Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trial
Objectives In two randomised controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. The current study investigated lo...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/10/1/e004025.full |
| _version_ | 1827151895777509376 |
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| author | Jos W R Twisk Maarten Boers Dirkjan van Schaardenburg Franktien Turkstra Henriët van Middendorp Martijn Gerritsen Marike van der Leeden Martin Van der Esch Carlijn A Wagenaar Wendy Walrabenstein Peter J M Weijs |
| author_facet | Jos W R Twisk Maarten Boers Dirkjan van Schaardenburg Franktien Turkstra Henriët van Middendorp Martijn Gerritsen Marike van der Leeden Martin Van der Esch Carlijn A Wagenaar Wendy Walrabenstein Peter J M Weijs |
| author_sort | Jos W R Twisk |
| collection | DOAJ |
| description | Objectives In two randomised controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. The current study investigated long-term outcomes.Methods After completion of two 16-week trials in people with (1) RA or (2) MSOA, control groups switched to the active PFJ intervention. At the end of the intervention, all participants were followed up in a 1-year observational extension study. Primary outcomes were 28-joint Disease Activity Score (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes and intervention adherence. An intention-to-treat analysis with a linear mixed model was used to analyse within-group changes.Results 65 (84%) of 77 RA participants and 49 (77%) of 64 MSOA participants completed the extension study. The effects of the PFJ intervention were replicated in the original control groups and sustained within the RA group a year after intervention completion (mean DAS28 –0.9 points; p<0.001), while in the MSOA group mean WOMAC increased towards but remained well under the starting value (–7.8 points, p<0.001). Improvements in C-reactive protein, waist circumference (RA and MSOA); low-density lipoprotein cholesterol (RA); and weight, haemoglobin A1c, blood pressure (MSOA) were also sustained. Participants had a net decrease of medication, and intervention adherence was largely sustained.Conclusions A year after the PFJ lifestyle intervention, improvements of disease activity and metabolic outcomes within RA and MSOA groups were largely sustained and related to sustained adherence, with a net decrease of medication.Trial registration numbers NL7800, NL7801. |
| first_indexed | 2024-03-07T21:16:44Z |
| format | Article |
| id | doaj.art-32ccbadff0554d55af78339c7d2357db |
| institution | Directory Open Access Journal |
| issn | 2056-5933 |
| language | English |
| last_indexed | 2025-03-20T21:57:15Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj.art-32ccbadff0554d55af78339c7d2357db2024-08-09T17:10:10ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-004025Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trialJos W R Twisk0Maarten Boers1Dirkjan van Schaardenburg2Franktien Turkstra3Henriët van Middendorp4Martijn Gerritsen5Marike van der Leeden6Martin Van der Esch7Carlijn A Wagenaar8Wendy Walrabenstein9Peter J M Weijs10Department of Epidemiology and Data Science, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands6 Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsReade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, NetherlandsARC | Reade, Rheumatology, Amsterdam, NetherlandsInstitute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Leiden, NetherlandsRheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, Amsterdam, NetherlandsReade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, NetherlandsReade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, NetherlandsReade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, NetherlandsAmsterdam Rheumatology and Immunology Center, Amsterdam, NetherlandsDepartment of Nutrition and Dietetics, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, NetherlandsObjectives In two randomised controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. The current study investigated long-term outcomes.Methods After completion of two 16-week trials in people with (1) RA or (2) MSOA, control groups switched to the active PFJ intervention. At the end of the intervention, all participants were followed up in a 1-year observational extension study. Primary outcomes were 28-joint Disease Activity Score (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes and intervention adherence. An intention-to-treat analysis with a linear mixed model was used to analyse within-group changes.Results 65 (84%) of 77 RA participants and 49 (77%) of 64 MSOA participants completed the extension study. The effects of the PFJ intervention were replicated in the original control groups and sustained within the RA group a year after intervention completion (mean DAS28 –0.9 points; p<0.001), while in the MSOA group mean WOMAC increased towards but remained well under the starting value (–7.8 points, p<0.001). Improvements in C-reactive protein, waist circumference (RA and MSOA); low-density lipoprotein cholesterol (RA); and weight, haemoglobin A1c, blood pressure (MSOA) were also sustained. Participants had a net decrease of medication, and intervention adherence was largely sustained.Conclusions A year after the PFJ lifestyle intervention, improvements of disease activity and metabolic outcomes within RA and MSOA groups were largely sustained and related to sustained adherence, with a net decrease of medication.Trial registration numbers NL7800, NL7801.https://rmdopen.bmj.com/content/10/1/e004025.full |
| spellingShingle | Jos W R Twisk Maarten Boers Dirkjan van Schaardenburg Franktien Turkstra Henriët van Middendorp Martijn Gerritsen Marike van der Leeden Martin Van der Esch Carlijn A Wagenaar Wendy Walrabenstein Peter J M Weijs Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trial RMD Open |
| title | Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trial |
| title_full | Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trial |
| title_fullStr | Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trial |
| title_full_unstemmed | Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trial |
| title_short | Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trial |
| title_sort | long term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis 1 year follow up of the plants for joints randomised clinical trial |
| url | https://rmdopen.bmj.com/content/10/1/e004025.full |
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