Current Arthritis News and Research » Juvenile Idiopathic Arthritis

FDA Investigates Link Between TNF Blockers and Cancer

awesome — Mon, 17 Jan 2011 22:46:42 +0000

The U.S. Food and Drug Administration has begun an investigation into links between anti-TNF (tumor necrosis factor) drugs, used to treat arthritis, and an increased risk of cancer in children. TNF blockers, sold under the names Enbrel, Remicade and Humira, are commonly used for the treatment of arthritis. The review is being conducted by the FDA’s Center for Drug Evaluation and Research.

The FDA has received 30 reports of cancer in children under the age of 18 who had been treated for JIA with anti-TNF drugs along with other medications, such as methotrexate, or similar immunosuppressant drugs.

Nearly 50% of the reports state the patients developed Hodgkin’s and non-Hodgkin’s lymphoma. The other reports indicate development of melanoma, leukemia and solid organ cancers.

Besides rheumatoid arthritis, TNF blockers are used to treat psoriatic arthritis, Crohn’s disease, plaque psoriasis, ankylosing spondylitis, as well as other diseases. TNF blockers are know to result in inflammation and weakening of the immune system.

The manufacturers of these drugs have been directed by the FDA to provide information about all TNF blocker recipients who have developed cancer, and in some cases to track cancer reports for 10 years. The FDA has also requested the assistance of medical professionals and patients in reporting any side effects from TNF blockers through the MedWatch Adverse Event Reporting program at www.fda.gov/medwatch/report.htm.

Originally posted 2008-06-06 22:25:05. Republished by Blog Post Promoter

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New Estimates of Children with Arthritis

awesome — Mon, 17 Jan 2011 22:46:29 +0000

A report published today by the Centers for Disease Control and Prevention estimates that 300,000 children in the U.S. suffer from some from of arthritis. Included in that estimate are some 50,000 to 100,000 that suffer from juvenile rheumatoid arthritis, a disease that can lead to permanent joint damage.

This report, published in the December issue of Arthritis Care & Research, says that 1 in 250 children under the age of 18 have been diagnosed with arthritis of another rheumatologic condition.

The study was lead by Dr. Jeffrey Sacks, an epidemiologist with the CDRC. His team studied information from doctor’s offices and emergency rooms across the U.S. One of the findings was that arthritis in children led to 744, 000 doctor visits and 83,000 emergency room visits annually.

This is the first comprehensive national estimate of kids with arthritis. It includes a state-by-state estimate of kids diagnosed with arthritis or other rheumatologic conditions. The report indicates the incidence ranges from a low of 500 kids in Wyoming to a high of 38,000 in California.

They also found that many of these children must travel long distances to receive specialized care. According to their analysis, 15,000 children with arthritis are residents of 11 states which have no pediatric rheumatologist. On average, children with arthritis must travel 57 miles to see a specialist. Those states are Alaska, Idaho, Maine, Montana, Nevada, New Hampshire, North Dakota, South Dakota, South Carolina, West Virginia and Wyoming.

Dr. Patience White, Arthritis Foundation chief public health officer and a pediatric rheumatologist, says “Due to the lack of availability of pediatric rheumatologists trained in the diagnosis and care of children with arthritis, we know that many children with inflammatory forms of arthritis are not diagnosed early enough to prevent disability”.

In addition, Dr. Suzanne Bowyer, pediatric rheumatologist at the Indiana University School of Medicine stated that kids might bounce from one doctor to another before one that is familiar with the disease makes an accurate diagnosis. She also says that “Pediatricians and emergency room doctors might miss the signs of the more serious form of arthritis and could send kids home without the proper treatment”.
A provision of the proposed Arthritis Prevention, Control and Cure Act introduced in 2004 called for a better determination of the size of the childhood arthritis problem. Passage of the Arthritis Prevention, Control and Cure Act is necessary as it would encourage more physicians to enter the field and also would highlight the research needs for children with arthritis.

Originally posted 2007-12-05 19:55:29. Republished by Blog Post Promoter

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Infections in Infants May Lead to Increased Rheumatoid Arthritis Risk

awesome — Mon, 17 Jan 2011 22:45:50 +0000

Swedish researchers have been investigating the link between serious infections during the first year of life and the risk of rheumatoid arthritis (RA). There have been previous studies that have indicated that infections can cause autoimmune diseases in adulthood. The current study seems to show that an infection in infants interferes with the normal maturation of the immune system.

To perform their analysis, the research team from the Karolinska Institute and Stockholm accessed information from national registers to conduct a case controlled study or people born between 1973 and 2002.

The research involved 333 cases of RA that were diagnosed in patients that were between the ages of 16 and 29 years and 3,334 cases of juvenile idiopathic arthritis (JIA). They matched each of these cases with 4 control subjects based on gender and age.

The researchers found that people who had a serious infection in their first year had twice the risk of developing JIA. They also found that babies that were premature, small or had a low birth weight demonstrated a reduced risk for RA, although they don’t know why.

In addition, they found that having a high birth weight or having more than 3 older siblings does not have a significant impact of risk of developing RA.

Said lead author Dr. Cecilia Carlens concludes, “Nobody had thought of this relationship with early-in-life infections and how they can affect the immune system.

“Our results indicate that infections during the first year of life and possibly also factors related to size at and timing of birth may be of etiological importance in the pathogenesis of RA and JIA.”

The results of the study were published in the Tuesday edition of the online journal Annals of the Rheumatic Diseases.

Originally posted 2008-10-31 12:00:01. Republished by Blog Post Promoter

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Rheumatoid Arthritis and Pregnancy

awesome — Mon, 17 Jan 2011 22:45:33 +0000

Many women who suffered with the symptoms of rheumatoid arthritis found that they got relief from the pain during pregnancy. It was not understood what caused this phenomenon but researchers have delved into this question and it appears they have discovered a possible mechanism that provides relief. The answer may lie in the fetus’ DNA.

There have been 2 prior studies into the relationship between fetal DNA and the improvement in the severity of the mother’s rheumatoid arthritis. As a result of technical advances scientists at the Fred Hutchinson Research Center in Seattle have been able to expand on the prior research. They studied the amount of fetal DNA in the blood of 25 pregnant women with arthritis, 19 of whom were diagnosed with rheumatoid arthritis and 6 with juvenile idiopathic arthritis (3 with polyarticular-onset, 2 with systemic-onset and 1 with oligoarticular-onset).

What they found was that there was a high level of fetal DNA in almost all of the women. Those women that had higher levels of fetal DNA experienced the most relief from their arthritis symptoms. The women who had low levels of fetal DNA experienced little or no relief. They refer to this as an inverse relationship between the level of fetal DNA in the mother’s blood and severity of the arthritis disease activity.

After 2 to 4 months had passed from delivery of their babies, almost all of the women who received relief found that their painful symptoms had returned.

Rheumatoid arthritis is marked by the body’s immune system attacking the synovial lining of the joints resulting in inflammation, pain, stiffness and loss of function. The researchers theorize that the body interprets the fetal DNA as a foreign substance. The immune system then focuses the attack on the DNA and reduces the focus on the synovial lining of the joints. Following the delivery of the baby, the level of DNA drops and the immune system again focuses on the joints.

Originally posted 2007-11-06 13:41:12. Republished by Blog Post Promoter

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Arthritis Drugs May Lead to Infection, Death

awesome — Mon, 17 Jan 2011 22:45:31 +0000

The FDA ordered that the class of drugs known as Tumor Necrosis Factor alpha blockers, which are also referred to as TNF blockers or anti-TNF, carry a warning on the packaging that their use carries the risk of developing a potentially deadly fungal disease called histoplasmosis. These drugs are marketed under the names Cimzia, Enbrel, Humira, and Remicade.

The packaging already is required to warn about fungal infections in general, but the new warnings will have to specifically call out histoplasmosis. This is a result of the FDA receiving reports of 240 patients who were taking TNF blockers that developed histoplasmosis. Of those 240, 45 patients died, including at least 12 who had not been immediately been diagnosed with histoplasmosis leading to a delay in treatment. The ages of these patients ranged from 8 to 86 years, however, none of the deaths involved children.

Histoplasmosis starts in the lungs and can spread to other organs in the body. If not treated in time, it can lead to death. In healthy people the body’s immune system is able to control the histoplasmosis infection. The risk is to people that have compromised immune systems, such as patients with AIDS or taking immune system suppressing drugs, such as alpha blockers.

The fungus that causes histoplasmosis, histoplasma capsulatum, is found throughout the world. It grows in the ground and in material that is contaminated with bat or bird droppings. Concentrations can be especially high in bird roosts, caves where bats roost and poultry house litter. Histoplasmosis is also more common in the Mississippi and Ohio River Valleys.

Symptoms of histoplasmosis include shortness of breath, fatigue, cough and fever.

Anti-TNF drugs are used to treat rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, juvenile idiopathic arthritis, ankylosing spondylitis and Crohn’s disease.

The FDA published their directive on September 4th. You can read the actual release here

Originally posted 2008-09-06 18:46:48. Republished by Blog Post Promoter

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