“This is particularly important as cardiovascular disease contributes significantly to the excess mortality in patients with RA,” says Dixon. However, he adds that the researchers were unable to determine whether the reduced risk of MI was specific to anti–TNF-α therapy or whether it would be seen with other therapies, as well.
The team had originally hypothesized that MIs would be reduced in all anti–TNF-α–treated patients with RA. “However, the finding that only responders have the added cardiovascular benefit fits with the paradigm of RA patients having increased cardiovascular burden acting via shared inflammatory mechanisms,” says Dixon.
Relaxation as RA Treatment
Another group of researchers suggest an added option in RA treatment – mindfulness-based stress reduction (MBSR).
In a recent issue of Arthritis Care & Research (2007;57:1134-1142), a team from the Center for Integrative Medicine at the University of Maryland School of Medicine in Baltimore found a 35% reduction in psychological distress and a significant improvement in well-being in RA patients who practiced MBSR for six months.
“Our findings are the first to indicate that the stress-reduction technique of meditation may prove valuable to patients in facing the emotional burden of this chronic disease,” says lead author Elizabeth K. Pradhan, PhD, assistant professor of family medicine.
With a group of 63 patients randomized to MBSR and control, the researchers found no differences between the groups following two months of MBSR. At six months, however, statistically significant benefits in psychological distress reduction and well-being were observed in the RA patients randomized to the MBSR group.
“It was surprising to us that, in this patient population, six months of mindfulness-based stress reduction practice were required to improve psychological distress and well-being significantly beyond the level found in the control group,” she says, adding that the control group showed initial improvement at two months, but returned to near baseline levels by study end.
“Our findings suggest that mindfulness-based stress reduction may be an effective complementary therapy for the management of RA,” she says.
Sue Pondrom is a medical journalist based in San Diego.