¹Dr. Schär AG/SPA, Postal
²Hescuro Clinics Bad Bocklet, Bad Bocklet
³Georg-August University of Göttingen, Department of Nephrology and Rheumatology, Göttingen

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Introduction: Rheumatoid arthritis (RA) involves a complex interplay of musculoskeletal and systemic impairments which significantly impact RA patient’s perceived (health-related) quality of life (QOL) [1]. QOL assessment has become increasingly essential in clinical practice, as it provides important insights into patient’s perceived health status, which often does not correspond to their disability levels as measured by disease activity indexes [2]. Here, we conducted a randomized, placebo-controlled, double-blind, monocentric trial to evaluate the effects of supplementing regular diet with medium-chain triglycerides (MCTs), with or without fiber, on patients’ mental and physical health, including measurements of pain and morning stiffness. These results follow our first publication analyzing the effect of this food formula on patient’s disease activity [3].

Methods: 61 RA patients were randomly divided into a test or a control group. Test group received a formulation containing MCTs (30 g/day) for 8 weeks followed by an additional 8 weeks of a regimen combining MCTs (30 g/day) and fiber (30 g/day). The control group followed a dietary regimen containing long chain triglycerides (LCTs) instead of MCTs. In both groups, formulations were administered twice daily, one hour before breakfast and as an afternoon snack, with no alterations to the existing drug therapy. QOL assessments were conducted at baseline (T0), week 8 (T2) and week 16 (T4).

Results: The test treatment significantly reduced the intensity and duration of morning stiffness (measured by the physician using a dedicated questionnaire), as well as pain intensity (assessed using the Visual Analogue Scale, VAS) from T0 to T4 compared to the control group. Additionally, the consumption of MCTs and fiber led to significant and clinically relevant improvements in patients' mental health index, emotional well-being, social behavior, and vitality (measured using the SF36, 36-Item Short Form Survey) from baseline to T4 and compared to the control group. In the same patient group, the MFI-20 (Multidimensional Fatigue Inventory) questionnaire indicated increased motivation and a reduction in general fatigue, both significant compared to the control.

Conclusion: Our findings concerning health related QOL assessments, along with our previously published data on disease activity and metabolic parameters, offer additional evidence supporting the significance of a targeted and holistic therapy in managing RA patients.

Disclosures: GG is employed by Dr. Schär AG/SPA, Postal, Italy.

MRB received a research grant from Dr. Schär AG/SPA, Postal, Italy.

Literatur

[1] Uhlig T, Loge JH, Kristiansen IS, Kvien TK. Quantification of reduced health-related quality of life in patients with rheumatoid arthritis compared to the general population. J Rheumatol. 2007 Jun;34(6):1241-7
[2] Sacristán JA, Dilla T, Díaz-Cerezo S, Gabás-Rivera C, Aceituno S, Lizán L. Patient-physician discrepancy in the perception of immune-mediated inflammatory diseases: rheumatoid arthritis, psoriatic arthritis and psoriasis. A qualitative systematic review of the literature. PLoS One. 2020 Jun 17;15(6):e0234705. DOI: 10.1371/journal.pone.0234705
[3] Heidt C, Pons-Kühnemann J, Kämmerer U, Marquardt T, Reuss-Borst M. MCT-Induced Ketosis and Fiber in Rheumatoid Arthritis (MIKARA)-Study Protocol and Primary Endpoint Results of the Double-Blind Randomized Controlled Intervention Study Indicating Effects on Disease Activity in RA Patients. Nutrients. 2023 Aug 25;15(17):3719. DOI: 10.3390/nu15173719