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The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study

Intermittent circadian fasting, namely Ramadan, is a common worldwide practice. Such fasting has a positive impact on psoriasis, but no data exist on its role in psoriatic arthritis (PsA)—a disease that is clearly linked to body mass index. We enrolled 37 patients (23 females and 14 males) with a me...

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Autores principales: Adawi, Mohammad, Damiani, Giovanni, Bragazzi, Nicola Luigi, Bridgewood, Charlie, Pacifico, Alessia, Conic, Rosalynn R. Z., Morrone, Aldo, Malagoli, Piergiorgio, Pigatto, Paolo Daniele Maria, Amital, Howard, McGonagle, Dennis, Watad, Abdulla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471071/
https://www.ncbi.nlm.nih.gov/pubmed/30871045
http://dx.doi.org/10.3390/nu11030601
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author Adawi, Mohammad
Damiani, Giovanni
Bragazzi, Nicola Luigi
Bridgewood, Charlie
Pacifico, Alessia
Conic, Rosalynn R. Z.
Morrone, Aldo
Malagoli, Piergiorgio
Pigatto, Paolo Daniele Maria
Amital, Howard
McGonagle, Dennis
Watad, Abdulla
author_facet Adawi, Mohammad
Damiani, Giovanni
Bragazzi, Nicola Luigi
Bridgewood, Charlie
Pacifico, Alessia
Conic, Rosalynn R. Z.
Morrone, Aldo
Malagoli, Piergiorgio
Pigatto, Paolo Daniele Maria
Amital, Howard
McGonagle, Dennis
Watad, Abdulla
author_sort Adawi, Mohammad
collection PubMed
description Intermittent circadian fasting, namely Ramadan, is a common worldwide practice. Such fasting has a positive impact on psoriasis, but no data exist on its role in psoriatic arthritis (PsA)—a disease that is clearly linked to body mass index. We enrolled 37 patients (23 females and 14 males) with a mean age 43.32 ± 7.81 and they fasted for 17 h for one month in 2016. The baseline PsA characteristics were collected and 12 (32.4%) patients had peripheral arthritis, 13 (35.1%) had axial involvement, 24 (64.9%) had enthesitis, and 13 (35.1%) had dactylitis. Three patients (8.1%) were treated with methotrexate, 28 (75.7%) with TNF-α blockers, and 6 (16.2%) with IL-17 blockers. After a month of intermittent fasting, C-reactive protein (CRP) levels decreased from 14.08 ± 4.65 to 12.16 ± 4.46 (p < 0.0001), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) decreased from 2.83 ± 1.03 to 2.08 ± 0.67 (p = 0.0078), Psoriasis Area Severity Index (PASI) decreased from 7.46 ± 2.43 to 5.86 ± 2.37 (p < 0.0001), and Disease Activity index for PSoriatic Arthritis (DAPSA) decreased from 28.11 ± 4.51 to 25.76 ± 4.48 (p < 0.0001). Similarly, enthesitis improved after fasting, with Leeds Enthesitis Index (LEI) decreasing from 2.25 ± 1.11 to 1.71 ± 0.86 (p < 0.0001) and dactylitis severity score (DSS) decreasing from 9.92 ± 2.93 to 8.54 ± 2.79 (p = 0.0001). Fasting was found to be a predictor of a decrease in PsA disease activity scores (DAPSA, BASDAI, LEI, DSS) even after adjustment for weight loss. IL-17 therapy was found to be an independent predictor of decreases in LEI after fasting. These preliminary data may support the use of chronomedicine in the context of rheumatic diseases, namely PsA. Further studies are needed to support our findings.
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spelling pubmed-64710712019-04-25 The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study Adawi, Mohammad Damiani, Giovanni Bragazzi, Nicola Luigi Bridgewood, Charlie Pacifico, Alessia Conic, Rosalynn R. Z. Morrone, Aldo Malagoli, Piergiorgio Pigatto, Paolo Daniele Maria Amital, Howard McGonagle, Dennis Watad, Abdulla Nutrients Article Intermittent circadian fasting, namely Ramadan, is a common worldwide practice. Such fasting has a positive impact on psoriasis, but no data exist on its role in psoriatic arthritis (PsA)—a disease that is clearly linked to body mass index. We enrolled 37 patients (23 females and 14 males) with a mean age 43.32 ± 7.81 and they fasted for 17 h for one month in 2016. The baseline PsA characteristics were collected and 12 (32.4%) patients had peripheral arthritis, 13 (35.1%) had axial involvement, 24 (64.9%) had enthesitis, and 13 (35.1%) had dactylitis. Three patients (8.1%) were treated with methotrexate, 28 (75.7%) with TNF-α blockers, and 6 (16.2%) with IL-17 blockers. After a month of intermittent fasting, C-reactive protein (CRP) levels decreased from 14.08 ± 4.65 to 12.16 ± 4.46 (p < 0.0001), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) decreased from 2.83 ± 1.03 to 2.08 ± 0.67 (p = 0.0078), Psoriasis Area Severity Index (PASI) decreased from 7.46 ± 2.43 to 5.86 ± 2.37 (p < 0.0001), and Disease Activity index for PSoriatic Arthritis (DAPSA) decreased from 28.11 ± 4.51 to 25.76 ± 4.48 (p < 0.0001). Similarly, enthesitis improved after fasting, with Leeds Enthesitis Index (LEI) decreasing from 2.25 ± 1.11 to 1.71 ± 0.86 (p < 0.0001) and dactylitis severity score (DSS) decreasing from 9.92 ± 2.93 to 8.54 ± 2.79 (p = 0.0001). Fasting was found to be a predictor of a decrease in PsA disease activity scores (DAPSA, BASDAI, LEI, DSS) even after adjustment for weight loss. IL-17 therapy was found to be an independent predictor of decreases in LEI after fasting. These preliminary data may support the use of chronomedicine in the context of rheumatic diseases, namely PsA. Further studies are needed to support our findings. MDPI 2019-03-12 /pmc/articles/PMC6471071/ /pubmed/30871045 http://dx.doi.org/10.3390/nu11030601 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Adawi, Mohammad
Damiani, Giovanni
Bragazzi, Nicola Luigi
Bridgewood, Charlie
Pacifico, Alessia
Conic, Rosalynn R. Z.
Morrone, Aldo
Malagoli, Piergiorgio
Pigatto, Paolo Daniele Maria
Amital, Howard
McGonagle, Dennis
Watad, Abdulla
The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study
title The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study
title_full The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study
title_fullStr The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study
title_full_unstemmed The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study
title_short The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study
title_sort impact of intermittent fasting (ramadan fasting) on psoriatic arthritis disease activity, enthesitis, and dactylitis: a multicentre study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471071/
https://www.ncbi.nlm.nih.gov/pubmed/30871045
http://dx.doi.org/10.3390/nu11030601
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