Background Rheumatoid arthritis (RA) is a chronic inflammatory disease which affects about 0.5% of adults in Malaysia.

Objectives This study aimed to explore the overall effect of Ramadhan fasting onto RA disease activity and identify drug modification, drug side effects and diet changes occurring in Ramadhan. The study was approved by the Ethics Committee of UKMMC.

Methods A retrospective case control study was done involving 71 patients who had appointments at the Rheumatology Clinic in UKMMC before Ramadhan and 2 months after Ramadhan, in 2010 and 2011. The fasting cohort (39 patients) and non fasting cohort (32 patients) were compared for RA disease activity (DAS28), intake of medication, side effects and diet before and during Ramadhan.

Results In the fasting cohort, the mean for DAS28 before Ramadhan was higher than that after Ramadhan but this was not significant (p>0.05). Clinical symptoms of morning stiffness and fatigue were found in fewer patients after Ramadhan but this was not significant (p>0.05). There was a significant reduction in morning stiffness (x²=13.380, p=0.001) and in functional class (Z=-2.548, p=0.011) after Ramadhan, in the fasting cohort in 2010. The fasting cohort also showed asignificant reduction in the intake of high calorie food (Z=-2.295, p=0.022) in Ramadhan. There was an improvement in medication compliance among the patients, although this was not significant (p<0.05).

Conclusions In conclusion, fasting lowers the mean of DAS28 in rheumatoid arthritis patients although this is statistically not significant. During fasting, changes in diet and medication intake do not significantly affect RA disease activity and do not cause significant side effects to fasting patients.

Disclosure of Interest None Declared