In the past three years there have been substantial outbreaks of Alphaviruses, such as Chikungunya virus, Dengue, HIV, influenza and Ross River virus, in Asia and Europe. These viruses are associated with infectious rheumatic disease, like rheumatoid arthritis, in humans.

Six million people in India, more than 300,000 in the French territories of the western Indian Ocean and 200 in Italy have been infected.

Researchers now believe that they have identified the cell and proteins responsible for causing the arthritic inflammation and tissue damage resulting from these infections.

The team from the University of Canberra, led by Professor Suresh Mahalingam, found that the immune cells, called macrophages, release toxic proteins that are responsible for the damage. They also found that a drug that is currently available for another disease can provide relief.

That drug, called sulfasalazine, is used for treating other inflammatory diseases, such as Crohn’s. Sulfasalazine improved arthritic symptoms in mice infected with the virus.

According to Professor Mahalingam, the treatment does not decrease the risk of contracting the virus, but it will significantly reduce the severity of the symptoms.

Their research has been published in the current issue of the Journal of Infectious Diseases.

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May is national Arthritis Awareness Month and if you hadn’t noticed, there are several activities being held around the U.S. Many communities are holding walks or runs to raise funds for arthritis research.

The Los Angeles walk in Brentwood had over 650 participants that raised nearly $200,000. The participants included former Dodger Ron Cey.

Nearly 300 people participated in the Arthritis Walk in Charlottesville, many who walked with their 4 legged friends. 20 teams participated in the 2nd annual run/walk in Bismark North Dakota.

If you are interested in helping out in one of these events you can check the Arthritis Foundation’s event page to find the date of the event near you.

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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.

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Several studies have been conducted into to effectiveness of the newest class of drugs, tumor necrosis factor (TNF)-alpha blockers, in treating rheumatoid arthritis. But there have been no published studies comparing TNF-alpha blockers with the older class of drugs, known as disease-modifying anti-rheumatic drugs (DMARDS), such as Remicade (infliximab), Enbrel (etanercept), and Humira (adalimumab).

Recently a team of Spanish researchers, led by Dr Alberto Alonso-Ruiz has reviewed the findings of 13 clinical trials involving over 7,000 participants to compare anti-TNF to DMARDS. The team analyzed the data to determine the benefits and side effects of different doses of the drugs.

The team determined that all of the trials showed that, with the proper dose, anti-TNF were better for treating rheumatoid arthritis than drugs like methotrexate.

The research also pointed out, however, that those patients using anti-TNF drugs were more likely to complain of adverse side effects. In addition, patients that were using etanercept experienced the lowest withdrawal rates due to adverse events.

“Performing comparisons of new drugs is vital for measuring safety/efficacy relationships and monitoring adverse side-effects” said Dr. Alonzo-Ruiz.

Their research was published in the journal BMC Musculoskeletal Disorders.

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Many people diagnosed with rheumatoid arthritis (RA) have found themselves unable to work. In fact, older studies have found that upwards of half of all people diagnosed with RA for 10 or more years have been unable to continue working.

But more recent information has shown that this statistic has been improving since the mid-1980s.

A report in the April issue of Arthritis Care and Research details the research conducted by a team from Boston University. The researchers analyzed data from nearly 5,400 rheumatoid arthritis patients who responded to semi-annual surveys between January 2002 and December 2005. The survey collected responses related to work status, discontinuation of work and discontinuation of work due to arthritis.

The study found that 85% of the participants were employed at the time they were diagnosed and that 56% were still employed. 44% of those that were not employed indicated that they were disabled.

As expected, the percentage of people that stopped working as a result of arthritis based disability increased with the duration of the disease.

The researchers concluded that even though the work disability was high, it may actually represent a decline from the 50% reported in 1987.

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