{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:28:23Z","timestamp":1792013303678,"version":"4.4.0"},"reference-count":45,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Stichting Vermeer 14"},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["555003210"],"award-info":[{"award-number":["555003210"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"name":"W.M. de Hoop Stichting"},{"name":"Reade"},{"name":"Reade Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2024,2,8]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In two randomised controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. The current study investigated long-term outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>After completion of two 16-week trials in people with (1) RA or (2) MSOA, control groups switched to the active PFJ intervention. At the end of the intervention, all participants were followed up in a 1-year observational extension study. Primary outcomes were 28-joint Disease Activity Score (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes and intervention adherence. An intention-to-treat analysis with a linear mixed model was used to analyse within-group changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>65 (84%) of 77 RA participants and 49 (77%) of 64 MSOA participants completed the extension study. The effects of the PFJ intervention were replicated in the original control groups and sustained within the RA group a year after intervention completion (mean DAS28 \u20130.9 points; p&lt;0.001), while in the MSOA group mean WOMAC increased towards but remained well under the starting value (\u20137.8 points, p&lt;0.001). Improvements in C-reactive protein, waist circumference (RA and MSOA); low-density lipoprotein cholesterol (RA); and weight, haemoglobin A1c, blood pressure (MSOA) were also sustained. Participants had a net decrease of medication, and intervention adherence was largely sustained.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A year after the PFJ lifestyle intervention, improvements of disease activity and metabolic outcomes within RA and MSOA groups were largely sustained and related to sustained adherence, with a net decrease of medication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration numbers<\/jats:title>\n                  <jats:p>NL7800, NL7801.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-004025","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T13:16:14Z","timestamp":1709039774000},"page":"e004025","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the \u2018Plants for Joints\u2019 randomised clinical trial"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0937-4450","authenticated-orcid":false,"given":"Carlijn A","family":"Wagenaar","sequence":"first","affiliation":[{"name":"Reade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands"},{"name":"Department of Clinical Immunology and Rheumatology, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2428-2845","authenticated-orcid":false,"given":"Wendy","family":"Walrabenstein","sequence":"additional","affiliation":[{"name":"Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marike","family":"van der 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Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6969-283X","authenticated-orcid":false,"given":"Maarten","family":"Boers","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"van der Esch","sequence":"additional","affiliation":[{"name":"Reade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands"},{"name":"Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri\u00ebt","family":"van Middendorp","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Leiden, 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