K Triantafyllias1, C Sauer2, A Schwarting3,4. 1. Rheumazentrum Rheinland-Pfalz GmbH, Kaiser-Wilhelm-Str. 9-11, 55543, Bad Kreuznach, Deutschland. ktriantafyllias@gmail.com. 2. Innere Medizin, Krankenhaus Sachsenhausen, DGD Kliniken, Frankfurt am Main, Deutschland. 3. Rheumazentrum Rheinland-Pfalz GmbH, Kaiser-Wilhelm-Str. 9-11, 55543, Bad Kreuznach, Deutschland. 4. Schwerpunkt Rheumatologie, I. Med. Klinik und Poliklinik, Johannes Gutenberg Universitätsmedizin Mainz, Mainz, Deutschland.
Abstract
INTRODUCTION: The concept of complex multimodal rheumatologic treatment (CMRT) has been established for several years in German rheumatologic departments and aims at a multifaceted therapeutic approach to patients with rheumatic diseases. Objective of this study was to examine the therapeutic effect of CMRT in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in an acute rheumatology center. METHODS: The treatment success of CMRT was evaluated by epidemiologic data, patient questionnaires on visual analog scales (VAS) regarding morning stiffness, pain and disease activity (DA), as well as clinical scores (Disease Activity Score 28 [DAS28], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Bath Ankylosing Spondylitis Functional Index [BASFI]), laboratory inflammation markers (CRP, erythrocyte sedimentation rate) and medication in three visits: visit 1 = begin of CMRT; visit 2 = end of CMRT; visit 3 = 3 months after CMRT. RESULTS: In this study 162 patients from the Rheumatology Center, Rhineland-Palatinate, Germany (96 (59.3%) RA, 30 (18.8%) AS, 36 (22.2%) PsA) were recruited. Statistical examinations revealed a significant improvement of VAS(DA) (visit 2 versus visit 1: RA: p = 0.02, AS: p < 0.001, PsA: p < 0.001), morning stiffness (RA: p < 0.001, AS: p = 0.03, PsA: p < 0.001) and patient reported pain (all; p < 0.001) in the context of CMRT. In the RA and AS subgroups improvements of DAS28 and BASDAI could also be observed (visit 2 versus visit 1: both; p < 0.001). Moreover, significant improvement of patient reported outcomes could be observed 3 months after CMRT regarding VAS(DA) (RA: p = 0.02 und AS: p = 0.03, morning stiffness (PsA: p = 0.02) and patient reported pain (RA: p = 0.01)). Interestingly, subgroup analyses showed that the therapeutic benefit was independent of the concomitant pharmacotherapy. CONCLUSION: The results of this study suggest a therapeutic benefit for patients being treated by CMRT and highlight the high value of this therapeutic concept in patients with systemic-inflammatory rheumatic diseases.
INTRODUCTION: The concept of complex multimodal rheumatologic treatment (CMRT) has been established for several years in German rheumatologic departments and aims at a multifaceted therapeutic approach to patients with rheumatic diseases. Objective of this study was to examine the therapeutic effect of CMRT in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in an acute rheumatology center. METHODS: The treatment success of CMRT was evaluated by epidemiologic data, patient questionnaires on visual analog scales (VAS) regarding morning stiffness, pain and disease activity (DA), as well as clinical scores (Disease Activity Score 28 [DAS28], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Bath Ankylosing Spondylitis Functional Index [BASFI]), laboratory inflammation markers (CRP, erythrocyte sedimentation rate) and medication in three visits: visit 1 = begin of CMRT; visit 2 = end of CMRT; visit 3 = 3 months after CMRT. RESULTS: In this study 162 patients from the Rheumatology Center, Rhineland-Palatinate, Germany (96 (59.3%) RA, 30 (18.8%) AS, 36 (22.2%) PsA) were recruited. Statistical examinations revealed a significant improvement of VAS(DA) (visit 2 versus visit 1: RA: p = 0.02, AS: p < 0.001, PsA: p < 0.001), morning stiffness (RA: p < 0.001, AS: p = 0.03, PsA: p < 0.001) and patient reported pain (all; p < 0.001) in the context of CMRT. In the RA and AS subgroups improvements of DAS28 and BASDAI could also be observed (visit 2 versus visit 1: both; p < 0.001). Moreover, significant improvement of patient reported outcomes could be observed 3 months after CMRT regarding VAS(DA) (RA: p = 0.02 und AS: p = 0.03, morning stiffness (PsA: p = 0.02) and patient reported pain (RA: p = 0.01)). Interestingly, subgroup analyses showed that the therapeutic benefit was independent of the concomitant pharmacotherapy. CONCLUSION: The results of this study suggest a therapeutic benefit for patients being treated by CMRT and highlight the high value of this therapeutic concept in patients with systemic-inflammatory rheumatic diseases.
Authors: Hanna W van Steenbergen; Daniel Aletaha; Liesbeth J J Beaart-van de Voorde; Elisabeth Brouwer; Catalin Codreanu; Bernard Combe; João E Fonseca; Merete L Hetland; Frances Humby; Tore K Kvien; Karin Niedermann; Laura Nuño; Sue Oliver; Solbritt Rantapää-Dahlqvist; Karim Raza; Dirkjan van Schaardenburg; Georg Schett; Liesbeth De Smet; Gabriella Szücs; Jirí Vencovský; Piotr Wiland; Maarten de Wit; Robert L Landewé; Annette H M van der Helm-van Mil Journal: Ann Rheum Dis Date: 2016-10-06 Impact factor: 19.103
Authors: M Rudwaleit; D van der Heijde; R Landewé; N Akkoc; J Brandt; C T Chou; M Dougados; F Huang; J Gu; Y Kirazli; F Van den Bosch; I Olivieri; E Roussou; S Scarpato; I J Sørensen; R Valle-Oñate; U Weber; J Wei; J Sieper Journal: Ann Rheum Dis Date: 2010-11-24 Impact factor: 19.103