Integrative Interventions in Rheumatoid Arthritis

The American College of Rheumatology (ACR) released a summary of its important new guideline for Exercise, Rehabilitation, Diet and Additional Integrative Interventions for Rheumatoid Arthritis. It’s the first ACR guideline about an integrative approach to Rheumatoid Arthritis (RA) and it is considered a complement to the ACR’s 2021 Guideline for the Treatment of RA, which covers pharmacologic therapies.

Benjamin J. Smith, DMSc, PA-C, DFAAPA, Interim Program Director and Associate Dean at the Florida State University College of Medicine and co-principal investigator of the guideline, said:

“Together with pharmacologic treatment options, exercise, rehabilitation, diet, and additional integrative interventions are considered as potential adjunctive treatments for RA. Patients and clinicians often seek evidence-based insight into these treatment options.  Recognizing the need to support patients and clinicians when considering treatments to complement their pharmacologic regimen, the ACR developed this guideline.”

The guideline reveals a total of 28 recommendations.  Out of the 27 conditional recommendations, four were about exercise, thirteen about rehabilitation, three about diet, and seven about additional integrative interventions.

The one “strong recommendation” states that consistent engagement in exercise is advised over no exercise. The type of exercise, frequency, intensity, and duration is not formally defined, but the guideline emphasizes moving regularly. The specific elements of an exercise intervention should be tailored to each patient at the given time in their disease trajectory, considering their capabilities, access, and other health conditions.