POS0952 THE IMPACT OF DIET ON DISEASE ACTIVITY IN SPONDYLOARTHRITIS: A SYSTEMATIC LITERATURE REVIEW

Background Diet is thought to have a role in inflammatory diseases development and course. However, at present, no recommendations can be given spondyloarthritis (SpA) patients regarding specific type of diet/dietary supplement, as evidence on the topic sparse. Objectives To review about effect supplements SpA disease activity Methods A systematic literature (SLR) was conducted MEDLINE SCOPUS according “PEO” format (Population: SpA, axial or peripheral, including Psoriatic Arthritis-PsA; Exposure: any kind supplement; Outcome: available measurement). Inclusion criteria were: adult patients, Randomized Controlled Trials (RCTs) longitudinal studies (so that pre-and post-intervention assessment were available), papers English. Risk bias (RoB) independently judged by 2 authors (AO, MF) with different tools study design: Newcastle Ottawa Scale (NOS) for observational studies, ROBINS-1 tool non-randomized Cochrane risk Bias 2.0 RCTs. Results Literature search yielded 286 publications. After exclusion 59 duplicates, 171 titles/abstract, 44 full-texts, we included 8 interventional 3 (Table 1). Among former, RCTs, one unclear low RoB, failed show benefit probiotics SpA. One RCT RoB showed weight loss, but not hypocaloric diet, associated MDA achievement PsA. The other RCT, well 4 quasi-interventional high/serious respectively. Mediterranean diet demonstrated an association adherence a>=20% decrease ASDAS axSpA. Two poor quality. Table 1. Characteristics Author year Popula - tion Interven Study design Rando-mized Sample size Follow-up (weeks ) Primary outcome Male Sex (% Mean Age (years Concomitant medications besides symptomatics Experimental Lassus 1990 PsA PU ethyl ester lipids supplementation Quasi-exp No 80 NR 50 49 stable csDMARDs Appelboom 1994 AS Milk product deprivation Yes (AS vs RA) 25/10 6 28% Sundström 2006 Omega fatty acids (high dose) 24 21 61 Di Minno 2014 Obese/ overweight Hypocaloric (hypocaloric free diet) 138 (+) 36 45 All started anti-TNF; concomitant MTX 29% Klinberg 2019 Obese 46 12-16 56 100% cs/bDMARDs 2020 (PsA controls) 74 20 Brophy 2008 Probiotics Internet- based (probiotics placebo) 147 12 Satisfaction CONSORT statement 64 10% b/csDMARDs Jenks K 2010 63 BASFI (-) 43 28.5% Observational Design Adawi 2018 Intermittent fasting cohort 37 Ben Nessib Fasting-refeeding 28 47 40% cs/ bDMARDs Ometto 2021 axSpA Mediterra-nean (Mediterra-nean 161 65 51 PsA: arthritis, ankylosing spondylitis, spondyloarthritis, ax: axial; RA Rheumatoid Arthritis, polyunsaturated; Trial; exp=experimemntal; Minimal Disease Activity; CONsolidated Standards Reporting Trials; Bath Ankylosing Spondylitis Functional Index; indicate whether primary met Conclusion loss seems able impact while effective RCTs so far. Adherence might play reducing activity. Evidence effectiveness dietary behaviors quite heterogeneous high quality are warranted better understand Disclosure Interests Augusta Ortolan: None declared, Mara Felicetti: Mariagrazia Lorenzin: Giacomo Cozzi: Giovanni Striani: Andrea Doria Speakers bureau: Novartis, AbbVie, Pfizer, MSD, Janssen, GSK, Consultant of: Roberta Ramonda honoraria speaker fees from Janssen