Abstract

Introduction

Aim of this randomized controlled trial was to evaluate the effects of serial locally applied water-filtered infrared A radiation (sl-wIRAR) in patients with axial spondyloarthritis (axSpA).

Methods

axSpA patients with active disease undergoing a 7-day multimodal rheumatologic complex treatment under non-steroidal anti-inflammatory drug (NSAID) therapy were eligible. Patients were randomly assigned in a 1:1 ratio. The intervention group (IG) received additional sl-wIRAR treatment of the back (2 treatments for 30 min per day for 6 days) to assess whether locally applied hyperthermia can i) reduce pain levels, ii) reduce disease activity and improve functionality and iii) whether an effect on tumor necrosis factor α (TNFα) levels is detectable. Additionally, it was examined whether a reduction in NSAID therapy could be achieved after trial completion.

Results

71 patients completed the trial (IG: 36 patients, control group (CG) 35 patients). sl-wIRAR led to a significant pain reduction measured by a numeric rating scale (p < .0005) and in comparison, to the CG (p = .006). sl-wIRAR treatment resulted in a significant reduction in the Bath Anyklosing Spondylitis Disease Activity Index (BASDAI) (p = .004) and Bath Ankylosing Spondylitis Functional Index (p = .004) with no significant difference to the CG. TNF-α levels were significantly decreased (p = .001) only in the IG with a significant difference to the CG (p = .01). 26 (76%) of patients in the IC reduced their NSAID therapy after trial completion.

Conclusion

sl-wIRAR treatment in axSpA leads to a rapid reduction in pain allowing NSAID dosage reduction. A reason for these desirable effects could be a change in TNFα levels.

中文翻译：

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局部应用水滤过红外线治疗轴向性脊柱关节炎的放射线-一项随机对照试验。

摘要

介绍

这项随机对照试验的目的是评估连续局部应用水过滤的红外A辐射（sl-wIRAR）对轴型脊椎关节炎（axSpA）患者的影响。

方法

在非甾体抗炎药（NSAID）治疗下接受7天多模式风湿病综合治疗的活动性疾病的axSpA患者是合格的。患者按1：1比例随机分配。干预组（IG）接受了额外的sl-wIRAR背部治疗（每天2次，每天30分钟，共6天），以评估局部应用的高热疗法是否可以i）减轻疼痛程度； ii）降低疾病活动性并改善功能，以及iii ）是否可以检测到对肿瘤坏死因子α（TNFα）水平的影响。此外，还检查了试验完成后是否可以减少NSAID治疗。

结果

71位患者完成了试验（IG：36位患者，对照组（CG）35位患者）。sl-wIRAR通过数字评分量表（p  <.0005）和CG（p  = .006）相比可显着减轻疼痛。sl-wIRAR治疗导致巴斯克强直性脊柱炎疾病活动性指数（BASDAI）（p  = .004）和巴斯克强直性脊柱炎功能指数（p  = .004）显着降低，而与CG无显着差异。 仅在IG中，TNF-α水平显着降低（p = .001），而与CG有显着差异（p  = .01）。试验完成后，IC中有26名患者（76％）减少了NSAID治疗。

结论

axSpA中的sl-wIRAR治疗可导致疼痛迅速减轻，从而可减少NSAID剂量。这些理想效果的原因可能是TNFα水平的变化。