TY - JOUR
T1 - The combination of Chinese and Western Medicine in the management of rheumatoid arthritis
T2 - A real-world cohort study across China
AU - Zhong, Linda L. D.
AU - Wang, Rongsheng
AU - Lam, Wai Ching
AU - Zhu, Qi
AU - Du, Peipei
AU - Cao, Pei Hua
AU - Jiang, Ting
AU - Zhang, Yuan Yuan
AU - Shen, Jie
AU - Su, Xiao
AU - Xue, Luan
AU - Mao, Jianchun
AU - Fang, Yong Fei
AU - Gao, Ming Li
AU - Hu, Chun Rong
AU - Peng, Jiang Yun
AU - Gu, Ying
AU - Wei, Qianghua
AU - Huang, Runyue
AU - Lyu, Aiping
AU - Liu, Hongxia
AU - He, Dongyi
N1 - Publisher Copyright:
Copyright © 2022 Zhong, Wang, Lam, Zhu, Du, Cao, Jiang, Zhang, Shen, Su, Xue, Mao, Fang, Gao, Hu, Peng, Gu, Wei, Huang, Lyu, Liu and He.
PY - 2022/10/6
Y1 - 2022/10/6
N2 - Objective: To investigate the efficacy of Integrative medicine (IM), compare with Western medicine (WM), in the treatment of rheumatoid arthritis (RA) in a cohort study. Methods: This is a cohort study with recruitment of RA patients from 10 hospitals in China. The primary outcome was change in disease activity score 28 (DAS28) during 4 follow-up visits. Generalized estimating equation (GEE) models that controlled for variables were used to investigate a time trend and assess group differences in the primary outcome and secondary outcomes after propensity score matching (PSM). Results: A total of 3195 patients with RA received IM (n = 1379, 43.2%) or WM (n = 1816, 56.8%). Following 1:1 propensity score matching, 1,331 eligible patients prescribed IM were compared to 1,331 matched patients prescribed WM. The GEE analysis with PSM showed that the IM was more beneficial to significantly decrease the levels of VAS, PGA and PhGA (VAS: odds ratio (OR), 0.76; 95% CI, 0.63–0.92; p = 0.004; PGA: OR, 0.76; 95% CI, 0.64–0.92; p = 0.007; and PhGA: OR, 0.77; 95% CI, 0.64, 0.93; p = 0.004), and reduce DAS28 (OR, 0.84; 95% CI, 0.73–0.98; p = 0.030) in the per-protocol population. Conclusion: This study suggests that compare to WM, IM has advantages in improving RA-related outcomes. However, the statistical significance might not reveal significant clinical difference. Further studies should be focused on specific treatment strategies and/or disease stages.
AB - Objective: To investigate the efficacy of Integrative medicine (IM), compare with Western medicine (WM), in the treatment of rheumatoid arthritis (RA) in a cohort study. Methods: This is a cohort study with recruitment of RA patients from 10 hospitals in China. The primary outcome was change in disease activity score 28 (DAS28) during 4 follow-up visits. Generalized estimating equation (GEE) models that controlled for variables were used to investigate a time trend and assess group differences in the primary outcome and secondary outcomes after propensity score matching (PSM). Results: A total of 3195 patients with RA received IM (n = 1379, 43.2%) or WM (n = 1816, 56.8%). Following 1:1 propensity score matching, 1,331 eligible patients prescribed IM were compared to 1,331 matched patients prescribed WM. The GEE analysis with PSM showed that the IM was more beneficial to significantly decrease the levels of VAS, PGA and PhGA (VAS: odds ratio (OR), 0.76; 95% CI, 0.63–0.92; p = 0.004; PGA: OR, 0.76; 95% CI, 0.64–0.92; p = 0.007; and PhGA: OR, 0.77; 95% CI, 0.64, 0.93; p = 0.004), and reduce DAS28 (OR, 0.84; 95% CI, 0.73–0.98; p = 0.030) in the per-protocol population. Conclusion: This study suggests that compare to WM, IM has advantages in improving RA-related outcomes. However, the statistical significance might not reveal significant clinical difference. Further studies should be focused on specific treatment strategies and/or disease stages.
KW - cohort study
KW - integrative medicine
KW - rheumatoid arthritis
KW - autoimmune disease
KW - clinical study
UR - http://www.scopus.com/inward/record.url?scp=85140270963&partnerID=8YFLogxK
U2 - 10.3389/fphar.2022.933519
DO - 10.3389/fphar.2022.933519
M3 - Journal article
AN - SCOPUS:85140270963
SN - 1663-9812
VL - 13
JO - Frontiers in Pharmacology
JF - Frontiers in Pharmacology
M1 - 933519
ER -
