Abstract
Goals:
Despite the efficacy of anti-TNF agents, most patients with psoriatic arthritis (PsA) maintain residual synovial inflammation activity. The primary aim of this study was to evaluate the effects of mud bath treatment on the clinical appearance of PsA patients receiving anti-TNF agents. The secondary objective was to assess synovial inflammation of the hands using contrast-enhanced ultrasound. Additional objectives were to verify the risk of arthritis flare and to assess the effects of spa treatment on function and quality of life.
Methods:
Thirty-six patients with psoriatic arthritis, treated for at least 6 months with anti-TNF, were included. After a 1:1 randomization, 18 patients (group A) received mud bath treatment (12 clay poultices and 12 thermal baths), while continuing their anti-TNF treatment and 18 patients (group B) continued with pharmacological treatment alone. CRP, PASI, DAS28, number of tender and swollen joints, VAS pain, HAQ and SF-36 were assessed at inclusion (T0) and after 45 days (T1). Synovial inflammation detected by contrast ultrasound, analyzed by computer software, was evaluated.
Results:
Significant improvement in PASI ( p < 0.005), DAS28 ( p < 0.05), swollen and tender joint count ( p < 0.001) and HAQ ( p < 0.001) between T0 and T1 was observed in group A. No patient had experienced a flare of their arthritis. Ultrasound videos showed a significant delay in onset ( p < 0.05) and a faster washout ( p < 0.02) of the contrast medium in group A compared with group B.
Conclusion:
These data suggest a decrease in residual synovial inflammation activity and a clinical benefit of spa on psoriatic arthritis in patients treated with anti-TNF alpha.
Despite the efficacy of anti-TNF agents, most patients with psoriatic arthritis (PsA) maintain residual synovial inflammation activity. The primary aim of this study was to evaluate the effects of mud bath treatment on the clinical appearance of PsA patients receiving anti-TNF agents. The secondary objective was to assess synovial inflammation of the hands using contrast-enhanced ultrasound. Additional objectives were to verify the risk of arthritis flare and to assess the effects of spa treatment on function and quality of life.
Methods:
Thirty-six patients with psoriatic arthritis, treated for at least 6 months with anti-TNF, were included. After a 1:1 randomization, 18 patients (group A) received mud bath treatment (12 clay poultices and 12 thermal baths), while continuing their anti-TNF treatment and 18 patients (group B) continued with pharmacological treatment alone. CRP, PASI, DAS28, number of tender and swollen joints, VAS pain, HAQ and SF-36 were assessed at inclusion (T0) and after 45 days (T1). Synovial inflammation detected by contrast ultrasound, analyzed by computer software, was evaluated.
Results:
Significant improvement in PASI ( p < 0.005), DAS28 ( p < 0.05), swollen and tender joint count ( p < 0.001) and HAQ ( p < 0.001) between T0 and T1 was observed in group A. No patient had experienced a flare of their arthritis. Ultrasound videos showed a significant delay in onset ( p < 0.05) and a faster washout ( p < 0.02) of the contrast medium in group A compared with group B.
Conclusion:
These data suggest a decrease in residual synovial inflammation activity and a clinical benefit of spa on psoriatic arthritis in patients treated with anti-TNF alpha.
| Original language | English |
|---|---|
| Pages (from-to) | 236-240 |
| Number of pages | 5 |
| Journal | Revue du Rhumatisme (Edition Francaise) |
| Volume | 82 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1 Jul 2015 |
| Externally published | Yes |