effectiveness of radon spa therapy in multimodal rehabilitative treatment of rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: the study aimed to investigate effects of radon (plus co2) baths on ra in contrast to artificial co2 baths in ra rehabilitation. 134 patients of an in-patient rehabilitative programme were randomly assigned to the groups. outcomes were limitations in occupational context/ daily living (main outcome), pain, medication, etc. measured before start, after end of treatment, and up to a year thereafter. superiority of radon treatment was found regarding reduced limitations in daily living until 12 months after end of treatment. steroid consumption and nsaids were significantly reduced.

objective: to replicate former observed beneficial effects of radon (plus co2) baths on ra in contrast to artificial co2 baths and to investigate its long-term effectiveness and impact on drug consumption. methods: randomised double-blinded trial with 2 randomised balanced groups enrolling 134 patients of an in-patient rehabilitative programme (a 3rd non-randomised group of 73 consecutive patients is not reported here). outcomes were limitations in occupational context/ daily living, pain, functional capacity, morning stiffness and medication measured before start, after end of treatment, and quarterly in the year thereafter. repeated-measures analysis of covariance (rm-ancova) of intent-to treat population was performed to investigate treatment effects. hierarchically ordered hypotheses ensured adherence of the nominal significance level and allowed examining of long-term effects. starting with all measures until 6 months' follow-up, significant main effects for group allocation (gme) or significant group x course-interactions (gxc) were regarded essential to add the next follow-up for analysis. results: radon treatment resulted in significantly lower limitations of daily living over at least 9 months whereas reference patients returned to baseline level after 6 months already (rm-ancova until 6 months: pgme=.15, pgxc=.016/ 9 months: pgme=.11, pgxc=.025/ 12 months: pgme=.17, pgxc=.033). furthermore, consumption of steroids and nsaid was remarkably reduced in the radon group (rm-ancova until 12 months: for steroids pgme=.064, interaction pgxc=.025, maximum difference after 12 months; for nsaid pgme=.035, interaction pgxc=.008, maximum difference after 9 months). conclusion: results suggest beneficial long-term effects of radon baths as adjunct to a multimodal rehabilitative treatment of ra.

Eligibility criteria:
inclusion criteria: * rheumatoid arthritis according to the 1987 revised acr criteria for ra exclusion criteria: * current exacerbations of the inflammatory process * other systemic inflammatory diseases * concomitant musculo-skeletal diseases possibly interfering with outcome measurement, * pregnancy or breast feeding * disorders of the central nervous system * a known tendency toward thrombosis * malignant hypertension * coronary heart disease * heart failure, arrhythmia * severe disorders of lungs, kidneys, or liver * advanced malignancies * abuse of alcohol or drugs, * major skin lesions, * severe fever, or infections.

Keywords: randomised double-blinded trial rehabilitation radon spa therapy long-term effectiveness