Department of Rheumatology, Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Benekestr. 2-8, 61231 Bad Nauheim, Germany.
Department of Rheumatology, Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Benekestr. 2-8, 61231 Bad Nauheim, Germany.
Eur J Intern Med. 2021 Nov;93:42-49. doi: 10.1016/j.ejim.2021.07.005. Epub 2021 Jul 31.
Aim of this study was to prospectively assess the effects of multimodal rheumatologic complex treatment (MRCT), a special concept of in-patient physical treatment (PT) for treating spondyloarthritis (SpA), namely radiographic (r-) and non-radiographic (nr-) axial (ax-) SpA and psoriatic arthritis (PsA).
r-, nr-axSpA and PsA patients receiving a 16-day MRCT were eligible. MRCT was delivered to participants over 64 PT sessions of various modalities with a minimum of 1,400 min of treatment. Primary outcome was a change in pain levels measured on a numeric rating scale (NRS, 0 - 10) between baseline and discharge. Secondary outcomes were assessments of i) disease activity ii) functional disabilities iii) serum cytokine levels iv) analgesic usage v) patient global health assessment and patients' satisfaction with their therapeutic response to MRCT from baseline to discharge and over a 12-week follow-up.
50 patients completed the study and were analysed. Pain levels were improved significantly (p < 0.001, 95% confidence interval -2.25 to -0.8,). Further analyses revealed no influencing factors or relevant inter-group differences. Positive effects of MRCT lasted up to 12 weeks after discharge. Analgesic usage was reduced compared to baseline. Patient global health assessment continued to be improved throughout the whole follow-up. No MRCT-related harms were recorded.
MRCT as a multimodal treatment concept with a strong emphasis on PT reduces pain in SpA meaningfully and facilitates reduced analgesic usage.
本研究旨在前瞻性评估多模式风湿科综合治疗（MRCT）对治疗脊柱关节炎（SpA），包括放射学（r-）和非放射学（nr-）轴向（ax-）SpA 和银屑病关节炎（PsA）的影响。
符合条件的 r-、nr-axSpA 和 PsA 患者接受 16 天的 MRCT。MRCT 通过 64 次不同方式的物理治疗（PT）疗程提供给参与者，治疗时间至少为 1400 分钟。主要结局是通过数字评分量表（NRS，0-10）在基线和出院时测量疼痛水平的变化。次要结局是评估 i）疾病活动度 ii）功能障碍 iii）血清细胞因子水平 iv）镇痛药物使用 v）患者整体健康评估和患者对 MRCT 治疗反应的满意度，从基线到出院以及 12 周随访。
50 例患者完成了研究并进行了分析。疼痛水平显著改善（p < 0.001，95%置信区间 -2.25 至 -0.8）。进一步分析显示没有影响因素或相关组间差异。MRCT 的积极作用持续到出院后 12 周。与基线相比，镇痛药物使用减少。患者整体健康评估在整个随访过程中持续改善。未记录到与 MRCT 相关的伤害。
MRCT 作为一种多模式治疗概念，强调物理治疗，可显著减轻 SpA 的疼痛，并有助于减少镇痛药物的使用。
