Dietary supplement in rheumatological diseases: a CReI-ISS cross-sectional survey to investigate their prescription and consumption

Rheumatological diseases represent a heterogeneous group of disorders, united by chronic inflammatory processes. Despite the increasing effectiveness of new therapies, the lack of adequate treatments and the occurrence of adverse drug reactions have led to the need for alternative strategies, including nutrition. Numerous studies have shown that diet can directly influence inflammatory processes; moreover, it plays an important role in the occurrence of comorbidities in the rheumatological conditions. Among possible alternative dietary strategies, a prominent role is played by dietary supplements, because of the belief that they can be a valuable aid, although not without adverse effects. They may be caused by improper use or drugs interaction, although the lack of data on their consumption hampers risk assessment. The project aims to collect accurate information on the dietary supplement use in rheumatology to fill the existing gap in this field and enable risk characterization. A survey-based cross-sectional study has been designed. It was divided into two consecutive phases to investigate i) rheumatologists' knowledge, attitudes, and recommendations to patients regarding dietary supplements and ii) patients' intake of dietary supplements, with a focus on the specific product, unit consumed and motivation for consumption. Questionnaires referring to a minimum of 236 rheumatologists and 2000 patients, distributed proportionally to the Italian population, will be collected. Information on sociodemographic variables, lifestyle, knowledge, consumption, and clinical practice on supplements will be sought. The results obtained will provide an understanding of the consumption of dietary supplements in rheumatology and establish the scientific basis of their use through a literature review. They will also allow the drafting of guidelines on their proper use in clinical practice in rheumatologic diseases and set up a validation of the rheumatologist's questionnaire by extending it to other health professional categories. Overall, this survey will allow us to better characterize the risk-benefit ratio of dietary supplements, preserving consumer health, and to increase people awareness about dietary supplements effects, so determining a conscious and safe use of them.