date assessments of RA population-based usage patterns may assist providers in remaining cognizant of their patients’ practices and enhance their ability to identify [natural-product dietary supplements]-related clinical outcomes,” DeSalvo and colleagues wrote.
“This is particularly important in the [United States] where federal oversight of [natural-product dietary supplements] is primarily limited to an assessment of adverse events reported postmarketing,” they added. “A continued increase and changing trends in the sale of specific [natural-product dietary supplements] suggest that current U.S.-based usage patterns may not be well captured in the disparate studies reported here, requiring a larger-scale, multiregional and nonprovider affiliated survey to identify more current estimates of the prevalence and pattern of [natural-product dietary supplements] use in the general RA population.” – by Jason Laday
Disclosure: The researchers report support from the NIH National Center for Complementary and Investigative Health. Please see the study for all other authors’ relevant financial disclosures.
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