改善疾病的抗风湿药物和运动治疗对类风湿关节炎患者的疾病活动性有联合作用吗?范围审查。

IF 5.7 2区 医学 Q1 RHEUMATOLOGY Current Rheumatology Reports Pub Date : 2023-04-01 DOI:10.1007/s11926-023-01098-6
M Sobejana, M van der Esch, J van den Hoek, G Kitas, M van der Leeden, M T Nurmohamed, G S Metsios
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引用次数: 0

摘要

综述目的:除了改善疾病的抗风湿药物(DMARD)治疗外,类风湿性关节炎(RA)患者越来越多地提倡运动。虽然已知两者都能减少疾病活动,但很少有研究调查这些干预措施对疾病活动的综合影响。本综述的目的是对已报道的证据进行概述,以确定是否存在联合效应。在对RA患者进行DMARD治疗的同时进行运动干预的研究中,可以检测到疾病活动性结果测量的更大降低。本次范围审查遵循PRISMA指南。对DMARDs治疗RA患者的运动干预研究进行文献检索。没有非运动对照组的研究被排除在外。纳入的研究报告了DAS28和DMARD的(组成部分)使用情况,并使用Cochrane随机试验风险偏倚工具第1版评估方法学质量。对于每项研究,报告了两组之间疾病活动结果测量的比较(即,运动+药物治疗与仅药物治疗)。提取与运动干预、药物使用和其他相关因素相关的研究数据,以评估在纳入的研究中可能影响疾病活动结果的因素。近期发现:共纳入11项研究,其中DAS28组分组间研究10项。剩下的一项研究只关注组内比较。运动干预研究的中位持续时间为5个月,参与者中位人数为55人。10项组间研究中有6项报告运动+药物治疗与仅药物治疗的DAS28成分组间无显著差异。四项研究表明,与仅服用药物的组相比,运动+药物组的疾病活动结果显著降低。大多数研究没有充分的方法学设计,以调查DAS28组分的比较,并且具有高的多域偏倚风险。由于现有研究的方法学质量较弱,在RA患者中同时应用运动疗法和DMARD药物是否对疾病结局有联合影响尚不清楚。未来的研究应关注以疾病活动性为主要指标的综合效应。
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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Do Disease-Modifying Anti-rheumatic Drugs and Exercise Therapy Have a Combined Effect on Disease Activity in Patients with RA? A Scoping Review.

Purpose of review: In addition to disease-modifying anti-rheumatic drug (DMARD) treatment, exercise is increasingly promoted in patients with rheumatoid arthritis (RA). Although both are known to reduce disease activity, few studies have investigated the combined effects of these interventions on disease activity. The aim of this scoping review was to provide an overview of the reported evidence on whether a combined effect-i.e., a greater reduction in disease activity outcome measures-can be detected in studies where an exercise intervention was performed in addition to the DMARD treatment in patients with RA. This scoping review followed the PRISMA guidelines. A literature search was performed for exercise intervention studies in patients with RA treated with DMARDs. Studies without a non-exercise control group were excluded. Included studies reported on (components of) DAS28 and DMARD use and were assessed for methodological quality using version 1 of the Cochrane risk-of-bias tool for randomized trials. For each study, comparisons between groups (i.e., exercise + medication vs. medication only) were reported on disease activity outcome measures. Study data related to the exercise intervention, medication use, and other relevant factors were extracted to assess what may have influenced disease activity outcomes in the included studies.

Recent findings: A total of 11 studies were included of which 10 between-group studies on DAS28 components were made. The remaining one study focused on within-group comparisons only. Median duration of the exercise intervention studies was 5 months, and the median number of participants was 55. Six out of the 10 between-group studies reported no significant differences between groups in DAS28 components between exercise + medication vs. medication only. Four studies showed significant reductions in disease activity outcomes for the exercise + medication group compared with the medication-only group. Most studies were not adequately designed methodologically in order to investigate for comparisons of DAS28 components and had a high risk of multi-domain bias. Whether the simultaneous application of exercise therapy and DMARD medication in patients with RA has a combined effect on disease outcome remains unknown, due to weak methodological quality of existing studies. Future studies should focus on the combined effects by having disease activity as the primary outcome.

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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
41
期刊介绍: This journal aims to review the most important, recently published research in the field of rheumatology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of rheumatologic conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as the many forms of arthritis, osteoporosis and metabolic bone disease, and systemic lupus erythematosus. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.
期刊最新文献
How to Distinguish Non-Inflammatory from Inflammatory Pain in RA? Telemedicine for the Care of Patients with Idiopathic Inflammatory Myopathies: Experience, Insights and Future Directions from the International Myositis Assessment and Clinical Studies Telemedicine Scientific Interest Group. Treatment of Reactive Arthritis with Biological Agents. Recent Updates on the Pathogenesis of Inflammatory Myopathies. Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD): Update on Prevalence, Risk Factors, Pathogenesis, and Therapy.
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