Arthritis
Vegan diet may help ease rheumatoid arthritis
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A gluten-free vegan diet full of nuts, sunflower seeds, fruit and vegetables appears to offer protection against heart attacks and strokes for people with rheumatoid arthritis, Swedish researchers said on Tuesday.
The diet appeared to lower cholesterol and also affect the immune system, easing some symptoms associated with the painful joint condition, they said.
The study suggested diet could play an important role for people with rheumatoid arthritis who are often more prone to heart attacks, strokes and clogged arteries, said the team from Sweden’s Karolinska Institute.
Misdiagnosis of rheumatoid arthritis
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In an article recommended by Annelies Boonen of Faculty of 1000 Medicine, researchers look at the way rheumatoid arthritis is diagnosed by analysing the administrative databases used by physicians in Quebec.
The authors of the paper, published in Arthritis & Rheumatism, report that general practitioners diagnosed 79% of the 10,001 rheumatoid arthritis cases but only 27% of patients then saw a rheumatologist. Half of these patients were seen in the first three months and of these it emerges that only 17% received confirmation they were actually suffering from rheumatoid arthritis.
Detecting bone erosion in arthritic wrists
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Both magnetic resonance imaging (MRI) and computed tomography (CT) are more sensitive than radiography – the standard imaging technique – for detecting bone erosions in rheumatoid arthritis (RA), according to research published in the open access journal Arthritis Research & Therapy. The early detection of bone erosions is crucial for identifying those people most at risk from RA.
Uffe Møller Døhn from the Copenhagen University Hospital at Hvidovre in Denmark and co-workers carried out CT, MRI and radiography on the wrist joints of 17 RA patients and four healthy controls.
Doctors Should Watch for Depression in Arthritis Patients
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Patients with rheumatoid arthritis are twice as likely to experience depression but are unlikely to talk to a doctor about it, according to researchers at the University of North Carolina at Chapel Hill.
Rheumatoid arthritis (RA) – the most common form of chronic inflammatory arthritis – is a debilitating disease characterized by inflammation of joint tissues, persistent pain, functional disability, stiffness and fatigue.
Betsy Sleath, PhD, a professor at the UNC School of Pharmacy, said that although depression in primary care settings has been well examined, no previous studies have looked at whether rheumatologists and RA patients discuss depression during medical visits.
The HLA-DRB1 gene and premature death in rheumatoid arthritis
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People with rheumatoid arthritis (RA), an inflammatory autoimmune disease, tend to die younger and, largely from cardiovascular disease (CVD). One explanation for this increasingly recognized fact is that inflammation promotes atherosclerosis. A marker of inflammation, elevation of the C-reactive protein (CRP) level has been shown to predict CVD in the general population. However, other highly inflammatory diseases—Crohn’s, for example—do not carry the same high risk of premature death from heart disease.
To identify other possible suspects, researchers in the United Kingdom investigated whether genetic variants linked to the likelihood of developing RA might also make patients more likely to die from CVD. Led by Dr. Tracey M. Farragher at the University of Manchester and funded by the Arthritis Research Campaign (arc), the study focused on two genes—HLA-DRB1and PTPN22—and their interactions with known RA risk factors. The evidence, presented in the February 2008 issue of Arthritis & Rheumatism, implicates HLA-DRB1 genotypes, already associated with RA susceptibility and severity, as a predictor of premature death from CVD for inflammatory arthritis patients. For RA patients in particular, having the shared epitope (SE)—a group of HLA-DRB1 alleles with kindred amino acid traits—plus anti-cyclic citrullinated peptide (anti-CCP) antibodies and current smoking is an especially deadly combination.
Rheumatoid arthritis patients’ mortality unchanged
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The decline in mortality seen in the U.S. population over the past four decades has not extended to patients with rheumatoid arthritis, despite innovations in rheumatoid arthritis treatment, according to a report in the current issue of Arthritis & Rheumatism.
Rheumatoid arthritis is known to be associated with excess mortality, the authors explain, but whether survival in rheumatoid arthritis patients has improved over time has been unclear.
Arthritis causes job limitations for many
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Nearly 12 percent of Americans ages 45 to 64 face work limitations because of arthritis, the U.S. Centers for Disease Control and Prevention said in a report on Thursday.
The CDC issued its first state-by-state assessment of work limitations caused by arthritis, an inflammation of the joints that causes pain, swelling, stiffness and restricted movement.
Physical fitness low in kids with arthritis
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Aerobic and anaerobic exercise capacity is decreased in children and adolescents with so-called juvenile idiopathic arthritis or JIA, according to the results of two studies by Dutch investigators.
The findings of a third study suggest that although the exercise capacity of these children is diminished, adherence to an exercise program can improve their functional level. All three studies are reported in the medical journal Arthritis and Rheumatism.
Biologic treatment for rheumatoid arthritis and the risk of cancer
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The relationship between rheumatoid arthritis (RA), an autoimmune disease marked by chronic inflammation of the joints and tissue surrounding vital organs, and the incidence of cancer is complicated. Epidemiologic studies have generally demonstrated that blood, lung, and skin cancers are increased among RA patients, while breast and colon cancers are decreased. Whether these cancer rates are caused by the nature of RA or by immunosuppressive drugs used to treat RA is an issue of ongoing debate and investigation.
Findings of various clinical trials and observational studies conflict over the risk of malignancy related to the use of tumor necrosis factor alpha (TNFá) blockers, a biologic therapy shown effective at controlling the symptoms of RA in patients who fail to respond to traditional disease-modifying antirheumatic drugs (DMARDs).
Minorities at higher risk of arthritis disability
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Black and Hispanic adults with arthritis are more likely than whites to become disabled from the joint disease, new research findings suggest.
In a study that followed nearly 7,300 Americans with arthritis for six years, researchers found that African-American patients were twice as likely to develop a disability as their white counterparts. The same was true of Hispanic adults who spoke Spanish as their primary language, but not primarily English-speaking Hispanic patients.
No race disparities found in rheumatoid arthritis
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Though some research has suggested there are racial differences in the severity of rheumatoid arthritis, a new study finds that the disease seems to affect men similarly regardless of race.
Researchers found that among 573 male veterans in their mid-60s with rheumatoid arthritis, white and African-American men had similar measures of disease severity. The exceptions were that black men tended to have less tenderness in the joints and fewer rheumatoid nodules—growths under the skin usually seen in more-advanced cases of rheumatoid arthritis.
Patient choice and treatment alternatives for arthritis
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Patients with osteoarthritis (OA) and rheumatoid arthritis (RA) face different treatment options and determining which ones to try can be confusing. Two new studies published in the July 2007 issue of Arthritis & Rheumatism examined patients’ decisions regarding therapy for RA and glucosamine for OA and found that most RA patients are reluctant to change their treatment as long as their condition didn’t worsen, and that there are discrepancies in clinical trial results for glucosamine.
Recent advances in RA treatment include multi-drug therapy with anitrheumatic drugs such as methotrexate, as well as improved tools for measuring the response to therapy. Although high-dose aggressive therapy seems to hold promise, patients’ decisions often do not follow this recommendation. Frederick Wolfe and Kaleb Michaud, of the National Data Bank for Rheumatic Diseases in Wichita, KS, queried over 6,000 RA patients about their acceptance and satisfaction with therapy, their willingness to change and their reasons for not changing.
Coffee consumption may lower blood uric acid levels—the precursor of gout
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High uric acid levels in the blood are a precursor of gout, the most common inflammatory arthritis in adult men. It is believed that coffee and tea consumption may affect uric acid levels but only one study has been conducted to date. A new large-scale study published in the June 2007 issue of Arthritis Care & Research examined the relationship between coffee, tea, caffeine intake, and uric acid levels and found that coffee consumption is associated with lower uric acid levels but that this appears to be due to components other than caffeine.
Coffee is one of the most widely consumed beverages in the world; more than 50 percent of Americans drink it at the average rate of 2 cups per day. Because of this widespread consumption, its potential effects have important implications for public and individual health.
Experimental gene therapy ‘abolishes’ arthritis pain and lessens joint damage
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Early-stage research has found that a new gene therapy can nearly eliminate arthritis pain, and significantly reduce long-term damage to the affected joints, according to a study published today in the journal Arthritis and Rheumatism. While the study was done in mice, they are the first genetically engineered to develop osteoarthritis like humans, with the same genetic predisposition that makes some more likely to develop the disease, the authors said. If all goes well with a follow-up study currently underway, researchers will apply to the U.S. Food and Drug Administration for permission to begin human trials next year.
Nearly everyone aged 65 or older suffers from the pain, swelling and permanent joint damage of osteoarthritis. The most common form of arthritis, it develops over time following initial joint injuries or just as a result of aging. In the current study, researchers found that one injection of a newly designed gene therapy relieved 100 percent of osteoarthritic pain in the study model. In addition, researchers were surprised to find that the therapy also brought about a nearly 35 percent reduction in permanent structural to joints caused by round and after round of osteoarthritic inflammation.
Counseling can improve arthritis pain, disability
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Giving people with arthritis the tools to cope with pain can help them feel, and function, better, the authors of a new analysis of research on counseling for arthritis patients conclude.
However, just a session or two isn’t enough to truly help individuals with rheumatoid arthritis or osteoarthritis develop the coping skills they need, Dr. Francis J. Keefe of Duke University Medical Center in Durham, North Carolina, told Reuters Health. Learning these skills takes time and practice, he added. “It’s like riding a bike.”
