Nonvitamin, Nonmineral Dietary Supplement Use in Individuals with Rheumatoid Arthritis.
complementary and alternative medicine
dietary supplements
herbals
natural products
rheumatoid arthritis
turmeric
vitamins
Journal
The Journal of nutrition
ISSN: 1541-6100
Titre abrégé: J Nutr
Pays: United States
ID NLM: 0404243
Informations de publication
Date de publication:
01 09 2020
01 09 2020
Historique:
received:
30
01
2020
revised:
27
02
2020
accepted:
18
06
2020
pubmed:
18
8
2020
medline:
17
12
2020
entrez:
18
8
2020
Statut:
ppublish
Résumé
Over-the-counter, natural product-based (nonvitamin, nonmineral) dietary supplement (NVNM DS) use is common in adults with rheumatoid arthritis (RA), a group at risk for drug-DS interactions, due to polypharmacy, but this use is underreported to health care providers. Recent dramatic changes in US sales of specific NVNM DS suggest that the prevalence and types of NVNM DS used in RA populations may also have shifted. A study was undertaken to identify current and past use of specific NVNM DS for RA disease treatment and to examine associations between use of NVNM DS, RA pharmaceuticals, and/or vitamin or mineral (VM) DS. We developed a survey instrument to capture current and ever use of specific NVNM DS, VM DS, and RA pharmaceuticals, with 696 subjects self-reporting an RA diagnosis recruited online or in clinic for survey participation. Analyses were limited to 611 subjects reporting RA diagnosis after age 18 y and treatment with specific RA pharmaceuticals. Most participants reported DS use, with current usage prevalence 49.6% (n = 303), 83.5% (n = 510), or 87.6% (n = 535) for NVNM, VM, or any DS, respectively. While not having appeared in previous RA surveys, turmeric and ginger were among the top 3 NVNM DS in current use, along with fish oil/ω-3 (n-3) PUFA. Concurrent NVNM DS use was reported by 48.2% (n = 243) of participants currently using RA pharmaceuticals (n = 504) and was more common in those using disease-modifying antirheumatic drugs only (no biologics). Most methotrexate users (83%) reported concurrent folate supplementation, with one-third also using turmeric, which is notable because methotrexate and turmeric have been associated with hepatotoxicity. Individuals with RA commonly use NVNM DS in combination with RA pharmaceuticals, including a previously undocumented but popular use of turmeric or ginger supplements with an unclear risk/benefit ratio.
Sections du résumé
BACKGROUND
Over-the-counter, natural product-based (nonvitamin, nonmineral) dietary supplement (NVNM DS) use is common in adults with rheumatoid arthritis (RA), a group at risk for drug-DS interactions, due to polypharmacy, but this use is underreported to health care providers. Recent dramatic changes in US sales of specific NVNM DS suggest that the prevalence and types of NVNM DS used in RA populations may also have shifted.
OBJECTIVES
A study was undertaken to identify current and past use of specific NVNM DS for RA disease treatment and to examine associations between use of NVNM DS, RA pharmaceuticals, and/or vitamin or mineral (VM) DS.
METHODS
We developed a survey instrument to capture current and ever use of specific NVNM DS, VM DS, and RA pharmaceuticals, with 696 subjects self-reporting an RA diagnosis recruited online or in clinic for survey participation. Analyses were limited to 611 subjects reporting RA diagnosis after age 18 y and treatment with specific RA pharmaceuticals.
RESULTS
Most participants reported DS use, with current usage prevalence 49.6% (n = 303), 83.5% (n = 510), or 87.6% (n = 535) for NVNM, VM, or any DS, respectively. While not having appeared in previous RA surveys, turmeric and ginger were among the top 3 NVNM DS in current use, along with fish oil/ω-3 (n-3) PUFA. Concurrent NVNM DS use was reported by 48.2% (n = 243) of participants currently using RA pharmaceuticals (n = 504) and was more common in those using disease-modifying antirheumatic drugs only (no biologics). Most methotrexate users (83%) reported concurrent folate supplementation, with one-third also using turmeric, which is notable because methotrexate and turmeric have been associated with hepatotoxicity.
CONCLUSION
Individuals with RA commonly use NVNM DS in combination with RA pharmaceuticals, including a previously undocumented but popular use of turmeric or ginger supplements with an unclear risk/benefit ratio.
Identifiants
pubmed: 32805045
pii: S0022-3166(22)02313-6
doi: 10.1093/jn/nxaa197
pmc: PMC7540062
doi:
Substances chimiques
Analgesics
0
Anti-Inflammatory Agents
0
Antirheumatic Agents
0
Minerals
0
Vitamins
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2451-2459Subventions
Organisme : NCI NIH HHS
ID : R01 CA174926
Pays : United States
Organisme : NCCIH NIH HHS
ID : R34 AT007837
Pays : United States
Informations de copyright
Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.
Références
J Med Food. 2017 Oct;20(10):1022-1030
pubmed: 28850308
J Nat Prod. 2009 Mar 27;72(3):403-7
pubmed: 19216559
Case Reports Hepatol. 2019 Apr 28;2019:6741213
pubmed: 31214366
Musculoskeletal Care. 2006 Jun;4(2):101-15
pubmed: 17042021
Natl Health Stat Report. 2015 Feb 10;(79):1-16
pubmed: 25671660
Semin Arthritis Rheum. 2010 Aug;40(1):2-14.e1
pubmed: 20674669
Am Fam Physician. 2008 Jan 1;77(1):73-8
pubmed: 18236826
J Clin Nurs. 2012 Nov;21(21-22):3198-204
pubmed: 22776021
Prev Chronic Dis. 2004 Oct;1(4):A12
pubmed: 15670444
Ann Rheum Dis. 2010 Sep;69(9):1580-8
pubmed: 20699241
Expert Rev Clin Pharmacol. 2016 Dec;9(12):1597-1609
pubmed: 27644147
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Arthritis Rheum. 2006 Nov;54(11):3452-64
pubmed: 17075840
Int J Rheum Dis. 2019 Oct;22(10):1857-1862
pubmed: 31482684
Indian J Med Res. 1980 Apr;71:632-4
pubmed: 7390600
Nutrition. 2018 Jan;45:114-124.e4
pubmed: 28965775
J Nutr. 2003 Feb;133(2):590S-600S
pubmed: 12566509
Ann Rheum Dis. 2009 Jul;68(7):1086-93
pubmed: 19033291
J Nat Prod. 2006 Mar;69(3):351-5
pubmed: 16562833
Cochrane Database Syst Rev. 2013 Jul 22;(7):ED000063
pubmed: 24151647
Mol Nutr Food Res. 2018 May 29;:e1800143
pubmed: 29808963
Prev Chronic Dis. 2016 May 05;13:E61
pubmed: 27149072
Arthritis Care Res (Hoboken). 2019 Jun;71(6):787-797
pubmed: 29975014
BMJ Case Rep. 2018 Sep 10;2018:
pubmed: 30206065
Nutrients. 2017 Jan 06;9(1):
pubmed: 28067815
Biomed Pharmacother. 2016 Apr;79:52-61
pubmed: 27044812
Nat Rev Rheumatol. 2019 Mar;15(3):180-186
pubmed: 30700865
Arthritis Rheumatol. 2016 Jan;68(1):1-26
pubmed: 26545940
Arthritis Care Res (Hoboken). 2014 Feb;66(2):180-9
pubmed: 23983105
Am J Law Med. 2015;41(2-3):374-94
pubmed: 26591824
J Clin Rheumatol. 2016 Mar;22(2):71-4
pubmed: 26906298
Mediterr J Rheumatol. 2019 Jun 29;30(2):94-102
pubmed: 32185348
Phytochemistry. 2006 Sep;67(18):2017-29
pubmed: 16890967
Gene. 2019 May 25;698:179-185
pubmed: 30844477
Complement Ther Med. 2016 Dec;29:152-157
pubmed: 27912939
Arthritis Rheum. 2008 Jan;58(1):15-25
pubmed: 18163481
Proc Nutr Soc. 2010 Aug;69(3):316-23
pubmed: 20509981
Am Fam Physician. 2017 Jul 15;96(2):101-107
pubmed: 28762712
Drugs. 2009;69(13):1777-98
pubmed: 19719333
Prev Chronic Dis. 2009 Apr;6(2):A44
pubmed: 19288987
Rheumatol Int. 2007 Jan;27(3):213-8
pubmed: 16953394
Phytother Res. 2012 Nov;26(11):1719-25
pubmed: 22407780
J Rheumatol. 1997 Aug;24(8):1489-94
pubmed: 9263140
Autoimmun Rev. 2017 May;16(5):548-554
pubmed: 28279841