Arthritis
Tai chi helps cut pain of knee arthritis: study
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The traditional Chinese form of exercise known as tai chi can help reduce pain and physical impairment in people who have knee arthritis, researchers said on Saturday.
In their study, one group of people in their 60s with severe knee osteoarthritis performed tai chi for an hour twice a week for 12 weeks while a similar group did the same amount of conventional stretching exercises over the same period.
Those who did tai chi experienced greater pain reduction, less depression and improvements in physical function and overall health, researchers led by Dr. Chenchen Wang of Tufts Medical Center in Boston reported at a meeting of the American College of Rheumatology in San Francisco.
30,000 Children with Form Of Juvenile Rheumatoid Arthritis May Have New Treatment Option
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Anakinra may be effective in the treatment of an estimated 30,000 children with a certain form of juvenile arthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco, Calif.
Systemic onset juvenile idiopathic arthritis (often referred to as systemic-onset juvenile rheumatoid arthritis or Still’s disease) affects about 10 percent of children with arthritis. It begins with a recurrent fever that can be 103° F or higher, often accompanied by a pink rash that comes and goes. Systemic onset JIA may cause inflammation of the internal organs as well as the joints. Swelling of the joints may not be present initially, and may appear months or even years after the onset of fevers. Anemia (a low red blood cell count) and elevated white blood cell counts are also typical. Arthritis may persist despite the fevers and other systemic symptoms going away.
In a recent multicenter, randomized, double-blind trial, researchers compared the effectiveness of a one-month treatment with anakinra (Kineret)—which was delivered at 2 milligrams per kilogram, subcutaneously, each day with a maximum of 100 milligrams—to a placebo in two groups of children, each containing 12 patients with JIA. Treatment was blinded so that neither the children nor the investigators knew which injection was being given. After 1 month, patients were allowed to continue un-blinded therapy for another 11 months.
Gene Expression May Influence Lack of Response to RA Treatment
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Genes might explain why some patients with rheumatoid arthritis respond better to anti-TNF therapy than others, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco, Calif.
Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.
Drugs known as tumor necrosis factor, or TNF, inhibitors are often prescribed to individuals with rheumatoid arthritis. They work by targeting and blocking the inflammation, and can help reduce pain, morning stiffness, tender and swollen joints, limit damage to the joints and improve function.
Traditional Cardiovascular Risk Factors Increase, Treatments Reduce Heart Attack Risk in People
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Traditional Cardiovascular Risk Factors Increase, Treatments Reduce Heart Attack Risk in People with Rheumatoid Arthritis
Age, sex and traditional risk factors—such as hypertension, diabetes, smoking, and body mass—are more important predictors of heart attack in patients with rheumatoid arthritis than the use of certain medications that have been considered the link between the two and lipid-lowering medications may actually reduce this risk, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco, Calif.
Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.
Disease-modifying antirheumatic drugs, or DMARDS as they are commonly called, are often the therapy of choice for patients with RA as they not only reduce inflammation and pain, but can slow the overall progression of the disease.
New study proves that pain is not a symptom of arthritis, pain causes arthritis
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Pain is more than a symptom of osteoarthritis, it is an inherent and damaging part of the disease itself, according to a study published today in journal Arthritis and Rheumatism. More specifically, the study revealed that pain signals originating in arthritic joints, and the biochemical processing of those signals as they reach the spinal cord, worsen and expand arthritis. In addition, researchers found that nerve pathways carrying pain signals transfer inflammation from arthritic joints to the spine and back again, causing disease at both ends.
Technically, pain is a patient’s conscious realization of discomfort. Before that can happen, however, information must be carried along nerve cell pathways from say an injured knee to the pain processing centers in dorsal horns of the spinal cord, a process called nociception. The current study provides strong evidence that two-way, nociceptive “crosstalk” may first enable joint arthritis to transmit inflammation into the spinal cord and brain, and then to spread through the central nervous system (CNS) from one joint to another.
Furthermore, if joint arthritis can cause neuro-inflammation, it could have a role in conditions like Alzheimer’s disease, dementia and multiple sclerosis. Armed with the results, researchers have identified likely drug targets that could interfere with key inflammatory receptors on sensory nerve cells as a new way to treat osteoarthritis (OA), which destroys joint cartilage in 21 million Americans. The most common form of arthritis, OA eventually brings deformity and severe pain as patients loose the protective cushion between bones in weight-bearing joints like knees and hips.
Working environment is 1 cause of rheumatoid arthritis
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It has long been known that environmental factors play a part in the development of rheumatoid arthritis; smoking and drinking alcohol, along with heredity, are particularly instrumental in increasing the risk of the disease. Scientists at Karolinska Institutet have now produced results that suggest that working environment factors can also increase the chances of developing rheumatoid arthritis.
This is especially true of psychosocial workload, in particular what is called “low decision latitude”, according to the results of a study in progress due to be published in Psychotherapy and Psychosomatics. The project is being led by Professor Lars Alfredsson of the Department of Environmental Medicine and Professor Lars Klareskog of the Department of Medicine.
“We’ve uncovered clear correlations between the disease and jobs in which one cannot control one’s own situation,” says Professor Alfredsson.
Clinicians Debate Use of Arthroscopy in Patients with Osteoarthritis
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In a study published in the New England Journal of Medicine (NEJM) issue of Sept. 11, 2008, investigators concluded that arthroscopic surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy. In an accompanying editorial, however, Robert G. Marx, M.D., an associate attending orthopedic surgeon at Hospital for Special Surgery (HSS) in New York, points out that the study has some weaknesses and argues strongly that arthroscopy does have a role in some patients with osteoarthritis.
“Arthroscopy is still valuable and you have to know when to use it,” said Dr. Marx, who is also director of the Foster Center for Clinical Outcome Research at HSS. “While I do not recommend arthroscopy as a treatment for an arthritic knee, it can be extremely helpful for people with arthritis who also have a co-existing knee problem such as a meniscal tear or a loose piece of cartilage that is causing the majority of their symptoms.”
In the study reported in the NEJM, investigators randomized 92 individuals to arthroscopic surgery and 86 to non-operative treatment for osteoarthritis of the knee. The non-operative treatments included one physical therapy session per week for twelve weeks with a home physical therapy program, patient education, and the step-wise use of acetaminophen, non-steroidal anti-inflammatory drugs, glucosamine and an injection of hyaluronic acid. The study did not identify any benefit in the group that received surgery.
Joint replacement may improve osteoarthritis symptoms in older adults
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Older adults who have hip or knee replacement surgery for severe osteoarthritis may take several weeks to recover but appear to have excellent long-term outcomes, according to a report in the July 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
As the U.S. population ages, the number of older adults with osteoarthritis is increasing, according to background information in the article. The disease causes debilitating pain and often restricts older adults’ mobility. Non-invasive treatments such as medications and physical therapy appear to be of limited value for the advanced stages of osteoarthritis. However, surgery may be associated with risks and discomfort.
Mary Beth Hamel, M.D., M.P.H., and colleagues at Beth Israel Deaconess Medical Center, Boston, studied medical decision-making and treatment outcomes in 174 patients age 65 and older (average age 75.2) who had severe osteoarthritis of the hip or knee. Participants’ arthritis symptoms and functional status were assessed at the beginning of the study, between 2001 and 2004, and again 12 months later. Patients who chose to have joint replacement surgery were assessed six weeks, six months and 12 months after the procedure.
Rheumatoid arthritis doubles heart risk: experts
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People with rheumatoid arthritis have double the risk of suffering heart attacks or strokes and should be considered for treatment with statins and blood pressure drugs, rheumatology experts said on Friday.
A report by a medical task force to the annual congress of the European League Against Rheumatism in Paris concluded the risk was comparable to that associated with type 2 diabetes, which is already an established cardiovascular risk factor.
Dr Michael Nurmohamed , leader of the task force, said the inflammatory processes underlying rheumatoid arthritis appeared to increase patients’ risk of serious heart problems.
Rheumatoid arthritis is a risk factor for cardiovascular disease
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Paris, France, Friday 13 June 2008: The risk of cardiovascular disease (CVD) for people with rheumatoid arthritis (RA) has been found to be comparable to the risk of CVD in people with type 2 diabetes, according to the conclusions of two studies presented today at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France.
At least one CV-event was reported in 8.6% of the RA population studied, a figure that was double that reported in the general population (4.3%), corresponding with an incidence of 3.14 per 100 patient/years (95% confidence interval (CI): 1.98-4.30) for RA patients, and 1.51 per 100 person/years (95%-CI: 1.18-1.84) for the general population.
In a second study, the age- and gender- adjusted prevalence odds ratios for CVD were found to be 2.3 (95%-CI: 1.3-4.0) for those with type 2 diabetes and 2.0 (95%-CI: 1.1-3.4) for those with RA, indicating a similar CVD risk for the two diseases.
Oily fish can protect against RA, but smoking and psychosocial stress increase its risk
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Paris, France, Friday 13 June 2008: New data presented today at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France, show that intake of oily fish is associated with a reduced risk of developing rheumatoid arthritis (RA), whereas psychosocial work stress and smoking can increase the risk of developing the condition. The findings, all taken from a large population-based case-control study in Sweden called EIRA (Epidemiological Investigation of Rheumatoid Arthritis), shed light on the important role of environmental and social factors in the development of RA.
Intake of Oily Fish
For the first time, the intake of oily fish has been demonstrated to have a protective effect against the development of RA, reducing an individual’s risk by 20-30%. Studying 1,899 subjects with a confirmed diagnosis of RA (fulfilling ACR criteria) and 2,145 controls (randomly selected and matched for age, sex and residential area), investigators concluded that the odds ratio (OR) for developing RA was 0.8 (0.7-1.0) for those who consumed oily fish 1-7 times per week or 1-3 times per month, compared with those who never, or seldom consumed oily fish. Interestingly, no significant association with RA risk was observed for consumption of fish oil supplements.
Combination therapy more effective in early RA
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In the treatment of early rheumatoid arthritis (RA), a combination of anti-RA drugs is superior to methotrexate alone, UK researchers report.
“Our study,” lead investigator Dr. Ernest H. Choy told Reuters Health, “confirmed that there is a window of opportunity in the treatment of rheumatoid arthritis.”
Choy of King’s College School of Medicine, London and colleagues randomly assigned 467 patients with early RA to treatment with methotrexate alone or with the addition of another “disease-modifying antirheumatic drug” (cyclosporine) or the steroid prednisolone, or both, for 9 months.
Cane Use May Reduce Risk of Knee Osteoarthritis Progression
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A common, incurable joint disease, osteoarthritis (OA) is the leading cause of disability in elderly people. While nearly any joint can be affected, OA most often strikes the knee, particularly the inner aspect of the tibiofemoral joint. One source of stress on this vulnerable joint compartment is the knee adduction moment, an indication of weight placement while walking. A 20 percent increase in the peak knee adduction moment is associated with a 6-fold or greater increase in the risk of knee OA progression over 6 years. To reduce knee load, pain and damage in knee OA patients, physicians often prescribe two inexpensive interventions: footwear and cane use. While these simple strategies have the potential to alter the knee adduction moment, there is little research attesting to their specific benefits for knee OA sufferers.
To assess the immediate effects of walking shoes and a walking cane on the peak knee adduction moment in people with knee OA, researchers at the University of Melbourne turned to 3-dimensional (3-D) gait analysis. Their findings, featured in the May 2008 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritis), strongly support using a cane on a regular basis to reduce the load borne across the knee, while underscoring the urgent need for studies into which aspects of shoe design best support the treatment of knee OA patients.
Arthritis is a potential barrier to physical activity for adults with diabetes
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People with diagnosed diabetes are nearly twice as likely to have arthritis, and the inactivity caused by arthritis hinders the successful management of both diseases, according to a new Morbidity and Mortality Weekly Report (MMWR) study released today by the Centers for Disease Control and Prevention (CDC). This is one of the first studies of its kind to look at the relationship between arthritis and diabetes and the outcomes associated with physical activity.
The report finds that arthritis appears to be a barrier to being physically active for people with diabetes. Despite the fact that physical activity helps control blood glucose levels and reduces joint pain, people with both diseases are more likely to be physically inactive (29.8%) compared to those with diabetes alone (20.1%).
“Arthritis is a frequent co morbid condition for adults with diabetes,” said John H. Klippel, M.D., president and CEO, Arthritis Foundation. “But for both diseases, physical activity is key to effective management. A lack of physical activity actually results in undesirable consequences including increased pain, stiffness, inflammation, physical limitation and potential disability.”
Strontium may relieve spinal osteoarthritis pain
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A compound called strontium ranelate may reduce back pain in women with osteoporosis and osteoarthritis (OA) of the spine, according to new study. The compound may also delay progression of spinal OA.
Strontium ranelate has been shown to stimulate bone formation while inhibiting bone resorption.
Dr. Olivier Bruyere from University of Liege, Belgium and colleagues say their findings suggest that “strontium ranelate may have symptom- and structure-modifying effects in women with osteoporosis and OA.”
