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The effectiveness and safety of lifestyle medicine and integrative therapies in inflammatory arthritis: an umbrella review using a hierarchical evidence gathering approach.

作者信息

Lin Joshua, Liu Jing, O'Fee Allana, Pandey Chhiti, Benna-Doyle Sarah, Maunder Alison, Rao Vibhuti, Alesi Simon, Ng Beverly, Ee Carolyn

机构信息

School of Medicine, Western Sydney University, Sydney, NSW, Australia.

NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.

出版信息

Front Med (Lausanne). 2024 Mar 13;11:1357914. doi: 10.3389/fmed.2024.1357914. eCollection 2024.


DOI:10.3389/fmed.2024.1357914
PMID:38545510
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10965540/
Abstract

OBJECTIVE: An umbrella review was conducted to provide a comprehensive evaluation of the evidence on lifestyle medicine and integrative therapies for inflammatory arthritis. METHODS: Five electronic databases were searched for umbrella reviews, meta-analyses, and systematic reviews of randomised controlled trials on acupuncture, diet, exercise, herbal medicine, nutrient supplements, and mind-body therapies for rheumatoid arthritis, spondyloarthritis, and gout published from January 2012 to December 2022. The primary outcomes were functional status and quality of life. Quality assessment was performed using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) tool, and the certainty of evidence for our primary outcomes was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach where possible. RESULTS: We included 52 reviews. Exercise was beneficial for functional status in both rheumatoid arthritis and spondyloarthritis, with moderate certainty of evidence. Chinese herbal medicine in combination with disease-modifying anti-rheumatic drugs may improve functional status in rheumatoid arthritis (very low certainty evidence). Acupuncture may improve functional status in rheumatoid arthritis and pain in both rheumatoid arthritis and gout; however, the evidence is of very low certainty. Evidence for other therapies was not clinically significant; however, it suggests possible benefits from quercetin and polyunsaturated fatty acids. Yoga may result in a moderate improvement in functional status when used as an adjunct to medication; however, the certainty of evidence is very low. Diet interventions offered inconsistent improvements to functional status in rheumatoid arthritis, spondyloarthritis, and gout with low to very low certainty. CONCLUSION: Exercise should be prescribed for people with rheumatoid arthritis and spondyloarthritis. More research is needed to confirm or refute evidence for Chinese herbal medicine, acupuncture, yoga, and anti-inflammatory diets.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0621/10965540/fe07e5540e06/fmed-11-1357914-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0621/10965540/fe07e5540e06/fmed-11-1357914-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0621/10965540/fe07e5540e06/fmed-11-1357914-g001.jpg

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引用本文的文献

[1]
The Role of Nutrient Supplements in Female Infertility: An Umbrella Review and Hierarchical Evidence Synthesis.

Nutrients. 2024-12-27

[2]
Therapeutic Potential of Plant-Derived Compounds and Plant Extracts in Rheumatoid Arthritis-Comprehensive Review.

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[3]
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本文引用的文献

[1]
Prevalence of Diagnosed Arthritis - United States, 2019-2021.

MMWR Morb Mortal Wkly Rep. 2023-10-13

[2]
Prioritization of clinical questions for the Australian Living Guideline for the Pharmacological Management of Inflammatory Arthritis.

Int J Rheum Dis. 2023-12

[3]
2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis.

Arthritis Care Res (Hoboken). 2023-8

[4]
Medical Conditions and Preference of Traditional Chinese Medicine: Results from the China Healthcare Improvement Evaluation Survey.

Patient Prefer Adherence. 2023-1-24

[5]
The impact of diet on disease activity in spondyloarthritis: A systematic literature review.

Joint Bone Spine. 2023-3

[6]
ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update.

Ann Rheum Dis. 2023-1

[7]
Efficacy and safety of non-pharmacological and non-biological interventions: a systematic literature review informing the 2022 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis.

Ann Rheum Dis. 2023-1

[8]
Safety and efficacy of probiotic supplementation in 8 types of inflammatory arthritis: A systematic review and meta-analysis of 34 randomized controlled trials.

Front Immunol. 2022

[9]
Clinical evidence construction of East Asian herbal medicine for inflammatory pain in rheumatoid arthritis based on integrative data mining approach.

Pharmacol Res. 2022-11

[10]
Conventional disease-modifying anti-rheumatic drugs combined with Chinese Herbal Medicines for rheumatoid arthritis: A systematic review and meta-analysis.

J Tradit Complement Med. 2022-1-26

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