The Role of Intermittent Fasting in Rheumatoid Arthritis-A Scoping Review.

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by progressive synovial inflammation, joint destruction, and metabolic abnormalities. In recent years, there has been growing interest in intermittent fasting (IF) as a potential dietary strategy for modulating inflammatory and immunometabolic processes in RA. Preliminary data suggest that IF may lead to reduced joint pain, lower inflammatory markers, improved well-being, and weight loss, but the available evidence is scattered and heterogeneous. The aim of this scoping review was to provide a comprehensive overview of the current state of knowledge regarding the effects of IF on inflammatory, immunological, and metabolic processes in patients with RA. Methods: The review was conducted in accordance with the Joanna Briggs Institute methodology and the PRISMA-ScR guidelines. The databases PubMed, Scopus, Web of Science, EBSCO, the Cochrane Library, and Google Scholar were searched (16 March to 12 April 2026) using the Population-Concept-Context model. Full-text observational and experimental studies, as well as reviews, on intermittent fasting in RA were included in the analysis. Results: Of the 137 publications identified, 9 studies were included in the review, covering populations from Iran, Luxembourg, Tunisia, Mexico, China, and Turkey. The results indicate that IF may lead to improvements in disease activity, quality of life, and selected metabolic parameters. Several studies reported a beneficial effect of IF on markers of oxidative stress and selected pro-inflammatory cytokines, although other analyses did not confirm significant changes in inflammatory biomarkers. Preclinical data have demonstrated strong anti-inflammatory and immunoregulatory effects of IF, including a reduction in pro-inflammatory cytokines and an increase in the Treg population. The heterogeneity of IF protocols, population differences, and small sample sizes limit the ability to interpret the results unequivocally. Conclusions: The available evidence suggests that intermittent fasting may represent a promising, nonpharmacological strategy to support the treatment of RA, particularly in terms of improving immunometabolic parameters and subjective disease symptoms. However, due to methodological limitations and the lack of long-term studies, further well-designed randomized clinical trials are needed to evaluate the efficacy and safety of IF in this population.