Serial locally applied water-filtered infrared a radiation in axial spondyloarthritis – a randomized controlled trial

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 a (TNFa) 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 ¼ .006). sl-wIRAR treatment resulted in a significant reduction in the Bath Anyklosing Spondylitis Disease Activity Index (BASDAI) (p ¼ .004) and Bath Ankylosing Spondylitis Functional Index (p ¼ .004) with no significant difference to the CG. TNF-a levels were significantly decreased (p ¼ .001) only in the IG with a significant difference to the CG (p ¼ .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 TNFa levels.

Efficacy and safety of non-pharmacological and non-biological interventions: a systematic literature review informing the 2022 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis

“…58,59 All these studies were conducted in r-axSpA except one in axSpA in general. 46 The RoB was high for all except two studies at unclear RoB on ultrasound therapy combined with exercise (Table 1). A higher decrease in ASDAS, BASFI and BASMI was shown in the ultrasound combined with exercise group compared with the control group (exercise only).…”

“…41,42 Other types of non-pharmacological interventions (e.g. transcutaneous electrical nerve stimulation, ultrasound therapy, moxibustion), were investigated in 14 RCTs/CCTs [44][45][46][47][48][49][50][51][52][53][54][55][56][57] and two observational studies (Supplementary Tables S9-14). 58,59 All these studies were conducted in r-axSpA except one in axSpA in general.…”

Hyperthermie – eine Behandlungsmöglichkeit bei Long-Covid?

“…Es tritt auch nach einer Vielzahl anderer Viruserkrankungen auf. Das prominenteste Beispiel ist die Infektiöse Mononukleose durch Epstein-Barr-Virus (EBV), aber auch andere Viren wie beispielsweise Humanes Herpesvirus (HHV), Influenzaviren oder Rickettsien sind Verursacher einer solchen postinfektiösen Symptomatik [ 9 ][ 10 ][ 11 ]. Das Vollbild eines post-infektiösen Chronischen Fatigue-Syndroms (CFS) (synonym Myalgische Encephalomyelitis, ME) (ICD-10 G93.3) ist möglich.“…”