Rheumatology Department, Kassab Orthopedics Institute, Mannouba, Tunisia.
Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia.
Clin Rheumatol. 2020 Aug;39(8):2433-2440. doi: 10.1007/s10067-020-05007-5. Epub 2020 Mar 5.
Ramadan intermittent fasting is observed by Muslims from sunrise to sunset and alternated with moments of re-feeding. The aims of this study were to assess the impact of Ramadan fasting on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity and to assess its impact on chronic medications intake in patients with rheumatic diseases.
This prospective monocentric study included patients with RA or SpA who fasted during Ramadan of 2019. The disease activity and the managing of chronic medications were assessed and compared between two visits: the first one 6 months before starting Ramadan fasting and the second after fasting at least 7 days.
Fifty-six patients were included: 36 with RA (average age 57.5 ± 10.9 years) and 20 with SpA (average age 47 ± 12.6 years). In the RA group, the Disease Activity Scores (DAS) 28 ESR, and DAS 28 CRP decreased after fasting respectively from 4.3 ± 1.3 to 3.5 ± 1.4 (p < 0.001) and from 3.4 ± 1.2 to 2.9 ± 1.3 (p = 0.001). In the SpA group, Ankylosing Spondylitis Disease Activity Scores (ASDAS) ESR and ASDAS CRP decreased respectively from 2.3 ± 0.5 to 1.9 ± 0.7 (p = 0.039) and from 1.9 ± 0.5 to 1.8 ± 0.8 (p = 0.388). Fasting did not affect significantly either compliance with chronic medications or tolerance.
Fasting can be a possible way to induce rapid improvement of rheumatic diseases activity. In addition, patients with a specific fear of drug intake during this period can be reassured, which will enhance the adherence to treatment. Key Points • Fasting during Ramadan, the ninth month of the Islamic calendar, consists of intermittent fasting observed from sunrise to sunset. • In this set of patients, beneficial effects of intermittent fasting were demonstrated on RA activity, but were less evident in patients with SpA despite a general trend towards improvement. • Fasting did not affect significantly either compliance with chronic medications or tolerance.
穆斯林从日出到日落期间进行斋月间歇性禁食，然后再进行一段时间的进食。本研究旨在评估斋月禁食对类风湿关节炎（RA）和脊柱关节炎（SpA）活动的影响，并评估其对风湿性疾病患者慢性药物摄入的影响。
这项前瞻性单中心研究纳入了 2019 年在斋月期间禁食的 RA 或 SpA 患者。在两次就诊期间评估疾病活动度和慢性药物的管理情况，这两次就诊分别是：开始斋月禁食前 6 个月的第一次就诊和至少禁食 7 天后的第二次就诊。
共纳入 56 例患者：36 例 RA（平均年龄 57.5±10.9 岁）和 20 例 SpA（平均年龄 47±12.6 岁）。在 RA 组中，禁食后 DAS28 ESR 和 DAS28 CRP 分别从 4.3±1.3 降至 3.5±1.4（p<0.001）和从 3.4±1.2 降至 2.9±1.3（p=0.001）。在 SpA 组中，强直性脊柱炎疾病活动评分（ASDAS）ESR 和 ASDAS CRP 分别从 2.3±0.5 降至 1.9±0.7（p=0.039）和从 1.9±0.5 降至 1.8±0.8（p=0.388）。禁食对慢性药物的依从性或耐受性均无显著影响。
禁食可能是一种快速改善风湿性疾病活动度的方法。此外，对于在此期间特别担心药物摄入的患者，可以让他们放心，这将增强他们对治疗的依从性。关键点：• 斋月，伊斯兰历的第九个月，是指从日出到日落的间歇性禁食。• 在这组患者中，间歇性禁食对 RA 活动有明显的益处，但对 SpA 患者的效果不太明显，尽管有总体改善的趋势。• 禁食对慢性药物的依从性或耐受性均无显著影响。
