Use of Oral Complementary Medicine in Inflammatory Arthritis: Data from the Australian Rheumatology Association Database (ARAD)

Ashley Fletcher^1,2, Margaret P. Staples^3,4, Catherine Hill^5,6,7, Marissa Lassere⁸, Lyn March^9,10,11,12, Graeme Carroll¹³, Claire Barrett¹⁴, Vibhasha Chand⁴ and Rachelle Buchbinder^4,15, ¹Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia, ²Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia, ³Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Australia, ⁴Monash University, Melbourne, Australia, ⁵The Queen Elizabeth Hospital, Adelaide, Australia, ⁶Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia, ⁷Medicine, The University of Adelaide, Adelaide, Australia, ⁸University of New South Wales, Sydney, Australia, ⁹Department of Rheumatology, Northern Clinical School, Institute of Bone and Joint Research, Kolling Institute, University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, Sydney, Australia, ¹⁰Institute of Bone and Joint Research, University of Sydney, Sydney, Australia, ¹¹Rheumatology, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia, ¹²Rheumatology, University of Sydney, Insitute of Bone and Joint Research, Royal North Shore Hospital, St Leonards NSW, Australia, ¹³Adult Rheumatology and Osteoarthritis, University of Notre Dame, Mount Lawley WA, Australia, ¹⁴Redcliffe Hospital, University of Queensland, Redcliffe, Australia, ¹⁵Cabrini Institute, Victoria, Australia

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Complementary alternative medicine, inflammatory arthritis and registry

Session Information

Date: Tuesday, October 23, 2018

Title: Rheumatoid Arthritis – Treatments Poster III: Biosimilars and New Compounds

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

To describe the use of oral complementary medicine (CM) in people with inflammatory arthritis.

Methods:

The Australian Rheumatology Association Database (ARAD), an observational database, collects outcome data from people with rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA) and juvenile idiopathic arthritis (JIA). Participants complete semi-annual then annual questionnaires. CM use from baseline questionnaire for participants recruited between 2006 and 2016 was categorised into fatty acids (eg. fish oil, evening primrose oil), herbs (eg. ginger, turmeric) or supplements (eg. glucosamine, vitamins). Changes in CM use over time were also determined.

Results:

Of 4,425 ARAD participants 43.4% were taking CM at enrolment (RA: 1,324 (45.7%), AS: 261 (40.7%), PsA 307 (43.2%), JIA: 31 (17.7%)). Use was more prevalent in women (OR 1.37; 95%CI 1.25-1.59), those with tertiary education (OR 1.26; 95%CI 1.10-1.44), private health insurance (OR 1.30; 95%CI 0.1.21-1.52), drinking alcohol sometimes compared to never (OR 1.24; 95%CI 1.06-1.44), and less prevalent in current smokers (OR 0.75; 95%CI 0.62-0.91). Levels of pain in the last week were not different between CM uses and non-users (OR 1.00; 95%CI 1.00-1.00).

Overall, 35% were taking fatty acids, 7% herbs and 19% supplements. The most common CMs were fish oils (1,489 (34%)) followed by glucosamine (605 (14%)), although both have declined in use over the last decade (fish oil 2006-2016: 31%-28%, p=0.85; glucosamine 20%-9%, p=<0.001). Over time, there has been increased use of supplements, particularly vitamin D (2006-2016: 1.6%-3.3%, p<0.001) and magnesium (2006-2016: 0.4%-2.7%, p=0.02), turmeric has also increased (2006-2016: 0%-1.2%, p<0.001), while the use of krill oil has declined (2012-2016: 3.9%-0.3%, p<0.001) and calcium has remained level (2006-2016: 3.0%-2.4%, p0.71).

Conclusion:

Just under half of ARAD participants were taking CM at ARAD entry. Types of CM used by people with inflammatory arthritis appear to change over time but appear to have no influence on levels of pain. Further research could investigate what prompts use of these products.

Disclosure: A. Fletcher, None; M. P. Staples, None; C. Hill, None; M. Lassere, None; L. March, None; G. Carroll, None; C. Barrett, None; V. Chand, None; R. Buchbinder, None.

To cite this abstract in AMA style:

Fletcher A, Staples MP, Hill C, Lassere M, March L, Carroll G, Barrett C, Chand V, Buchbinder R. Use of Oral Complementary Medicine in Inflammatory Arthritis: Data from the Australian Rheumatology Association Database (ARAD) [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/use-of-oral-complementary-medicine-in-inflammatory-arthritis-data-from-the-australian-rheumatology-association-database-arad/. Accessed .

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