Deane commented, however, that treatment of pre-RA “may not involve ‘established’ DMARDS,” but also include lifestyle changes and recognized the need to “shift our mindset from DMARDs, which we now think of in terms of drugs, to disease-modifying approaches.”

To address this, the 18-month WE-CAN study compared a diet and exercise intervention – involving walking, weight training, and low-calorie meals or meal replacements – with a control intervention comprising face-to-face nutrition and health education meetings.

In addition, since recovery from MetS can lower the risk of gout, it is important to implement strategies such as lifestyle modification and appropriate pharmacologic treatment for MetS management in young men,” say the researchers.

Adhering to a healthy lifestyle, namely never smoking, moderate alcohol use, regular exercise, healthy BMI, and healthy diet, is associated with a significantly reduced risk for rheumatoid arthritis in women, show data from the Nurses’ Health Studies.

Additional revisions were suggested by the second cohort to increase the legibility of the text, insert more Indigenous imagery, address formulary coverage for non-status First Nations patients, and include information about lifestyle factors in managing RA.

The team analyzed data for 44,654 men, aged a mean of 54 years, from the US-based Health Professionals Follow-up Study who completed a questionnaire pertaining to their medical history, current diet, and lifestyle habits every 2 years from 1986 to 2012.

Noting that patients in the study had a “high prevalence of modifiable risk factors,” including obesity (24.5%) and current smoking (24.2%), the researchers say that their findings highlight “the need to implement and evaluate intensive lifestyle modification interventions” among people receiving glucocorticoid treatment.

Lifestyle choices such as smoking, alcohol, and obesity also have differential impact on the appropriateness of therapy choice.

Discussing the practical implications of their study, they say that physical inactivity “is frequently associated with lower serum IGF1,” and lifestyle interventions to increase physical activity and increase IGF1 levels “could be an attractive [option] for RA patients.”

Maintaining a nonsmoking status for a sustained period is associated with a reduction in the excess risk for developing seropositive rheumatoid arthritis, findings suggest.

Participants were randomly assigned to receive the treat-to-target intervention – involving initiation of antihypertensive treatment, lipid-lowering drugs, antidiabetic agents, and dietary/lifestyle advice as needed according to a protocol with specific targets for each CV risk factor – or to receive usual care based on physicians’ judgement.

She received advice regarding lifestyle alterations together with a home exercise program, and she progressed well with this approach.

Bricca A et al. Arthritis Care Res 2018. doi: 10.1002/acr.23791

David Sherry discusses various pharmacologic and non-pharmacologic treatments for management of pediatric fibromyalgia, and outlines the impact of an interdisciplinary approach on physical function, mental health and pain outcomes in these patients.

David Sherry discusses various pharmacologic and non-pharmacologic treatments for management of pediatric fibromyalgia, and outlines the impact of an interdisciplinary approach on physical function, mental health and pain outcomes in these patients.

The aim of this study was to investigate the association between the Mediterranean diet and risk of rheumatoid arthritis (RA), taking RA subtype, gender and other RA risk factors into account [ read more ]. Johansson K et al. Arthritis Res Ther 2018; 20: 175. doi: 10.1186/s13075-018-1680-2

Overweight and obese patients with osteoarthritis who lose weight through lifestyle intervention experience a decrease in levels of collagen degradation markers, suggests a secondary analysis of the IDEA trial.