Prevalence of Restless Legs Syndrome in Rheumatoid Arthritis: A Systematic Review and Meta-analysis
-
Mehrdad Bagherpour-Kalo
,
Parvaneh Darabi
,
Ali Moghadas Jafari
,
Hamid Najafimehr
,
Kamal Azam
,
Mostafa hosseini
Abstract
Background: Restless legs syndrome (RLS) is a common sensorimotor sleep disorder, and rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes disability. Previous studies showed that the prevalence of RLS varies in different populations of RA (13.2 – 68.4%). It raises the need for a pooled meta-analysis to determine a more reliable estimate. Therefore, we aimed to perform a meta-analysis to assess the pooled prevalence of RLS in RA patients.
Methods: Meta-analysis was performed according to the PRISMA checklist. Embase, MEDLINE, Ovid, Web-of-Science, and Scopus databases were used for the systematic search, and eligible studies were analyzed using R version 4.0.3. For further review, we performed sensitivity analyzes to identify influential studies.
Results: Of a total of 763 studies, 11 studies (3 were from Europe, 4 from North America, and 4 from Asia) were suitable for synthesis. A total of 931 RA patients were identified, 300 of whom had symptoms of RLS. The pooled prevalence of RLS among people with RA from 11 studies was 34% (95% CI: 26-43%). The pooled prevalence of RLS in Europe, Asia, and North America was 48% (95% CI: 32-65%), 32% (95% CI: 18-45%), and 28% (95% CI: 15-42%), respectively. RLS prevalence was dramatically high in RA women patients (32% CI: 23-41%) than RA men patients (3%; 95% CI: 2-5%).
Conclusion: This systematic review and meta-analysis indicates that the risk of RLS in RA patients was 34% and female patients with RA were more prone to having RLS than male patients.
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15. Mustafa M, Bawazir Y, Merdad L, Wali S, Attar S, Fathaldin O, et al. Frequency of sleep disorders in patients with rheumatoid arthritis. Open Access Rheumatology: Research and Reviews. 2019;11:163.
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19. Taylor-Gjevre RM, Gjevre JA, Skomro R, Nair B. Restless legs syndrome in a rheumatoid arthritis patient cohort. JCR: Journal of Clinical Rheumatology. 2009;15(1):12-5.
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21. Yunus MB, Aldag JC. Restless legs syndrome and leg cramps in fibromyalgia syndrome: a controlled study. Bmj. 1996;312(7042):1339.
22. Moher D, Liberati A, Tetzlaff J, Altman DG, The PG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLOS Medicine. 2009;6(7):e1000097.
23. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Bmj. 2003;327(7414):557-60.
24. Zhang T, Zhong W, Li B. Applied methodology for evidence-based medicine. Press of Central South University. 2011.
25. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50(4):1088-101.
26. Ondo W, Tan EK, Mansoor J. Rheumatologic serologies in secondary restless legs syndrome. Movement disorders: official journal of the Movement Disorder Society. 2000;15(2):321-3.
27. Taylor‐Gjevre R, Gjevre J, Nair B, Skomro R, Lim H. Components of sleep quality and sleep fragmentation in rheumatoid arthritis and osteoarthritis. Musculoskeletal care. 2011;9(3):152-9.
28. Taylor-Gjevre RM, Gjevre JA, Skomro RP, Nair BV, Lim HJ. Improved sleep efficiency after anti-tumor necrosis factor α therapy in rheumatoid arthritis patients. Therapeutic advances in musculoskeletal disease. 2011;3(5):227-33.
29. Berger K, Luedemann J, Trenkwalder C, John U, Kessler C. Sex and the risk of restless legs syndrome in the general population. Archives of internal medicine. 2004;164(2):196-202.
30. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet (London, England). 2016;388(10055):2023-38.
31. Schormair B, Zhao C, Bell S, Tilch E, Salminen AV, Pütz B, et al. Identification of novel risk loci for restless legs syndrome in genome-wide association studies in individuals of European ancestry: a meta-analysis. The Lancet Neurology. 2017;16(11):898-907.
32. Wang Y, Xie X, Zhang C, Su M, Gao S, Wang J, et al. Rheumatoid arthritis, systemic lupus erythematosus and primary Sjögren’s syndrome shared megakaryocyte expansion in peripheral blood. Annals of the rheumatic diseases. 2022;81(3):379-85.
33. Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lespérance P. Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Movement disorders: official journal of the Movement Disorder Society. 1997;12(1):61-5.
2. Trenkwalder C, Paulus W, Walters AS. The restless legs syndrome. The Lancet Neurology. 2005;4(8):465-75.
3. Yeh P, Walters AS, Tsuang JW. Restless legs syndrome: a comprehensive overview on its epidemiology, risk factors, and treatment. Sleep and Breathing. 2012;16(4):987-1007.
4. Ekbom K, Ulfberg J. Restless legs syndrome. Journal of Internal Medicine. 2009;266(5):419-31.
5. Taylor-Gjevre RM, Gjevre JA, Skomro R, Nair B. Restless legs syndrome in a rheumatoid arthritis patient cohort. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases. 2009;15(1):12-5.
6. Majithia V, Geraci SA. Rheumatoid Arthritis: Diagnosis and Management. The American Journal of Medicine. 2007;120(11):936-9.
7. Gabriel SE. The epidemiology of rheumatoid arthritis. Rheumatic disease clinics of north America. 2001;27(2):269-81.
8. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet (London, England). 2016;388(10053):1459-544.
9. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet (London, England). 2016;388(10053):1545-602.
10. Sokka T, Häkkinen A, Kautiainen H, Maillefert JF, Toloza S, MØrk hansen T, et al. Physical inactivity in patients with rheumatoid arthritis: data from twenty‐one countries in a cross‐sectional, international study. Arthritis Care & Research: Official Journal of the American College of Rheumatology. 2008;59(1):42-50.
11. Auger C, Montplaisir J, Duquette P. Increased frequency of restless legs syndrome in a French-Canadian population with multiple sclerosis. Neurology. 2005;65(10):1652-3.
12. Demir S, Kucuk A, Altas M, Cure E. Restless Leg Syndrome and Sleep Disorders in Patients with Rheumatoid Arthritis and Its Relation with Anemia Parameters. ACTA MEDICA. 2021;64(3):137-44.
13. Hirsch M, Carlander B, Vergé M, Tafti M, Anaya JM, Billiard M, et al. Objective and subjective sleep disturbances in patients with rheumatoid arthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1994;37(1):41-9.
14. Ishaq M, Sualeh Muhammad J, Hameed K. Risk of restless legs syndrome in low socioeconomic rheumatoid arthritis patients. Modern rheumatology. 2013;23(4):705-8.
15. Mustafa M, Bawazir Y, Merdad L, Wali S, Attar S, Fathaldin O, et al. Frequency of sleep disorders in patients with rheumatoid arthritis. Open Access Rheumatology: Research and Reviews. 2019;11:163.
16. Reynolds G, Blake D, Pall H, Williams A. Restless leg syndrome and rheumatoid arthritis. British Medical Journal (Clinical research ed). 1986;292(6521):659.
17. Salih A, Gray R, Mills K, Webley M. A clinical, serological and neurophysiological study of restless legs syndrome in rheumatoid arthritis. Rheumatology. 1994;33(1):60-3.
18. Taylor-Gjevre RM, Gjevre JA, Nair BV. Increased nocturnal periodic limb movements in rheumatoid arthritis patients meeting questionnaire diagnostic criteria for restless legs syndrome. BMC Musculoskeletal Disorders. 2014;15(1):1-5.
19. Taylor-Gjevre RM, Gjevre JA, Skomro R, Nair B. Restless legs syndrome in a rheumatoid arthritis patient cohort. JCR: Journal of Clinical Rheumatology. 2009;15(1):12-5.
20. Urashima K, Ichinose K, Kondo H, Maeda T, Kawakami A, Ozawa H. The prevalence of insomnia and restless legs syndrome among Japanese outpatients with rheumatic disease: a cross-sectional study. PloS one. 2020;15(3):e0230273.
21. Yunus MB, Aldag JC. Restless legs syndrome and leg cramps in fibromyalgia syndrome: a controlled study. Bmj. 1996;312(7042):1339.
22. Moher D, Liberati A, Tetzlaff J, Altman DG, The PG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLOS Medicine. 2009;6(7):e1000097.
23. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Bmj. 2003;327(7414):557-60.
24. Zhang T, Zhong W, Li B. Applied methodology for evidence-based medicine. Press of Central South University. 2011.
25. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50(4):1088-101.
26. Ondo W, Tan EK, Mansoor J. Rheumatologic serologies in secondary restless legs syndrome. Movement disorders: official journal of the Movement Disorder Society. 2000;15(2):321-3.
27. Taylor‐Gjevre R, Gjevre J, Nair B, Skomro R, Lim H. Components of sleep quality and sleep fragmentation in rheumatoid arthritis and osteoarthritis. Musculoskeletal care. 2011;9(3):152-9.
28. Taylor-Gjevre RM, Gjevre JA, Skomro RP, Nair BV, Lim HJ. Improved sleep efficiency after anti-tumor necrosis factor α therapy in rheumatoid arthritis patients. Therapeutic advances in musculoskeletal disease. 2011;3(5):227-33.
29. Berger K, Luedemann J, Trenkwalder C, John U, Kessler C. Sex and the risk of restless legs syndrome in the general population. Archives of internal medicine. 2004;164(2):196-202.
30. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet (London, England). 2016;388(10055):2023-38.
31. Schormair B, Zhao C, Bell S, Tilch E, Salminen AV, Pütz B, et al. Identification of novel risk loci for restless legs syndrome in genome-wide association studies in individuals of European ancestry: a meta-analysis. The Lancet Neurology. 2017;16(11):898-907.
32. Wang Y, Xie X, Zhang C, Su M, Gao S, Wang J, et al. Rheumatoid arthritis, systemic lupus erythematosus and primary Sjögren’s syndrome shared megakaryocyte expansion in peripheral blood. Annals of the rheumatic diseases. 2022;81(3):379-85.
33. Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lespérance P. Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Movement disorders: official journal of the Movement Disorder Society. 1997;12(1):61-5.
| Files | ||
| Issue | Vol 9 No 1 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jbe.v9i1.13971 | |
| Keywords | ||
| Restless legs syndrome Rheumatoid arthritis Prevalence Meta-analysis | ||
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How to Cite
1.
Bagherpour-Kalo M, Darabi P, Moghadas Jafari A, Najafimehr H, Azam K, hosseini M. Prevalence of Restless Legs Syndrome in Rheumatoid Arthritis: A Systematic Review and Meta-analysis. JBE. 2023;9(1):131-146.
