The effects of lifestyle interventions on disease activity and quality of life in patients with systemic lupus erythematosus: A systematic review

IF 9.2 1区 医学 Q1 IMMUNOLOGY Autoimmunity reviews Pub Date : 2024-10-01 DOI:10.1016/j.autrev.2024.103609
B.C. Geertsema-Hoeve, A.A. Sickinghe, S.J. van Schaik-Mast, J. Spierings, J.M. van Laar, M. Limper
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Abstract

Introduction

Systemic Lupus Erythematosus (SLE) is an autoimmune disease affecting multiple organs, characterized by flares and remission. Treatment aims to reduce flare severity and prevent long-term damage, but remission is often elusive, and patients may still experience flares and a reduced quality of life (QoL). This had led to a growing interest in non-pharmacological therapies to improve patient wellbeing.

Objective

We aimed to assess and summarize the efficacy of lifestyle interventions in SLE patients on disease activity and QoL.

Methods

A systematic search on lifestyle interventions, SLE, disease activity, and QoL was conducted in PubMed/Medline, Embase and Clinicaltrials.gov in August 2024. Included studies were randomized controlled trials on lifestyle interventions in adult SLE patients. Each trial was appraised using Scottish Intercollegiate Guidelines Network (SIGN) criteria, with participant numbers, study duration, intervention type and outcome measures detailed in separate tables.

Results

A total of 3564 articles were screened, resulting in the inclusion of 25 randomized controlled trials with 1521 patients. Study quality varied from high (11 studies) to low (6 studies) with considerable intervention heterogeneity. The interventions fell into five categories: physical activity, psychotherapy, lifestyle coaching, supplements and dietary interventions. Physical activity (2 studies, 116 patients), psychotherapy (5 studies, 507 patients) and coaching (1 study with 30 patients) had no significant effect on disease activity, while fish oil supplementation showed a slight benefit in two studies with a total of 102 patients. Quality of life generally improved with physical activity (4 studies with in total 253 patients) and psychotherapy (9 studies with in total 623 patients), with significant mental health benefits, but coaching (3 studies with in total 186 patients) showed no effect.

Conclusion

Various lifestyle interventions influence quality of life in SLE patients. Consistent with recent guidelines, both exercise and psychotherapy may positively impact the health-related quality of life in these patients. However, some studies were biased due to self-reported outcomes and the Hawthorne effect, where participants' behavior changed from receiving extra attention. Further research with larger patient cohorts is necessary to reduce the influence of heterogeneity across different studies and to better understand the potential of these promising therapies.
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生活方式干预对系统性红斑狼疮患者疾病活动和生活质量的影响:系统综述。
导言系统性红斑狼疮(SLE)是一种影响多个器官的自身免疫性疾病,其特点是病情发作和缓解。治疗的目的是减轻疾病发作的严重程度并防止长期损害,但缓解往往难以实现,患者仍可能出现疾病发作和生活质量下降的情况。因此,人们对改善患者生活质量的非药物疗法越来越感兴趣:我们旨在评估和总结生活方式干预对系统性红斑狼疮患者疾病活动和生活质量的影响:2024年8月,我们在PubMed/Medline、Embase和Clinicaltrials.gov上对生活方式干预、系统性红斑狼疮、疾病活动性和QoL进行了系统检索。纳入的研究均为针对成年系统性红斑狼疮患者的生活方式干预随机对照试验。每项试验均采用苏格兰校际指南网络(SIGN)标准进行评估,参与者人数、研究持续时间、干预类型和结果测量详见不同的表格:共筛选了 3564 篇文章,最终纳入了 25 项随机对照试验,涉及 1521 名患者。研究质量从高(11 项研究)到低(6 项研究)不等,干预异质性相当大。干预措施分为五类:体育锻炼、心理治疗、生活方式指导、补充剂和饮食干预。体育锻炼(2 项研究,116 名患者)、心理疗法(5 项研究,507 名患者)和生活方式指导(1 项研究,30 名患者)对疾病活动无显著影响,而鱼油补充剂在两项研究(共 102 名患者)中略有益处。体育锻炼(4 项研究,共 253 名患者)和心理治疗(9 项研究,共 623 名患者)普遍提高了生活质量,对心理健康有明显的益处,但辅导(3 项研究,共 186 名患者)没有效果:结论:各种生活方式干预措施都会影响系统性红斑狼疮患者的生活质量。结论:各种生活方式干预措施都会影响系统性红斑狼疮患者的生活质量。与最新指南一致,运动和心理治疗都会对这些患者的健康相关生活质量产生积极影响。然而,由于自我报告的结果和霍桑效应(即参与者的行为因受到额外关注而发生改变),一些研究存在偏差。有必要对更大的患者群体进行进一步研究,以减少不同研究中异质性的影响,并更好地了解这些前景广阔的疗法的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Autoimmunity reviews
Autoimmunity reviews 医学-免疫学
CiteScore
24.70
自引率
4.40%
发文量
164
审稿时长
21 days
期刊介绍: Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.
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