AUTHOR=Zhong Linda LD. , Wang Rongsheng , Lam Wai Ching , Zhu Qi , Du Peipei , Cao Pei Hua , Jiang Ting , Zhang Yuan Yuan , Shen Jie , Su Xiao , Xue Luan , Mao Jianchun , Fang Yong Fei , Gao Ming Li , Hu Chun Rong , Peng Jiang Yun , Gu Ying , Wei Qianghua , Huang Runyue , Lyu Aiping , Liu Hongxia , He Dongyi
TITLE=The combination of Chinese and Western Medicine in the management of rheumatoid arthritis: A real-world cohort study across China
JOURNAL=Frontiers in Pharmacology
VOLUME=13
YEAR=2022
URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.933519
DOI=10.3389/fphar.2022.933519
ISSN=1663-9812
ABSTRACT=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.