Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany.
Department of Medical Statistics, University Medical Center Göttingen, Germany.
Clin Exp Rheumatol. 2022 Nov;40(11):2133-2140. doi: 10.55563/clinexprheumatol/lrff6k. Epub 2022 Mar 1.
To evaluate effects of whole-body cryotherapy (WBC) in rheumatoid arthritis (RA).
Patients with active RA undergoing a 16-day multimodal rheumatologic complex treatment were randomly assigned to either WBC (6 applications in 14 days at -130°C for 3 min) or no treatment. The primary outcome was the difference between groups in pain on a numerical rating scale after intervention. Secondary outcomes assessed effects on i) disease activity, ii) functional capacity, iii) cytokine levels, and iv) use of analgesics.
A total of 56 RA patients completed the trial (intervention group [IG]: 31 patients, control group [CG]: 25 patients). The mean change (± standard error) in pain after intervention was -2 in the IG (95% confidence interval [CI] -2.75 to -1.31, p<0.001) and -0.88 (95% CI -1.43 to -0.33, p=0.003) in the CG, with a baseline-adjusted between-group difference of -1.31 ± 0.4 (95% CI -2.1 to -0.53; p=0.002). Pain at the 12-week follow-up visit remained significantly below baseline values in the IG. Disease activity and functional capacity showed statistically and clinically meaningful improvement after intervention but were not significant at the 12-week follow up. TNF and IL-6 levels changed significantly in the IG. Eighteen of 31 (58%) patients of the IG reduced or discontinued analgesics at the 12-week follow-up. No WBC-related side effects were reported.
WBC in RA reduces pain and disease activity significantly and in a clinically meaningful manner, resulting in a reduction of analgesics. These effects are potentially based on a change in cytokine levels.
评估全身冷冻疗法（WBC）在类风湿关节炎（RA）中的疗效。
接受 16 天多模式风湿科综合治疗的活动期 RA 患者被随机分为 WBC 组（在 14 天内接受 6 次治疗，每次 3 分钟，温度为-130°C）或对照组（不接受治疗）。主要结局是干预后两组患者数字评分量表上疼痛的差异。次要结局评估对以下方面的影响：i）疾病活动度，ii）功能能力，iii）细胞因子水平，以及 iv）镇痛药的使用。
共有 56 例 RA 患者完成了试验（干预组 [IG]：31 例，对照组 [CG]：25 例）。干预后疼痛的平均变化（±标准误差）在 IG 为-2（95%置信区间 [CI] -2.75 至-1.31，p<0.001），在 CG 为-0.88（95% CI -1.43 至-0.33，p=0.003），组间差异为-1.31 ± 0.4（95% CI -2.1 至-0.53；p=0.002）。IG 在 12 周随访时疼痛仍明显低于基线值。疾病活动度和功能能力在干预后均有显著改善，但在 12 周随访时无统计学意义。IG 中 TNF 和 IL-6 水平发生显著变化。IG 中有 18 例（58%）患者在 12 周随访时减少或停用了镇痛药。未报告与 WBC 相关的不良反应。
WBC 可显著减轻 RA 患者的疼痛和疾病活动度，且具有临床意义，从而减少镇痛药的使用。这些效果可能基于细胞因子水平的变化。
