Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis

Area of Science:

• Rheumatology
• Psychiatry
• Behavioral Medicine

Background:

• Rheumatoid arthritis (RA) is a chronic autoimmune disease impacting joints and potentially leading to significant psychological distress.
• Mindfulness-based interventions (MBIs) are increasingly explored for their potential to manage chronic conditions and improve patient well-being.

Purpose of the Study:

• To systematically review the efficacy of mindfulness-based interventions (MBIs) on both clinical and patient-reported outcomes in individuals diagnosed with rheumatoid arthritis (RA).

Main Methods:

• A comprehensive literature search was conducted across multiple databases (MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, Cochrane Library) and hand searches.
• Five randomized clinical trials (RCTs) with a total of 399 participants were included after screening 338 references. A post-hoc analysis was also considered.
• Outcome measures were heterogeneous; clinical outcomes were assessed by rheumatologists, and psychological outcomes included depressive symptoms, distress, and self-efficacy. Meta-analyses were performed on specific metrics like DAS28-CRP and pain VAS.

Main Results:

• One study reported improvements in RA disease activity. A meta-analysis of DAS28-CRP from two studies showed no statistically significant difference between MBI and control groups.
• Four studies reported improvements in psychological outcomes, including reduced depressive symptoms, psychological distress, and enhanced self-efficacy.
• A meta-analysis of pain Visual Analog Scale (VAS) levels from three studies found no significant difference between groups, although other studies indicated potential pain improvement.

Conclusions:

• There is a limited number of trials evaluating MBIs in RA patients.
• Preliminary findings suggest MBIs may be beneficial for improving psychological distress in individuals with RA.
• Further research with robust methodologies is needed to confirm the efficacy of MBIs on clinical outcomes in rheumatoid arthritis.