Arthritis Australia hopes that these activities will make all Australians aware that [...] No related posts.]]> Arthritis Awareness Week is March 29th to April 4th, an initiative of Arthritis Australia, and is a time of promotional and educational activities, held around the country, to raise awareness about arthritis, its effects, and the various treatment and management options available.

Arthritis Australia hopes that these activities will make all Australians aware that arthritis is not a natural part of ageing but a disease that affects many people of working age and also children.

Arthritis includes more than 100 different diseases such as osteoarthritis, rheumatoid arthritis, gout, ankylosing spondylitis, Reiter’s syndrome and systemic lupus erythematosus (SLE or lupus), that affect the musculoskeletal system.

Pain, stiffness, inflammation, and damage to the cartilage, bones and other structures within the joints are all common manifestations of arthritis. Although it cannot be cured, the symptoms and impacts of arthritis can be reduced through early diagnosis and appropriate treatment and management.

An estimated three million Australians – 15 per cent of the population – have some form of arthritis, the most common types being osteoarthritis (affecting more than 1.5 million Australians) and rheumatoid arthritis (affecting around 491,000 Australians).

Although the number of people who have arthritis increases with age, about one in every four Australians with arthritis are less than 50 years of age and there are an estimated 4600 Australians with arthritis who are less than 16 years.

In 2003, around 34 per cent of people with a disability reported that arthritis or another musculoskeletal condition was their main disabling condition.

In 2004-05, arthritis and musculoskeletal conditions accounted for the fourth highest amount of direct health expenditure at a total of $4 billion. Close to one-third of this amount was spent on osteoarthritis, with hospital inpatient costs accounting for a large proportion.

In cases of severe osteoarthritis, people may have their symptoms relieved and joint function improved through joint replacement. More than 17,000 total hip replacements and almost 25,000 total knee replacements for arthritis were performed in Australian hospitals in 2006-07, most of these for osteoarthritis.

Originally posted 2009-03-25 06:00:12. Republished by Blog Post Promoter

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On May 1st, the [...] No related posts.]]> Etanercept, marketed under the name Enbrel, is a drug that belongs to the class of drugs known as tumor necrosis factor (TNF)-alpha blocker. It is used primarily to treat rheumatoid arthritis, but has also been approved for use in treating polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis.

On May 1st, the U.S. Food and Drug Administration (FDA) announced that it has required a warning label be added to Enbrel to increase the awareness of the risk of infections, particularly tuberculosis. The updated warning recommends screening for latent tuberculosis infection (LTBI) before beginning treatment with Enbrel.

It also warns that patients be monitored for possible antimicrobial treatment if the develop an infection and to stop taking Enbrel if a serious infection develops.

“Tuberculosis has been observed in patients receiving TNF-blocking agents, including Enbrel,” according to the warning. “Tuberculosis may be due to reactivation of latent tuberculosis infection or to new infection. Data from clinical trials and preclinical studies suggest that the risk of reactivation of latent tuberculosis infection is lower with Enbrel than with TNF-blocking monoclonal antibodies. Nonetheless, postmarketing cases of tuberculosis reactivation have been reported for TNF blockers, including Enbel.”

The warning’s section on adverse events now says, “In global clinical studies of 20,070 patients (28,308 patient-years of therapy), tuberculosis was observed in approximately 0.01% of patients. In 15,438 patients (23,524 patient-years of therapy) from clinical studies in the U.S. and Canada, tuberculosis was observed in approximately 0.007% of patients. These studies include reports of pulmonary and extra-pulmonary tuberculosis.”

The changes were distributed to clinicians in a letter from Amgen and Wyeth, which market the drug for the manufacturer, Immunex.

Originally posted 2008-05-03 21:47:03. Republished by Blog Post Promoter

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Since Chlamydia trachomatis or Chlamydia pneumoniae frequently cause reactive arthritis, a new study [...] No related posts.]]> Spondylarthritis (SpA) represents a group of arthritis diseases that have similar symptoms such as inflammatory back pain and inflammation at sites where tendons attach to bone. It includes ankylosing spondylitis, psoriatic arthritis, inflammatory bowel-disease-related arthritis, reactive arthritis and undifferentiated spondylarthritides (uSpA).

Since Chlamydia trachomatis or Chlamydia pneumoniae frequently cause reactive arthritis, a new study led by John D. Carter of the University of South Florida examined whether there was a connection between these two infections and uSpA.

The study involved analysis of blood and synovial tissue from 26 patients who had chronic uSpA or Chlamydia-induced reactive arthritis. Synovial tissue samples from 167 osteoarthritis patients were used as controls. Samples were analyzed to assess chlamydial DNA and the 26 subjects were asked if they had any known exposure to Chlamydia trachomatis or Chlamydia pneumoniae and if so, the infection was documented in relation to the onset of their uSpA. They also underwent a physical exam that included evaluation of swollen and tender joints and other symptoms of SpA. The results showed that the rate of Chlamydia infection was 62 percent in uSpA patients, significantly higher than the 12 percent seen in control subjects.

It is believed that as many as 150,000 cases of Chlamydia trachomatis-induced reactive arthritis may appear in the U.S. each year compared to about 125,000 new cases of rheumatoid arthritis. This is a low estimate since it does not include cases resulting from Chlamydia pneumoniae. “Thus, Chlamydia-induced reactive arthritis represents a considerable burden on the health care systems of the U.S. and other nations, and its impact on those systems may well be significantly underrecognized,” the authors state.

Most women with genital Chlamydia trachomatis infection have no symptoms at the time of the initial infection; this was also true of the patients in the study who had DNA evidence of Chlamydia. For Chlamydia pneumoniae, as many as 70 percent of acute infections are asymptomatic and, even when there are symptoms, definitive identification of the organism is rare. The authors point out that relying on identification of a symptomatic infection may therefore result in routine underdiagnosis or misdiagnosis of Chlamydia-induced reactive arthritis.

They add that because reactive arthritis is a type of SpA and patients with reactive arthritis do not have the classic combination of symptoms of arthritis, conjunctivitis/iritis and urethritis, it is reasonable to believe that Chlamydia trachomatis plays a role in causing uSpA, which may in fact be reactive arthritis. They conclude that although there is no diagnostic test for Chlamydia-induced reactive arthritis, testing for chlamydial DNA in the synovial tissue of patients thought to have reactive arthritis may be the most accurate way of diagnosing the condition.

Originally posted 2009-05-01 13:41:26. Republished by Blog Post Promoter

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The National Institute for Health and Clinical Excellence (NICE), the national drug rationing body, has ruled that infliximab, has ruled that the drug is not cost effective. At £15,000 ($30,000) a year it is £5,000 ($10,000) a [...] No related posts.]]> If you live in the U.K. and suffer from ankylosing spondylitis, you had better live in Scotland.

The National Institute for Health and Clinical Excellence (NICE), the national drug rationing body, has ruled that infliximab, has ruled that the drug is not cost effective. At £15,000 ($30,000) a year it is £5,000 ($10,000) a year more than the two approved drugs, adalimumab and etanercept. In addition, if an AS patient does not respond to the one of those 2 drugs they are prescribed by their physician they will no longer be allowed to switch to the other.

Estimates are that 200,000 people in the UK suffer from ankylosing spondylitis, a form of arthritis that attacks the spine and can also flare up in joints, tendons and ligaments.

Adalimumab and etanercept are injected at home while infliximab is administered in the hospital through an intravenous drip.

These are the latest in a series of treatments that are being disallowed based on NICE’s evaluation of effectiveness vs. cost. Scotland uses a different system for determining the cost effectiveness of drugs.

For example, Scotland’s equivalent of NICE recently approved Macugen and Lucentis for the treatment of age related macular degeneration, which is the most common cause of blindness in the elderly. But NICE in England disapproved Macugen and decreed that Lucentis could only be prescribed to patients that had already lost the sight in one eye and were in severe danger of losing sight in the other.

Jane Skerrett, director of the National Ankylosing Spondylitis Society said: “Essentially they are limiting people with AS to just one out of three potentially life-changing treatments by refusing to approve one treatment and preventing people from switching to another treatment on the grounds of efficacy. The three drugs under review from NICE are the only real treatment options for people with severe ankylosing spondylitis.”

“NICE is condemning people who fail on just one of these advanced therapies to treatment with drugs they have already failed on and a lifetime of pain and disability. There is no alternative effective treatment for patients with severe AS.”

“There are only these three drugs and NICE has effectively cut this to one.”

Arthritis charities in England are considering appealing the NICE ruling.

Infliximab has been approved by the U.S. Food and Drug Administration for the treatment of psoriasis, pediatric Crohn’s disease, ankylosing spondylitis, Crohn’s disease, psoriatic arthritis, rheumatoid arthritis, and ulcerative colitis.

Originally posted 2008-01-02 20:20:59. Republished by Blog Post Promoter

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