Effectiveness of Acupuncture on Pain, Physical Function and Health-Related Quality of Life in Patients with Rheumatoid Arthritis: A Systematic Review of Quantitative Evidence

2018 ◽  
Vol 25 (9) ◽  
pp. 704-709 ◽  
Author(s):  
Susana Seca ◽  
Diana Miranda ◽  
Daniela Cardoso ◽  
Bernice Nogueira ◽  
Henry J. Greten ◽  
...  
2014 ◽  
Vol 41 (6) ◽  
pp. 1067-1076 ◽  
Author(s):  
Clifton O. Bingham ◽  
Michael Weinblatt ◽  
Chenglong Han ◽  
Timothy A. Gathany ◽  
Lilianne Kim ◽  
...  

Objective.To evaluate the effects of intravenous (IV) golimumab 2 mg/kg + methotrexate (MTX) on patient-reported measures of health-related quality of life (HRQOL) in patients with active rheumatoid arthritis (RA) despite prior MTX therapy.Methods.In this randomized, multicenter, double-blind, placebo-controlled, phase III trial, adults with RA were randomly assigned to receive IV placebo (n = 197) or golimumab 2 mg/kg (n = 395) infusions at Week 0, Week 4, and every 8 weeks thereafter. All patients continued stable oral MTX (15–25 mg/wk). HRQOL assessments included Health Assessment Questionnaire-Disability Index (HAQ-DI; physical function), Medical Outcomes Study Short Form-36 questionnaire physical/mental component summary (SF-36 PCS/MCS) scores, EQ-5D assessment of current health state, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) questionnaire, and disease effect on productivity [10-cm visual analog scale (VAS)].Results.Mean HAQ-DI improvements from baseline were significantly greater with golimumab + MTX than placebo + MTX at Week 14 and Week 24 (p < 0.001). Significantly greater improvements in all 8 individual SF-36 subscores and both the SF-36 PCS and MCS scores (p < 0.001) also accompanied golimumab + MTX therapy. Improved EQ-5D and EQ-5D VAS (p < 0.001) and FACIT-Fatigue (p < 0.001) scores were also observed for golimumab + MTX-treated patients at Week 12, Week 16, and Week 24, and greater proportions of golimumab + MTX-treated patients had clinically meaningful improvements in these measures. Greater reductions in disease effect on productivity were observed with golimumab + MTX versus placebo + MTX at Week 24 (p < 0.001). Improvements in physical function, HRQOL, fatigue, and productivity significantly correlated with disease activity improvement.Conclusion.In active RA, IV golimumab + MTX significantly improved physical function, HRQOL, fatigue, and productivity using multiple measurement tools; all correlated with improvements in disease activity (NCT00973479, EudraCT 2008-006064-11).


2021 ◽  
Author(s):  
Alessio Bricca ◽  
Madalina Jäger ◽  
Marie Johnston ◽  
Graziella Zangger ◽  
Lasse K. Harris ◽  
...  

Abstract Background To investigate the effect of behavioural interventions targeting lifestyle behaviours on physical activity, weight loss, physical function, health-related quality of life and depression in people with multimorbidity and to investigate which Behaviour Change Techniques (BCTs) are associated with better outcomes.Methods Systematic review of randomised controlled trials targeting lifestyle behaviours in people with multimorbidity following the Cochrane recommendations. Data sources included MEDLINE, EMBASE, CENTRAL and CINAHL up to June 19th, 2020 and screening reference list of Cochrane reviews including people with multimorbidity, ongoing systematic reviews of the MOBILIZE project, the WHO registry and citation tracking of included studies. Meta-analyses using random-effects model to assess the effect of behavioural interventions on physical activity, weight loss, physical function and health-related quality of life and depression. Meta-regression analyses and effectiveness ratios to investigate the impact of pre-specified mediators of effect estimates. Cochrane ‘Risk of Bias Tool’ 2.0 and the GRADE assessment to evaluate the overall quality of evidence.Results Fourteen papers involving 1,378 people. Behavioural interventions had little to no effect on physical activity (standardised mean difference 0.38, 95%CI -0.12 to 0.61 – very low certainty) and the effect on weight loss is uncertain (BMI mean difference -0.17, 95%CI -1.17 to 0.83 – very low certainty) at the end-treatment follow-up (mean duration 23 weeks, SD 15). Small improvements were seen in health-related quality of life (SMD 0.29, 95% CI 0.17 to 0.42 – moderate certainty) and physical function (SMD 0.42, 95% CI 0.12 to 0.73 – low certainty), and moderate improvements were seen for depression symptoms (SMD -0.70, 95%CI -0.98 to -0.42 – moderate certainty). Studies using the BCTs ‘action planning’ and ‘social support (practical)’ reported greater physical activity and weight loss. The effects of behavioural interventions diminished for all the outcomes at long-term follow-ups (mean duration of 36 weeks, SD 15).Conclusions Behavioural interventions targeting lifestyle behaviours improve health-related quality of life and physical function, and reduce depression symptoms, whereas little to no effect was achieved on physical activity and weight loss in people with multimorbidity. However, the evidence for physical activity and weight loss were of low quality and the end-treatment benefits diminished over time.Systematic review protocol Open Science Framework: https://osf.io/r7pm5/


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