Long-term efficacy of radon spa therapy in rheumatoid arthritis - a randomized, sham-controlled study and follow-up

Objective. To quantify the efficacy of a series of baths containing natural radon and carbon dioxide (1.3 kBq/l, 1.6 g carbon dioxide/l on average) versus artificial carbon dioxide baths alone in patients with rheumatoid arthritis. Subjects. Sixty patients participating in an in-patient rehabilitation programme including a series of 15 baths were randomly assigned to two groups. Design. Pain intensity (100 mm visual analogue scale) and functional restrictions [Keitel functional test, Arthritis Impact Measurement Scales (AIMS questionnaire)] were measured at baseline, after completion of treatment and 3 and 6 months thereafter. To investigate whether the overall value of the outcomes was the same in both groups, the overall mean was analysed by Student's t-test for independent samples. Results. The two groups showed a similar baseline situation. After completion of treatment, relevant clinical improvements were observed in both groups, with no notable group differences. However. the follow-up revealed sustained effects in the radon arm, and a return to baseline levels in the sham arm. After 6 months, marked between-group differences were found for both end-points (pain intensity: -16.9%, 95% confidence interval -27.6 to -6.2% AIMS score: 0.57, 95% confidence interval 0.16 to 0.98). The between-group differences were statistically significant for both overall means (pain intensity, P = 0.04; AIMS, P = 0.01). Conclusion. Marked short-term improvements in both groups at the end of treatment may have masked potential specific therapeutic effects of radon baths. However, after 6 months of follow-up the effects were lasting only in patients of the radon arm. This suggests that this component of the rehabilitative intervention can induce beneficial long-term effects.