AB0396 EFFECT OF A MULTIDISCIPLINARY LIFESTYLE PROGRAM IN PATIENTS WITH RHEUMATOID ARTHRITIS: THE PLANTS FOR JOINTS RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Lifestyle factors have been associated with the development and progression of rheumatoid arthritis (RA). Interventions involving whole food plant‐based diets (WFPDs), physical activity or stress management have shown promising results for people with RA but were not yet evaluated in an integrated program. Objectives: To determine the effect of a 16‐week multidisciplinary lifestyle program on disease activity in patients with RA. Methods: In the 'Plants for Joints' (PFJ) parallel‐arm, assessor‐blind randomized clinical trial, patients with RA and a 28‐joint Disease Activity Score [DAS28] score ≥ 2.6 and ≤ 5.1, were assigned to the P FJ group or the control group. The P FJ group followed a lifestyle program based on a WFPD, physical activity, and stress management in addition to usual care. The control group received usual care. Medication was kept stable three months before and during the trial. Secondary outcomes included anthropometric, and metabolic markers. An intention‐to‐treat analysis with a linear mixed model, adjusted for baseline values was used to analyze between‐group differences of continuous outcomes. Results: Of 115 people screened, 85 were randomized and 79 completed the study. Participants were 91% female with a mean (SD) age of 55 (12) and body mass index of 26 (4) kg/m2. After 16 weeks the P FJ group had a mean 0.85‐point greater improvement of the DAS28 versus the control group (95% CI 0.40 to 1.30; p < 0.001) (Figure 1). Subgroup analyses showed signifcant improvements in the seropositive as well as the seronegative subgroup, although the effect was more profound in the seronegative group. Weight, fat mass, HbA1c, LDL and triglycerides also showed signifcant improvements in the P FJ versus control group, while blood glucose and HDL remained unchanged (Table 1). No serious adverse events occurred. Conclusion: The 16‐week P FJ lifestyle program substantially decreased disease activity in people with RA with low‐moderate disease activity.