scholarly journals Change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Yoshinari Matsumoto ◽  
Nitin Shivappa ◽  
Yuko Sugioka ◽  
Masahiro Tada ◽  
Tadashi Okano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Quantitative Measure ◽  
Inflammatory Change ◽  
Multivariable Logistic Regression Analysis ◽  
Dietary Inflammatory Index ◽  
Low Disease Activity ◽  
Inflammatory Index ◽  
Rheumatoid Arthritis Disease ◽  
Anti Inflammatory

Abstract Background The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, the association between DII score and disease activity of rheumatoid arthritis (RA) is unclear. Therefore, this study was designed to test whether higher DII score contributes to disease activity and as a corollary, whether reducing DII score helps to achieve or maintain low disease activity or remission in patients with RA. Methods We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) in TOMORROW, a cohort study consisting of 208 RA patients and 205 gender- and age-matched controls started in 2010. Disease activity of RA patients was assessed annually using DAS28-ESR (disease activity score 28 joints and the erythrocyte sedimentation rate) as a composite measure based on arthritic symptoms in 28 joints plus global health assessment and ESR. Dietary data were collected in 2011 and 2017 using the brief-type self-administered diet history questionnaire (BDHQ). Energy-adjusted DII (E-DII™) score was calculated using 26 nutrients derived from the BDHQ. Data were analyzed with two-group comparisons, correlation analysis, and multivariable logistic regression analysis. Results One hundred and seventy-seven RA patients and 183 controls, for whom clinical and dietary survey data were available, were analyzed. RA patients had significantly higher E-DII (pro-inflammatory) score compared to controls both in 2011 and 2017 (p < 0.05). In RA patients, E-DII score was not a factor associated with significant change in disease activity. However, anti-inflammatory change in E-DII score was associated maintaining low disease activity (DAS28-ESR ≤ 3.2) or less for 6 years (OR 3.46, 95% CI 0.33–8.98, p = 0.011). Conclusions The diets of RA patients had a higher inflammatory potential than controls. Although E-DII score was not a factor associated with significant disease activity change, anti-inflammatory change in E-DII score appeared to be associated with maintaining low disease activity in patients with RA. Trial registration UMIN Clinical Trials Registry, UMIN000003876. Registered 7 Aug 2010—retrospectively registered.

scholarly journals The change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study

2020 ◽  
Author(s):  
Yoshinari Matsumoto ◽  
Nitin Shivappa ◽  
Yuko Sugioka ◽  
Masahiro Tada ◽  
Tadashi Okano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Quantitative Measure ◽  
Significant Negative Correlation ◽  
Change Score ◽  
Multivariable Logistic Regression Analysis ◽  
Dietary Inflammatory Index ◽  
Cross Sectional ◽  
Inflammatory Index ◽  
Rheumatoid Arthritis Disease

Abstract Background The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, to the best of our knowledge, there is no report which investigated the association between rheumatoid arthritis (RA) and DII. Therefore, we investigate the association between the DII and disease activity in patients with RA.Methods We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) in TOMORROW, a 10-year prospective cohort study consisting of 208 RA patients and 205 gender- and age-matched non-RA controls recruited in 2010. Disease activity of RA patients was assessed annually using DAS28-ESR (disease activity score 28 joints and the erythrocyte sedimentation rate) as a composite measure based on arthritic symptoms in 28 joints plus global health assessment and ESR. Dietary data were collected in 2011 and 2017 using the brief-type self-administered diet history questionnaire (BDHQ). Energy-adjusted DII (E-DIITM) score was calculated using 26 nutrients derived from the BDHQ. Data were analyzed with two-group comparisons, correlation analysis, and multivariable logistic regression analysis. Results RA patients had significantly higher E-DII (pro-inflammatory) score compared to controls both in 2011 and 2017 (p < 0.05). E-DII score showed statistically significant negative correlation with age in RA patients, both in 2011 (r = -0.20) and 2017 (r = -0.23). Controls also showed a similar trend. In RA patients, E-DII score was not a factor associated with disease activity in a cross-sectional analysis. However, decline in E-DII (anti-inflammatory change) score was a factor that increased the odds of maintaining low disease activity (DAS28-ESR ≤ 3.2) or less for 6 years (OR: 4.33, 95%CI: 1.66-11.29, p = 0.003).Conclusions E-DII score was high in RA patients and lowering E-DII score over time may be beneficial in controlling disease activity in patients with RA.Trial registration UMIN Clinical Trials Registry, http://www.umin.ac.jp/ctr/, UMIN000003876. Registered 7 Aug 2010 - Retrospectively registered.

scholarly journals Regular use of non-steroidal anti-inflammatory drugs can effectively control pain and global health in patients with moderate activity of rheumatoid arthritis

2021 ◽  
Vol 15 (2) ◽  
pp. 57-63
Author(s):  
A. E. Karateev ◽  
E. Yu. Pogozheva ◽  
V. N. Amirdzhanova ◽  
E. S. Filatova ◽  
V. A. Nesterenko
Keyword(s):  
Rheumatoid Arthritis ◽  
Global Health ◽  
Disease Activity ◽  
Baseline Level ◽  
Mean Value ◽  
Moderate Activity ◽  
Low Disease Activity ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Control Pain

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to control pain in rheumatoid arthritis (RA). However, many aspects of the therapeutic effect of NSAIDs in RA have not been sufficiently studied. In particular, this concerns the effect of NSAIDs on the inflammatory activity of the disease.Objective: to study the comparative efficacy and safety of NSAIDs in RA patients with moderate and low disease activity.Patients and methods. The study group consisted of 404 patients with RA, 69% women and 31% men, mean age 58.6±10.0 years, with moderate and low disease activity – DAS28<5.1 (mean value 3.7±1.5), who initially had moderate or severe pain: >4 cm on the visual analog scale (VAS) 0–10 cm. All patients received DMARDs, mostly methotrexate 15 to 25 mg weekly, 8.2% biological agents, 18.6% glucocorticoids. All patients were prescribed NSAIDs at the full therapeutic dose. The results of treatment were evaluated after 2 weeks, 1, 3 and 6 months. Criteria of efficacy were the dynamics of pain (10 cm VAS), Patient Global Health (PGH on a 10-cm VAS), the change in the tender joints count (TJC) and swollen joints count(SJC), and dynamics of RA activity (DAS28).Results and discussion. 54.2% of patients received aceclofenac, 19.8% nimesulide, 14.3% meloxicam, 9.1% diclofenac, 2.6% – other NSAIDs. After 2 weeks, the pain decreased from 6.3±1.2 cm to 4.5±1.5 cm on VAS (p<0.001). The severity of pain continued to decrease further, and after 6 months of observation was 4.0±1.2 (p< 001, compared with the baseline level). A similar result was observed for the TJC, SJC, and PGH: the dynamics of these indicators, in comparison with the baseline level, was statistically significant after 2 weeks and after 1, 3, and 6 months of observation (p< 0.05). There was a decrease in the disease activity by DAS28: from 3.7±1.5 to 3.4±1.1 after 3 months (p=0.041) and 3.1±0.9 after 6 months (p=0.02). The effectiveness of aceclofenac and other NSAIDs for pain reduction, TJC, SJC, PGH and DAS28 did not differ. The tolerability of aceclofenac was better than of other NSAIDs: the frequency of dyspepsia after 2 weeks was 23.3% and 36.2% (p=0.004). The frequency of arterial hypertension and edema in patients who used aceclofenac, after 2 weeks and 6 months was slightly lower than in patients treated with other NSAIDs, but the difference was not statistically significant.Conclusion. The use of NSAIDs can effectively control the pain and other symptoms of RA, as well as the disease activity by DAS28 in patients with moderate or low disease activity. Aceclofenac is not inferior to other NSAIDs in analgesic potential and exceeds them in tolerability.

scholarly journals Associations Between Dietary Inflammatory Index Scores And The Increased Disease Activity of Rheumatoid Arthritis: A Cross-Sectional Study

2021 ◽  
Author(s):  
Atiyeh Nayebi ◽  
Davood Soleimani ◽  
Shayan Mostafaei ◽  
Negin Elahi ◽  
Naseh Pahlavani ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Mean Difference ◽  
Fat Free Mass ◽  
P Value ◽  
Dietary Inflammatory Index ◽  
Sectional Study ◽  
Cross Sectional ◽  
Inflammatory Index

Abstract Background: Diet plays an important role in regulating inflammation, which is a hallmark of rheumatoid arthritis (RA). Our aim was to investigate the association between the inflammatory potential of diet and RA activity.Methods: This cross-sectional study was conducted on 184 patients with RA in rheumatology clinic in Kermanshah city, Iran, in 2020. RA was diagnosed according to the criteria of the 2010 American College of Rheumatology/ European League against Rheumatism. The overall inflammatory potential of the diet was extracted from a validated 168-item food frequency questioner (FFQ) using the Dietary Inflammatory Index (DII). RA disease activity was assessed using Disease Activity Score 28 (DAS28) scores. Logistic regression and one-way ANOVA/ ANCOVA were conducted. Results: Individuals in the highest DII quartile had the significantly higher odds of positive C-reactive protein (CRP) than those in the lowest quartile of the DII scores (OR: 4.5; 95% CI: 1.16 – 17.41; P-value: 0.029). A statistically significant downward linear trend in fat-free mass and weight were observed with increasing the DII quartiles (P-value=0.003, P-value=0.019, respectively). Patients in the highest DII quartile had higher DAS 28 scores than those in the first quartile (Mean difference: 1.16; 95% CI: 0.51 – 1.81; P-value <0.001) and second quartile of the DII scores (Mean difference: 1.0; 95% CI: 0.34 – 1.65; P-value <0.001).Conclusion: Our results indicated that reducing inflammation through diet might be one of the therapeutic strategies to control and reduce the disease activity in RA patients.

FRI0076 Low Disease Activity or DAS-Remission as Treatment Target in Early Rheumatoid Arthritis Patients

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 454.1-454
Author(s):  
G. Akdemir ◽  
I.M. Markusse ◽  
A.A. Schouffoer ◽  
P.B. de Sonnaville ◽  
B.A. Grillet ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Treatment Target ◽  
Low Disease Activity
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