Report on the application of the Castra-Verduzan balneotherapy care facility to obtain the agreement to treat patients with rheumatic conditions "RHEUMATOLOGY-RH"

The academy must examine the study by analogy and the clinical study carried out to obtain "Rheumatology" approval by the thermal care facility of Castera-Verduzan. The water of Castera is a natural mineral, cold, sulphated water. Such waters are widely used in rheumatology. Twenty-one French thermal spas approved in Rheumatology use mineral waters of this type. Eighteen controlled randomised studies, published in the English-speaking international literature with impact factor, attest to a clinical benefit in chronic low back pain, knee osteoarthritis, and generalised osteoarthritis. The clinical study carried out, in accordance with the 2020 criteria, is an interventional, prospective study having enrolled 62 patients who were compared to a randomised controlled trial control population as part of an MAIC. Sixty-one patients completed the thermal treatment. The inclusion and exclusion criteria were specified, and the endpoints defined. The study meets the criteria of the Academy. All subjects had symptomatic knee osteoarthritis. Pain was measured by the 100 mm visual analogue scale, disability by the Womac scale and the Lequesne index, quality of life by the SF 12, level of physical activity by the IPAQ, painkillers taken were noted. The 6th month evaluation showed a significant improvement, comparable to what was measured at the end of the treatment, of pain, disability, quality of life (somatic score) and a decrease in drug consumption. The comparison with the control population of the "Thermarthrose" trial performed in a MAIC using IPTW method showed a significant difference in favor of the spa group to achieve a the MCII (Minimum Clinical Important Improvement). The petitioner has fulfilled the legal obligations. Sulphated waters can be used in rheumatology. The interventional study carried out, in accordance with the 2020 criteria of the Academy, allows the verification of the quality of care in terms of implementation, health benefit, and safety for patients and staff. The Academy gave a favorable opinion on the request of the thermal care facilty of Castera-Verduzan.(c) 2023 l'Academie nationale de medecine. Published by Elsevier Masson SAS. All rights reserved.