Learn more about treatment guidelines for integrative medicine to manage rheumatoid arthritis presented at ACR Convergence 2022.
One of the most common rheumatologic conditions, rheumatoid arthritis, impacts patients around the world. And as clinical data emerges, rheumatologists’ approach to treatment continues to change. The American College of Rheumatology (ACR) released a summary of its new guidelines titled “Exercise, Rehabilitation, Diet and Additional Integrative Interventions for Rheumatoid Arthritis,” presented at the ACR’s annual Convergence.
These guidelines focus on taking an integrative approach to the management of rheumatoid arthritis. What else do these guidelines tell us?
The guidelines include 28 recommendations—one strong, and 27 conditionals. Of the 27 conditional recommendations:
- 4 were about exercise
- 13 were about rehabilitation
- 3 were about diet
- 7 were about additional integrative interventions
The one strong recommendation states that consistent engagement in exercise is recommended as opposed to no exercise. While the type of exercise, frequency, intensity, and duration is not defined, the guideline emphasizes moving regularly.
Other recommendations featured in the guidelines include adhering to a Mediterranean-style diet over no formally defined diet. This diet encourages the intake of vegetables, fruits, whole grains, nuts, seeds, and olive oil, moderate amounts of low-fat dairy and fish, and advises against adding sugars, sodium, highly processed foods, refined carbohydrates, and saturated fats.
The conditional recommendation for adhering to a Mediterranean-style diet but not other formally defined diets, to improve RA-specific outcomes, may be surprising to some clinicians,” said Dr. Bryant R. England, an Associate Professor of Rheumatology and Immunology at the University of Nebraska Medical Center and one of the guideline’s co-principal investigators. “The Voting Panel acknowledged, however, that other health indications may exist for alternative diet and dietary supplements, which makes it crucial for clinicians and patients to engage in shared decision-making.”
The Patient Panel, which provided input in these guideline recommendations, emphasized the importance of clinicians being knowledgeable about integrative therapies to help guide their patients and to incorporate shared decision-making into clinical practice. It’s also vital information to incorporate into the interprofessional care team, which could be made up of occupational therapists, physical therapists, dietitians, and more.
“Being able to include the diverse integrative interventions in the management of persons with RA throughout their disease course, as an interdisciplinary team, is essential. This guideline highlights the vital role expert members of interprofessional healthcare teams serve in providing optimal care to people with RA,” said Dr. Benjamin J. Smith, who is the Interim Program Director and Associate Dean at the Florida State University College of Medicine and co-principal investigator of the guideline.
Dr. Smith will be co-moderating a session on these recommendations at ACR Convergence 2022 on Sunday, November 13. This session will summarize the draft recommendations for exercise, rehabilitation, diet, and additional integrative interventions for rheumatoid arthritis; take a look at the evidence supporting integrative therapies for the treatment of rheumatoid arthritis, and show a shared decision-making approach to discussing integrative therapies for rheumatoid arthritis.