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.
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Originally posted 2008-01-02 20:20:59. Republished by Blog Post Promoter
On May 12, 2009 millions of people worldwide will observe Fibromyalgia Awareness Day. Led by the National Fibromyalgia Association, the theme for this year’s campaign is “Fibromyalgia Affects Everyone” and focuses on the far-reaching effects of this common, chronic pain disorder—from broken lives to the economic costs for patients and society.
An estimated 10 million men, women and children in the United States suffer from fibromyalgia (up to 80% are women), which is characterized by chronic widespread pain, multiple tender points, abnormal pain processing, sleep disturbances, and fatigue.
Fibromyalgia most commonly hits between the ages of 20-40 years old, at the “prime of life.”
It has been nick-named “the pain disease” because of the characteristic wide-spread, migrating body pain patients have. The pain has been described differently by each patient from dull aches to deep bone pain to burning, tearing, singeing, stabbing or shooting. The breadth of pain descriptions is what makes diagnosis difficult.
Fibromyalgia is considered as functionally disabling as rheumatoid arthritis but is much less accepted and recognized by both the medical establishment, Social Security and the community at large.
For those with severe symptoms, fibromyalgia can be extremely debilitating and interfere with basic daily activities.
People with Fibromyalgia have cognitive difficulties, such as memory problems and attention issues, that has been nicknamed “Fibro fog” or “brain fog.”
Total healthcare costs over 12 months are about three times higher among fibromyalgia patients compared to patients without the disorder.
Fibromyalgia costs the U.S. between $12-$14 billion each year
Fibromyalgia Awareness Day provides an opportunity to educate people in local communities about this life-altering disorder—and to bring hope to the millions of people who suffer from it.
Researchers in the United Kingdom recently investigated the incidence of stroke among rheumatoid arthritis (RA) patients. They analyzed data from the United Kingdom General Practice Research Database of over 7 million patients. These records include diagnosis and prescription medication information.
The team looked at histories from 33,191 RA patients compared to 99,570 patients without RA. They analyzed several risk factors including age, sex, smoking, diabetes, body mass index, heart attack, heart failure, kidney failure and cholesterol. They also considered the treatments and therapies used by these patients including corticosteroids and anti-rheumatic drugs.
The conclusion was that, when considering multiple variables, patients with RA have a significantly higher risk of stroke. In addition, traditional risk factors were associated with increased risk of stroke in both RA and non-RA patients. They also found that there was no significant effect on the risk by using anti-rheumatic drugs, although there was a slight increase in risk for those patients using methotrexate.
According to lead investigator Dr. Christopher Edwards, “Rheumatoid arthritis is known to be associated with an increased risk of myocardial infarction. These unique data suggest that the disease is associated with an increased risk of stroke as well. Appropriate risk assessment and intervention for this important cause of morbidity and mortality in rheumatoid arthritis is clearly a critical issue.”
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Originally posted 2007-11-26 21:55:59. Republished by Blog Post Promoter
In the last post I described the basics about infectious arthritis. It can be caused by bacteria, fungus or virus. The warning signs to look for differ based on the type of germ that caused the joint infection.
Something to keep in mind is that people with chronic health conditions tend to be more susceptible to psoriatic arthritis because their immune systems are weakened. Also, people with an existing form of arthritis are more susceptible as the germs target damaged joints and certain treatments for arthritis, such as disease-modifying anti-rheumatic drugs (DMARDs), suppress the immune system.
If the joint infection is caused by a virus the pain tends to be “all-over” as opposed to being in a particular joint. There is generally no fever associated with viral based infectious arthritis.
Fungal infectious arthritis pain and swelling may be localized or all-over and may develop slowly, over an extended period of time. There may also be a mild fever.
Bacterial infectious arthritis comes on very quickly with fever and chills. The pain and swelling will be very localized, occurring in on area of the body.
Infectious arthritis is a treatable condition. Obtaining prompt treatment should clear up the infection and leave no permanent damage. However, if treatment is delayed, the damage can spread to other joints and become permanent.
If you are experiencing pain or swelling in any joints, whether accompanied by fever or not, it is important that you check with your doctor to get proper treatment.
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Originally posted 2008-06-04 19:17:37. Republished by Blog Post Promoter
We have provided numerous posts regarding the potential positive effects of foods on arthritis symptoms. Some of these include coffee, green tea, alchohol, soft drinks, fish oil, and vegan diet. So it should be no surprise when more are discovered.
Another of these foods that has been researched in recent years is tart red cherries.
A study conducted in 2003 by the University of California, Davis was the first to test for key inflammatory indicators, called markers, in blood samples from healthy people. Prior studies had analyzed sweet and tart cherry extracts in test tubes.
The primary focus of the investigation was gout, which results from the body’s inability to excrete uric acid. This excess uric acid forms crystals which settle in joints, primarily the big toe, and cause severe pain. The precursor of these crystals is urate and it was the blood plasma urate level that was being measured. They also measured the amount of urate removed from the body through urine.
There were 10 women is this study who were 22 to 40 years of age. They were given instructions not to eat strawberries or other fruits and vegetables, or drink red wine or tea for 2 days prior to the test because these foods are high in antioxidants and the researchers did not want these to interfere with the results of the cherry analysis.
On the day of the test they were given 45 pitted fresh cherries for breakfast. Blood and urine samples were then taken at 1-1/2, 3 and 5 hours afterward.
The results showed that their plasma urate levels were significantly reduced over the 5 hours following the breakfast. Likewise, the level of urate removed through the urine increased over those 5 hours.
There were other inflammation markers the researchers looked for. These include C-reactive protein (CRP), nitric oxide (NO) and tumor necrosis factor alpha (TNF).
CRP is produced in the liver and increases rapidly during inflammation. Normal levels are extremely low. TNF alpha is produced by the body when fighting tumors and may increase inflammation. NO is a biochemical that is believed to cause damage to arthritic joints.
Results from the blood draw 3 hours after eating the cherries showed that levels of CRP and NO were lower than at the start of the test. However, the TNF alpha level was unchanged.
A follow up study, which included 18 women and 2 men, was conducted over a longer period. This group was asked to consume the same amount of cherries as the earlier group, but throughout the day for 28 consecutive days.
This study reported a 25% decrease in CRP by the 28th day and an 18% decrease in NO after 21 days. The report concluded that, “supplementing the diets of healthy men and women with cherries reduced the serum/plasma concentrations of some markers of inflammation, whereas circulating concentrations of many other markers of inflammation, lipids and their subfractions, and particle sizes were not affected. The anti-inflammatory effects of cherries may be of clinical significance and should be investigated in further studies. “
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Originally posted 2008-09-26 21:48:29. Republished by Blog Post Promoter
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