Life In Rheumatoid Arthritis Patients Research Articles

Effect of Integrated Naturopathy Interventions on Systemic Inflammatory Markers and Quality of Life in Patients With Active Rheumatoid Arthritis: A Randomized Controlled Trial.

Rheumatoid arthritis (RA) is a chronic, systemic, polyarticular autoimmune inflammatory disease that destroys the capsule and synovial lining of joints. Antirheumatic treatment reduces disease activity and inflammation, but not all patients respond to treatment. Naturopathy, a research-based complementary and alternative medicine, may be useful in these patients, but there is little data on the effect of Naturopathy interventions on inflammation and disease activity in RA. To explore the effect of 12 weeks of integrated naturopathy interventions on disease-specific inflammatory markers and quality of life in RA patients. A total of 100 RA patients were randomized into two groups: the naturopathy group (integrated naturopathy interventions with routine medical therapy) and the control group (only with routine medical therapy). Blood samples were collected pre- and post-intervention for primary outcome measurements of systemic inflammatory markers (ESR, CRP, and IL-6). Disease activity score (DAS-28) and quality of life were used to assess disease activity and functional status using SF-36, respectively, at pre- and post-intervention time points. The results of the present study show a notable decrease in disease activity after 12 weeks of naturopathy intervention. As such, a significant decrease was found in levels of systemic inflammatory markers such as ESR (p = 0.003)and IL-6 (p < 0.001), RA disease activity score (DAS-28) (p = 0.02), and most of the components of health-related quality of life (SF 36 scores) (p < 0.05) except in vitality (p = 0.06). Conclusions: The findings of the present study suggest that integrated naturopathy treatments may have the ability to control persistent inflammation, maintain immune homeostasis, and lower disease activity.

Sleep quality, anxiety, depression, and quality of life in rheumatoid arthritis patients and impact of disease activity

BackgroundRheumatoid arthritis (RA) is an autoimmune lifelong disease. Systemic manifestations represent a significant aspect of the disease burden. This study aimed to assess sleep quality and psychosocial aspects among RA patients and the impact of disease duration and activity.ResultsThe mean age for included RA patients was 50.00 ± 9.37 years. The median disease duration was 9.50 (Interquartile range (IQR)=5–15) years and 90% of patients were females. Disease activity score 28 was 4.65 ± 1.66. Anxiety and depression were significantly higher among RA participants. Regarding sleep quality assessment, RA group had significantly higher levels of insomnia than the control group (Insomnia Severity Index median (IQR) was 4.5 (0–15) versus 1 (0–3); p value = 0.013) and daytime sleepiness (Epworth Sleepiness Scale median (IQR) was 4 (1–11.25) versus 1 (0–3); p value = 0.002). RA patients showed significantly higher values of Pittsburgh Sleep Quality Index components as well as the global score indicating poor sleep quality. The 36-item short-form health survey domains, representing physical and mental health, were significantly lower among RA cases versus control subjects. Higher disease activity was positively correlated with anxiety, depression, insomnia, sleep quality, sleep efficiency, and daytime dysfunction, while negatively correlated with all domains of the 36-item short-form health survey.ConclusionsRA patients have increased anxiety and depression levels in addition to poor sleep quality. High disease activity is linked to increased anxiety and depression levels, impaired quality of life, and poor sleep quality.

The role of psychological interventions in improving quality of life and reducing symptoms in patients with rheumatologic conditions: systematic review

The long-term condition known as rheumatoid arthritis (RA) severely reduces bodily, emotional, and psychological functioning. Hence, the need of psychological interventions is important to improve the quality of life and reduce symptoms. For instance, this review aimed to explain the role psychological interventions in reducing symptoms and improving quality of life in rheumatoid arthritis patients. A thorough search was carried out in November 2023, mostly using PubMed, in compliance with PRISMA criteria. The search was limited to English-language research that looked at the effect of psychological interventions on rheumatoid arthritis patients. To guarantee the quality and applicability of the evaluated research, certain inclusion and exclusion criteria were developed. A wide spectrum of research from various countries and areas was included in the study, without any focus on a specific age. A discernible pattern indicated a high proportion of individuals with effect of psychological interventions in long term condition. According to the findings of the current investigation, there is confirmed evidence to prove the positive effect of psychological interventions on rheumatoid conditions.

Effect of treatment on genetic predictors and quality of life in rheumatoid arthritis patients with type 2 diabetes, hypertension, and obesity

Background. Connective tissue disease, in particular rheumatoid arthritis (RA), is characterized by a progressive joint damage and polymorphism of extra-articular lesions that affect the patient’s quality of life. Although the widespread implementation of basic therapy through the use of disease-modifying antirheumatic drugs has a positive effect on social consequences, the experience gained shows the impossibility of achieving a stable remission of the disease or reducing the activity of autoimmune inflammation against the background of using these medicines in all patients for a number of reasons. One of these reasons is the presence of comorbid pathology, which requires a personalized approach to each person. The objective was to study the quality of life of patients with RA in combination with type 2 diabetes mellitus (T2DM), hypertension and obesity depending on the T-786C polymorphism of the endothelial nitric oxide synthase gene promoter. Materials and methods. A laboratory and instrumental examination involved 110 patients who were treated at the clinical base of the Department of Internal Medicine of Bukovinian State Medical University, Chernivtsi Regional Endocrinology Center, Chernivtsi Regional Clinical Hospital, and Reference Center for Molecular Genetic Research of the Ministry of Health of Ukraine. Results. When assessing the quality of life in the studied groups, a decrease in indicators on all scales was detected. Thus, in RA combined with hypertension and obesity, PF was 1.73 times lower, RP— 1.97 times, BP— 1.44 times, SF— 1.46 times, MH— 1.26 times , RE— 1.66 times, GH— 1.35 times (p&lt;0.05) lower than in patients with isolated RA. Taking into account the T-786C polymorphism of the eNOS gene, it can be asserted that all indicators of quality of life were reduced in the carriers of the СС genotype, in contrast to the carriers of the T-allele: PF— by 2.06 (pTT&lt;0.05) and 2.46 times (pTС&lt;0.05); RP— by 2.0 (pTT&lt;0.05) and 2.87 times (pTС&lt;0.05); BP— by 1.86 (pTT&lt;0.05) and 2.52 times (pTС&lt;0.05); SF— by 1.55 and 2.07 times (рTС&lt;0.05); MH— by 1.42 (pTT&lt;0.05) and 1.53 times (pTС&lt;0.05); RE— by 1.30 (pTT&lt;0.05) and 1.54 times (pTС&lt;0.05); VT— by 3.34 (pTT&lt;0.05) and 3.72 times (pTС&lt;0.05); GH— by 2.32 (pTT&lt;0.05) and 2.38 times (pTС&lt;0.05), respectively. Conclusions. When comparing the quality of life in the studied groups, it can be stated that the lowest indicators on all scales were in patients with RA combined with hypertension, obesity and T2DM and in carriers of the СС genotype of the analyzed gene, which reflected the worst physical condition and psychosocial status.

Disease Activity and Health-Related Quality of Life Among Patients With Rheumatoid Arthritis With Different Alcohol Consumption Habits.

Multiple studies have found a relationship between alcohol consumption and disease activity in rheumatoid arthritis (RA), although reverse causation has been suggested to explain the association. We aimed to study the relationship between alcohol consumption and disease activity, disease progression, and health-related quality of life in patients with RA. We followed up 1,228 patients with newly diagnosed RA from a population-based case-control study, Epidemiological Investigation of Rheumatoid Arthritis (EIRA). Drinkers and non-drinkers were compared to evaluate risk of unfavorable outcomes regarding disease activity and health-related quality of life. Odds ratios with 95% confidence intervals were calculated using logistic regression models. Non-drinkers at baseline had higher disease activity and estimated their pain as more severe compared to drinkers. At 1 year of follow-up, non-drinkers reported higher swollen and tender joint counts and experienced more pain and fatigue, lower global health scores, and lower health-related quality of life. The inverse relationship between alcohol consumption and RA-specific outcomes was also observed when comparing drinkers and non-drinkers who had not changed their alcohol consumption habits at or after the year of disease onset. Those who stopped drinking postbaseline experienced higher disease activity, more pain, and lower health-related quality of life at 1 year of follow-up, compared to drinkers, although there was no difference in disease activity at baseline between drinkers who continued versus discontinued drinking. Our findings argue against bias due to reverse causation. Alcohol consumption was associated with lower disease activity and higher health-related quality of life in RA patients in a dose-dependent manner.

The Role of Physical Therapy in the Management of Rheumatoid Arthritis

Rheumatoid arthritis is a persistent and severe clinical condition that causes gradual joint degeneration, impairs quality of life, and shortens life expectancy. Even mild inflammation is responsible for causing permanent disability and impairment. Patients with rheumatoid arthritis may experience an intermittent or progressive clinical course, depending on their symptoms. The primary objective of managing rheumatoid arthritis is to relieve discomfort while avoiding joint deterioration and functional loss. Physical therapy plays a vital role in the management of rheumatoid arthritis, as physical therapy considerably supplements pharmacological therapy by enhancing the management of rheumatoid arthritis and lowering the limitations on daily life for rheumatoid arthritis patients. Among physical therapy modalities, physiotherapy treatments are frequently employed, which include hydrotherapy, electrical stimulation, and cold/hot treatments. Furthermore, it has been demonstrated that exercise training for rheumatoid arthritis patients is effective in reversing cachexia, significantly increasing function without escalating disease activity, and likely lowering cardiovascular risk. For rheumatoid arthritis patients, physical therapy, including exercise, is safe and effective. Exercise and increased physical activity have been shown to reduce disease symptoms such as pain and exhaustion, enhance physical function, and improve mental health, ultimately leading to an improved quality of life. The purpose of this research is to review the available information about the role of physical therapy in the management of rheumatoid arthritis

Drug Prescription Patterns and Quality of Life in Rheumatoid Arthritis Patients at a Tertiary Care Teaching Hospital in Central India: A Cross-Sectional Study

Objective: Drug use research’s main goal is to assist patients in using medications responsibly. The chronic inflammatory disease rheumatoid arthritis (RA) is a condition comprising long-term disability. Disease-modifying antirheumatic drugs (DMARDs) are the mainstay of therapy preventing joint damage. The study’s aim was to examine the prescription trends for medications used to treat RA. Methodology: In conjunction with the orthopedic department, a cross-sectional observational study was carried out in a tertiary care hospital for 6 months. The current study included 90 patients in total who met the inclusion and exclusion requirements. Data from patients were collected in a case report format and examined to determine the prescription pattern in all 90 patients participated in the study. Female preponderance was seen in the study with 68.8% of female patients compared to 31.1% of male patients affected by the disease. Patients of the age group of 40–60 years (63.3%) were most commonly affected, followed by 61–70 years (26.6%). A combination of two DMARDs, methotrexate and hydroxychloroquine (HCQ), was the most common in 90% of patients. Triple-DMARD combination was required only in 4.4% of patients. Etoricoxib was most the commonly prescribed analgesic in 28.8% of patients, followed by etodolac in 16.6%. Conclusions: RA affects females more often than males. DMARD combination of methotrexate and HCQ was the most commonly used compared to monotherapy and triple-drug therapy. Drug utilization studies give the prescriber feedback and raise their awareness of the proper usage of medications.

Assessment of the impact of different rheumatoid arthritis stages on the quality of life of a sample of Iraqi patients

Rheumatoid arthritis is a chronic systemic disease affecting joints, muscles, eyes, and nerves, accompanied by pain and deformity of bones that lead to reduced quality of life of rheumatoid arthritis patients in many aspects. This cross-sectional study aimed to assess patients&#39; quality of life with rheumatoid arthritis. Eighty patients who fulfilled the disease&#39;s diagnostic criteria were included in this study between August 2019 and February 2020. The study is based on interviews with 8

The Therapeutic Potential of Targeted Nanoparticulate Systems to Treat Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a widespread autoimmune inflammatory disease. It implicates damage to bones, cartilage, and joints with uncertain pathogenesis. It is coupled with an elevated risk of cardiovascular complications and human disability. The conventional dosage forms for RA treatment pose numerous problems including poor efficacy, large dosages, frequent administration, limited responsiveness, greater expenses, and severe side effects. The nanoparticulate systems are emerging as a new thought for the diagnosis and treatment of RA. Anti-inflammatory drug-loaded nanoparticulate systems aid in the active and passive targeting of the inflamed region. Improved bioavailability and targetability are achieved by using these systems. In this review, the pathophysiology of RA and its conventional treatment has been discussed. The role of various nanoparticulate systems for passive and active targeting of RA has been reviewed. The authors have summarized the current practices in the typical and novel nanosystems to improve the quality of life in RA patients.

Subjective symptoms contributing to the quality of life of rheumatoid arthritis patients with clinical remission from the IORRA database.

To explore patient-reported outcomes (PROs) related to quality of life (QOL) in patients with rheumatoid arthritis (RA) who achieved clinical remission. In the Institute of Rheumatology, Rheumatoid Arthritis dataset, RA patients >18 years old who met the simplified disease activity index (SDAI) remission criteria in April 2017 were enrolled in this analysis. Pain-visual analogue scale (pain-VAS) (0-100 mm), patient's global assessment of disease activity (Pt-GA; 0-100 mm), Japanese version of the Health Assessment Questionnaire, duration of morning joint stiffness, and fatigue [Checklist Individual Strength 8R (CIS)] were the tools used to evaluate PROs. To assess the contribution of each PRO to the European QOL-5 Dimensions-5 Level (EQ-5D-5L) score, an analysis of variance was conducted. Among the 2443 patients with remission, the mean EQ-5D-5L was 0.9. The mean pain-VAS and Pt-GA were 7.2 and 7.4, respectively. Factors that significantly contributed to the EQ-5D-5L were pain-VAS (48.8%), CIS score (18.1%), and Pt-GA (15.6%). Around 82.5% of the variance in EQ-5D-5L was explained by the three PROs. This study demonstrated that pain-VAS, CIS, and Pt-GA were significant contributors to the EQ-5D-5L score in patients with RA who achieved the simplified disease activity index remission criteria.

Oral health-related quality of life and dental caries in rheumatoid arthritis patients: a cross-sectional observational study.

Rheumatoid arthritis (RA) is a systemic, chronic, and inflammatory joint disease with oral complications. This research aimed to compare the oral health-related quality of life and decayed, missing and filled teeth (DMFT) index in rheumatoid arthritis patients over 18 years with healthy individuals. In this study, 45 rheumatoid arthritis cases were assigned to the experimental group, and 45 healthy individuals were assigned to the control group. After completing biography forms, the participants filled out two questionnaires. These questionnaires included the Oral Health Impact Profile-14 (OHIP-14) and the Oral Health Assessment Index (GOHAI). Next, their teeth were clinically examined to check for caries. Finally, the data were analyzed statistically. RA and control groups were similar in gender, marital status, age, occupation, and level of education. However, a significant difference was observed between the two groups concerning DMFT (P<0.001) and total OHIP-14 score (P<0.001). Moreover, no significant difference was observed between the groups concerning the total GOHAI score (P=0.526). The oral health-related quality of life in rheumatoid arthritis patients was lower than that in the general population, with the rate of dental caries being higher in these patients.

The impact of sleep disorders on the daily activity and quality of life in rheumatoid arthritis patients - a systematic review and meta-analysis.

We aimed at determining the relationship between sleep disorders and daily activity and quality of life (QoL) of patients with rheumatoid arthritis (RA). A systematic search of databases was carried out. We used the Cochrane guidelines to perform the meta-analysis following the PRISMA statement. Fifteen full-text papers were ultimately included in the subsequent statistical analyses. The study was registered in the PROSPERO database (No. CRD42021245664). In group 1, the mean sleep quality score measured with the Pittsburgh Sleep Quality Index (PSQI) was 6.93. The mean QoL score for the physical domain and the mental domain of the Short Form (36) Health Survey (SF-36) was 38.15 and 41.83, respectively. In group 2, the mean PSQI score was 7.21. The mean daily activity score measured with the Health Assessment Questionnaire (HAQ) was 0.80. A strong negative correlation was observed between the PSQI scores, and the SF-36 total score each unit increase in the SF-36 total score was associated with an average decrease of 0.35 points in the PSQI score. A one-point increase in the PSQI score was associated with an average decrease of 2.4 points in the QoL score measured with SF-36. RA patients have a low quality of sleep. Sleep disorders correlate negatively with the QoL scores in the physical and mental domains.

Correlation of Body Mass index with Disease Activity in Rheumatoid Arthritis

Objective: To evaluate correlation between body mass index and disease activity in rheumatoid arthritis patients. Methodology: This comparative case-control observational study was conducted at Pakistan Institute of Medical Sciences, on rheumatoid arthritis patients visiting the (Out Patient Departments) OPDs between July, 2021 and December, 2021.The study subjects were selected by non-probability convenient sampling from outpatient department. Body mass index and disease activity score were calculated for rheumatoid arthritis patients in OPD. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis. Mean ± S.D was calculated for age, body mass index and disease activity. Pearson’s correlation coefficient was used for establishing an association between variables. P value less than 0.05 was considered significant. Simple scatter with fit line was plotted to show graphical association between body mass index and disease activity.  Results: A total 60 patients with 35 (58.3%) female and 25(41.7%) were male. The mean age was 47.21 years. The mean DAS-28 for normal weight group was 2.74 and for overweight group was 4.17. There was positive correlation between body mass index and DAS-28 with r was 0.584 (p&lt;0.05). When correlation on gender basis was calculated, for female patients r was 0.653 and for males 0.529, respectively. Conclusion: In Rheumatoid Arthritis patients, body mass index is positively correlated with disease activity. Evaluation of this requires trial on large scale, thus, helping in tailoring new management plan, including, weight reduction rather than escalating drug treatment for disease control and improving quality of life in rheumatoid arthritis patients.

Anxiety, Depression, Disease Disability, and Health-Related Quality of Life in Rheumatoid Arthritis Patients during the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Study

Anxiety, Depression, Disease Disability, and Health-Related Quality of Life in Rheumatoid Arthritis Patients during the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Study

Effect of subcutaneous high-dose methotrexate treatment on the management of rheumatoid arthritis

Purpose: Methotrexate (MTX) is still the main treatment option for rheumatoid arthritis (RA). There is no consensus on drug administration routes and dosage when administered alone or in combination with other drugs. This study aims to identify the effects of early administration of a combination therapy containing high dose subcutaneous (SC) MTX on RA management.&#x0D; Materials and Methods: Forty-five patients with RA who newly diagnosed were divided into two groups randomly. The patients who took 12.5 mg SC MTX per week in the first 4 weeks defined as a "low dose group". The patients who took 25 mg SC MTX per week in the first 4 weeks defined as a "high dose group". Then, patients of both groups continued with 12.5 mg oral MTX per week. Clinical and laboratory findings, disease activity scores and response rates of the patients were recorded at the beginning, 3rd months and 6th months. &#x0D; Results: There was no significant difference between the two groups at 3rd month’s values. There were statistically significant improvements at 6th month’s values. Values were as follows in low and high dose groups: mean DAS28-CRP (3.5 vs 2.7), VAS pain score (3.3 vs 1.6), and TJC28 (3 vs 1.5), respectively. &#x0D; Conclusion: Early administration of high-dose SC MTX effectively controls disease activity and increases the quality of life in RA patients.

Predictors of Quality of Life in Patients With Rheumatoid Arthritis in Pakistan: A Cross-Sectional Study.

Retracted

Clinical effect and mechanism of moxibustion combined with western medication for rheumatoid arthritis of liver-kidney deficiency

To observe the clinical effect of moxibustion combined with western medication for rheumatoid arthritis (RA) of liver-kidney deficiency, and explore the mechanism of moxibustion for RA. A total of 60 patients with RA of liver-kidney deficiency were randomly divided into an observation group and a control group, 30 cases in each group. In the control group，leflunomide tablets were taken orally, once a day. On the base of the treatment as the control group, moxibustion was applied at Sanyinjiao (SP 6), Shenshu (BL 23), Zusanli (ST 36) and ashi points in the observation group, once every other day, three times a week. Totally 8 weeks were required in both groups. Before and after treatment, the TCM syndrome score, health assessment questionnaire (HAQ) score, 28-joint disease activity score (DAS-28) and serum levels of calcium ion (Ca2+), erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP) and rheumatoid factors (RF) were compared, and the clinicial efficacy was evaluated in the two groups. After treatment, the TCM syndrome scores, HAQ scores and DAS-28 scores were decreased in the two groups (P<0.01), and those in the observation group were lower than the control group (P<0.01). After treatment, the serum levels of Ca2+ were increased (P<0.01), ESR and hs-CRP were decreased in the two groups (P<0.01), and the serum level of RF was decreased in the observation group (P<0.01). The serum level of Ca2+ in the observation group was higher than the control group (P<0.01), ESR and RF were lower than the control group (P<0.01). The total effective rate was 83.3% (25/30) in the observation group，higher than 60.0% (18/30) in the control group (P<0.05). Moxibustion combined with western medication can effectively relieve clinical symptoms, improve quality of life in RA patients, the curative effect is better than simple western medication. And its mechanism may be related to the regulation of serum level of Ca2+ and immune inflammatory response to inhibit bone destruction.

Assessment of Depression, Anxiety, Stress, and quality of life in rheumatoid arthritis patients and comparison with healthy individuals.

Background:Rheumatoid arthritis (RA) is a disabling condition that results in considerable suffering and negatively impacts an individual's psychological, financial, social, and quality of life (QoL). Pain, fatigue, and disabilities, which may be considered as stress factors, are common challenges that may subsequently lead to psychological distress.Aim:Assessment of Depression, Anxiety, Stress, and QoL in RA patients and Comparison with healthy individuals.Materials and Methods:This cross-sectional analytical study included 50 RA patients who have reported to a tertiary health care center on outpatient basis and an equal number of age- and sex-matched healthy individuals. The study was conducted after obtaining Institutional Ethics Committee approval and informed consent of the participants. Patients were assessed based on Disease Activity Score incorporating erythrocyte sedimentation rates, Depression Anxiety Stress Scale (DAS21), Health Assessment questionnaire, Visual Analog Scale, and Multidimensional scale of Perceived Social Support.Results:Levels of anxiety, depression, and stress in patients with RA were significantly higher as compared to age- and sex-matched healthy controls. RA patients had significantly lower scores on total social support, as well as social support of family and friends. However, there was no difference between RA patients and healthy controls on social support from significant others.Conclusion:Patients with RA had significantly higher levels of anxiety, depression, and stress and significantly lower levels of social support compared to age- and sex-matched healthy controls. The therapeutic implications of these findings need further evaluation.

Impact of Clinical Pharmacy Services on Health-Related Quality of Life in Rheumatoid Arthritis Patients

Impact of Clinical Pharmacy Services on Health-Related Quality of Life in Rheumatoid Arthritis Patients

Effect of an 8-Week Yoga-Based Lifestyle Intervention on Psycho-Neuro-Immune Axis, Disease Activity, and Perceived Quality of Life in Rheumatoid Arthritis Patients: A Randomized Controlled Trial

Various external stressors and environmental challenges lead to the provocation of the immune system in autoimmune diseases like Rheumatoid arthritis (RA). The inappropriate immune response further triggers the cascade of inflammatory changes resulting in precipitation of symptoms and hampers quality of life (QOL). The underlying psycho-somatic component of the disease requires a holistic approach to its treatment dimension rather than the use of pharmacotherapy. The applicability of mind-body interventions has become essential in today’s fast-paced life. Yoga, a mind-body technique, alters the mind’s capacity to facilitate systemic functioning at multiple organ system levels. Hence, we conducted this study to evaluate the impact of 8 weeks of a yoga-based lifestyle intervention (YBLI) on psycho-neuro-immune markers, gene expression patterns, and QOL in RA patients on routine medical therapy. A total of 66 patients were randomized into two groups: yoga group or non-yoga group and were assessed for a panel of inflammatory cytokines (IL-6, IL-17A, TNF-α, and TGF-β), mind-body communicative markers (BDNF, DHEAS, β-endorphin, and sirtuin) and transcript levels of various genes (IL-6, TNF-α, NFKB1, TGF-β, and CTLA4). We assessed disease activity and QOL using the DAS28-ESR and WHOQOL-BREF questionnaire, respectively. Yoga group observed significant improvements in the levels of markers, which influenced the psycho-neuro-immune axis (p < 0.001) with an estimated effect size from small to medium range. In the yoga group, there was a significant reduction in DAS28-ESR (p < 0.001) and improvement seen in the physical health, psychological, social relationships domains (p < 0.001) of QOL, except environmental (p > 0.05). The yoga group showed downregulation of IL-6, TNF-α, and CTLA4 and upregulation of TGF-β. These results suggest that a decrease in disease activity after yoga practice is associated with a significant reduction in inflammatory cytokines, the elevation of mind-body communicative markers, and normalization of various transcript levels, which improved QOL. Thus the adoption of YBLI improves clinical outcome in RA, and decreases systemic inflammation by its beneficial effects on psycho-neuro-immune axis and normalization of dysregulated transcripts. Thus YBLI may be used for RA patients as an adjunctive therapy.