Published Paper Details:

Background: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease significantly impacting patients' quality of life and functional capacity. While conventional disease-modifying anti-rheumatic drugs (DMARDs) remain the cornerstone of treatment, complementary interventions like yoga have gained attention for their potential therapeutic benefits. Objective: To systematically review and analyze the effects of yoga-based interventions on clinical, immunological, and molecular outcomes in patients with rheumatoid arthritis. Methods: A comprehensive search was conducted following PRISMA 2020 guidelines. Four randomized controlled trials (RCTs) involving 331 participants with rheumatoid arthritis were included. Studies evaluated yoga interventions ranging from 8 to 12 weeks compared to usual care or educational control groups. Primary outcomes included disease activity scores (DAS28-ESR), health-related quality of life measures, and various biomarkers. Data synthesis was performed using standardized mean differences with 95% confidence intervals. Results: Meta-analysis revealed significant improvements in disease activity (pooled SMD: -0.52, 95% CI: -0.78 to -0.26, p < 0.001) and fatigue scores (SMD: -0.48, 95% CI: -0.72 to -0.24, p < 0.001). Yoga interventions demonstrated beneficial effects on inflammatory markers, including IL-6, IL-17, and TNF-?, while enhancing anti-inflammatory cytokines like TGF-? and IL-10. Molecular analyses revealed improved mitochondrial function, normalized T cell populations, and favorable gene expression patterns. Conclusions: Yoga-based interventions show promise as adjunctive therapy for rheumatoid arthritis, with evidence supporting improvements in disease activity, fatigue, and immune function. However, the limited number of studies and moderate quality of evidence necessitate further high-quality randomized controlled trials to establish definitive clinical recommendations.