Current Arthritis News and Research http://4-arthritis-info.com Regular Updates on the Many Forms of Arthritis Tue, 08 Nov 2011 17:30:28 +0000 en hourly 1 http://wordpress.org/?v=3.2.1 New Treatment for Adult-Onset Still’s Disease Studied http://4-arthritis-info.com/treatment-adult-onset-stills/ http://4-arthritis-info.com/treatment-adult-onset-stills/#comments Thu, 27 Jan 2011 21:48:10 +0000 awesome http://4-arthritis-info.com/?p=5224 Still’s Disease is a form of arthritis that is characterized by high spiking fevers and transient salmon-colored rash. Still’s disease was first described in children, but it is now known to occur, much less commonly, in adults (in whom it is referred to as adult-onset Still’s disease). There is commonly swelling of the lymph [...] No related posts.]]> Still’s Disease is a form of arthritis that is characterized by high spiking fevers and transient salmon-colored rash. Still’s disease was first described in children, but it is now known to occur, much less commonly, in adults (in whom it is referred to as adult-onset Still’s disease). There is commonly swelling of the lymph glands, enlargement of the spleen and liver, and sore throat. Some patients develop inflammation of the lungs (pleuritis) or around the heart (pericarditis) with occasional fluid accumulation around the lungs (pleural effusion) or heart (pericardial effusion). Although the arthritis may initially be overlooked because of the impressive nature of the systemic symptoms, everyone with Still’s Disease eventually develops joint pain and swelling. This usually involves many joints (polyarticular arthritis). Any joint can be affected, although there are preferential patterns of joint involvement in Still’s Disease.

There is no known cause or cure for Still’s Disease but there is research into treatment options. One such study was reported in the January, 2011 issue of Arthritis Care & Research.

This was a small cohort study which included only 14 patients with Still’s Disease. The study participants had failed all available therapies, which in some cases included three TNF inhibitors, abatacept, and rituximab. Eight of the patient’s had suffered irreversible joint damage as a result of their arthritis. Recurrent systemic symptoms were present in seven of the patients.

The 14 study participants were treated with the anti-interleukin (IL)-6 receptor antibody tocilizumab (Actermra). The dosages varied in the study, but the most common was the recommended dose for rheumatoid arthritis – 8mg/kg every 4 weeks.

The average disease activity score in 28 joints (DAS28) decreased from 5.61 at the beginning of the study to 3.21 after three months and decreased further, to 2.91 after six months.

Based on the European League Against Rheumatism (EULAR), a good response to treatment requires a DAS28 score or 3.2 or lower. 64% of the patients achieved this level. In addition, EULAR describes remission as a DAS28 score below 2.6, which was achieved by 57% of the patients.

Concurrent with the treatment with tocilizumab the patient’s average dosage of prednisone fell from 23.3 mg/day and the beginning of the study to 13 mg/day after three months and to 10.3 mg/day after six months.

A 60% improvement was seen in number of tender and swollen joints and in patient global health rating at six months and systemic symptoms resolved in 86% by three months.

The study was conducted by Xavier Puéchal, MD, PhD, of Le Mans General Hospital in Le Mans, France, and colleagues.

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]]> http://4-arthritis-info.com/treatment-adult-onset-stills/feed/ 2 NHS in England Denies Ankylosing Spondylitis Treatment http://4-arthritis-info.com/nhs-in-england-denies-ankylosing-spondylitis-treatment/ http://4-arthritis-info.com/nhs-in-england-denies-ankylosing-spondylitis-treatment/#comments Mon, 17 Jan 2011 22:47:26 +0000 awesome http://4-arthritis-info.com/wp/2008/01/02/nhs-in-england-denies-ankylosing-spondylitis-treatment/ 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 [...] 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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]]> http://4-arthritis-info.com/nhs-in-england-denies-ankylosing-spondylitis-treatment/feed/ 0 Alcohol Consumption Reduces Rheumatoid Arthritis Risk http://4-arthritis-info.com/alcohol-consumption-reduces-rheumatoid-arthritis-risk/ http://4-arthritis-info.com/alcohol-consumption-reduces-rheumatoid-arthritis-risk/#comments Mon, 17 Jan 2011 22:47:25 +0000 awesome http://4-arthritis-info.com/wp/?p=121 Two Scandinavian studies indicate that alcohol consumption decreases the risk of developing rheumatoid arthritis (RA) by up to 50%. The studies included 2,750 people who were assessed for environmental and genetic risk factors for RA.

More than half of the participants had rheumatoid arthritis while the non-RA group were selected randomly from the general population and had a similar distribution of age, sex and residence.

The study groups completed surveys related to lifestyle, including alcohol consumption and smoking. They also had blood samples taken to test for genetic risk factors.

The results revealed that alcohol consumption was associated with a substantially reduced risk of development of rheumatoid arthritis. It also showed that the risk decreased as the amount of alcohol consumed increased.

Among the regular drinkers, the top 25% in terms of alcohol consumed were 50% less likely to develop RA. This was true for both women and men. The highest reduction in risk was in those who smoked and also had risk factors for rheumatoid arthritis.

The researchers stated that these studies reinforce the idea that lifestyle factors have a significant impact in the development of rheumatoid arthritis, and that quitting smoking is still the most importance step in reducing risk.

These studies were also compatible with previous studies that showed that alcohol consumption helps protect against the development and the severity of rheumatoid arthritis, as well as other inflammatory diseases, such as cardiovascular disease.

This research was published in the June 5th issue of Annals of the Rheumatic Diseases.

Originally posted 2008-08-12 17:36:10. Republished by Blog Post Promoter

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]]> http://4-arthritis-info.com/alcohol-consumption-reduces-rheumatoid-arthritis-risk/feed/ 1 Gout Passed Across the Pacific http://4-arthritis-info.com/gout-passed-across-the-pacific/ http://4-arthritis-info.com/gout-passed-across-the-pacific/#comments Mon, 17 Jan 2011 22:47:24 +0000 awesome http://4-arthritis-info.com/wp/2007/12/27/gout-passed-across-the-pacific/ Interesting story from New Zealand discussing the possibility that high rates of gout in Pacific Islanders may be a genetic trait passed to them by ancient voyagers across the Pacific Ocean.

Dr. Hallie Buckley, from Otago University’s Department of Anatomy and Structural Biology, has been studying bones from the oldest cemetery found in thePacific [...] No related posts.]]> Interesting story from New Zealand discussing the possibility that high rates of gout in Pacific Islanders may be a genetic trait passed to them by ancient voyagers across the Pacific Ocean.

Dr. Hallie Buckley, from Otago University’s Department of Anatomy and Structural Biology, has been studying bones from the oldest cemetery found in thePacific Islands. These remains are estimated to be 3000 to 3200 years old and were discovered on Efate Island in Vanuatu.

Dr. Hallie’s team examined the bones from 20 skeletons using radiography and other techniques and found damage to the joints in seven of them. Analysis of the damage, or erosive lesions, indicated that they were most likely caused by gouty arthritis, a build up of uric acid crystals in the joints.

The skeletons that were studied were from a people known as “Lapita”. They were named for the distinctive decorated pottery that has been found across the Pacific.

The Lapita’s diet would have consisted of plants and seafood, a diet that is rich in purines which are organic compounds that are a crucial part of DNA and RNA. This high purine diet may have set off attacks of gout in people that are susceptible.

There are scientists that have theorized that as the descendents of the Lapita people migrated across the Pacific they passed their genetic predisposition to gout on to their descendents. This is known as the “founder effect”, where a small number of people pass a genetic trait on to a large number of descendents. This could explain the high incidence of high uric acid levels and gout in many modern Pacific Island societies. The Maori of New Zealand have an incidence of gout of over 10%.

Dr. Hallie’s research was published in the publication Current Anthropolgy.

Originally posted 2007-12-27 19:54:50. Republished by Blog Post Promoter

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]]> http://4-arthritis-info.com/gout-passed-across-the-pacific/feed/ 0 IBS Common in Fibromyalgia Patients http://4-arthritis-info.com/ibs-common-fibromyalgia-patients/ http://4-arthritis-info.com/ibs-common-fibromyalgia-patients/#comments Mon, 17 Jan 2011 22:47:23 +0000 awesome http://4-arthritis-info.com/wp/?p=284 There can be several other conditions that are co-existent with fibromyalgia. One of those conditions that has recently been identified is irritable bowel syndrome, or IBS.

IBS is a gastrointestinal disorder that has no apparent cause. Symptoms include intestinal discomfort and pain along with “alterations” in bowel habits. This means constipation, diarrhea or switching between the two. IBS is reported to affect as many as 20% of the general population and is 2 to 3 times more prevalent in women than men.

Diagnosis of IBS generally is made after eliminating all other possible causes of the digestive issues.

Current studies indicate that as many as 77% of patients with fibromyalgia also have IBS. In fact, there are four conditions that have a higher than expected rate of co-occurrence with IBS that have little relationship to the digestive system:

  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • Temporomandibular Joint Disorder (TMJ or TMD)
  • Chronic Pelvic Pain

Other studies have shown that patients with both fibromyalgia and IBS experience symptoms that are 38% more severe than patients with only one of the conditions. Studies have also shown that people with both conditions tend to have a worse quality of life than those with only one.

Common Characteristics

Fibromyalgia and IBS are both complex, chronic conditions that actually have a number of common characteristics. Several studies have attempted to determine a causal link between the two conditions, but to date have not been successful. But these characteristics have been noted:

  • Both Fibromyalgia and IBS exhibit abnormalities in the function of the autonomic nervous system. However, the pattern of the dysfunction is different in the two conditions and actually tends in opposite directions
  • Pain sensitivity is also a common and shared characteristic of both conditions but likewise does not have a comparable pattern. IBS patients have pain inside the intestine whereas fibromyalgia patients have musculoskeletal pain but not intestinal.
  • Stress is also a common characteristic including hormonal response to stress, such as corticotrophin-releasing hormone (CRH) and adrenocorticotropin hormone (ACTH). But again, the pattern between the two conditions is different. IBS appears to have exaggerated stress hormone activity while fibromyalgia has suppressed stress hormone activity.

These facts lead some researchers to theorize that fibromyalgia and IBS are different “surface reflections” of the same broader “somatic syndrome”.

Originally posted 2008-12-04 12:00:27. Republished by Blog Post Promoter

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