They say the body remembers what the mind wants to forget. For those who have experienced trauma, not only does the body remember, in some cases it works on making things worse. Such is the situation with trauma and lupus, says a new study published in Arthritis & Rheumatology in October. The study, titled, “Association…
What factors drive inflammation and progressive disease in ankylosing spondylitis (AS)? The answers have long eluded rheumatologists. Although 90% of patients with AS test positive for the HLA-B27 gene, pieces remain missing in our understanding of this chronic, inflammatory disease, which often leads to pain, spinal fusion and, in about half of patients, gut involvement,…
To determine if varus thrust, a bowing out of the knee during gait (i.e., the first appearance or worsening of varus alignment during stance), is associated with incident and progressive knee osteoarthritis (OA), these researchers undertook an Osteoarthritis Initiative ancillary study. They also considered hypothesized associations adjusted for static alignment, anticipating some attenuation. Methods: Gait…
Nationally, opioid use and addiction are drawing increased scrutiny. An increase in the number of overdoses and addiction to heroin and prescription pain relievers in the past decade has been attributed in part to increased prescribing of opioids for the treatment of pain by physicians. National trends suggest the rate of opioid prescribing plateaued in…
NEW YORK (Reuters Health)—Tofacitinib begun two to three weeks after live zoster vaccination does not impair immunogenicity, and vaccination appears to be safe in patients with pre-existing varicella zoster virus (VZV) immunity, researchers report. Patients with rheumatoid arthritis (RA) are about twice as likely as healthy adults to develop herpes zoster, or shingles, and the…
A new guideline developed by the ACR and the American Association of Hip and Knee Surgeons addresses the perioperative use of antirheumatic drug therapy. Specifically, it provides recommendations on the use of traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib and glucocorticoids in adults with RA; SpA, including ankylosing spondylitis and psoriatic arthritis; JIA; or SLE undergoing elective THA or TKA. The guideline provides recommendations regarding when to continue, when to withhold and when to restart these medications, and the optimal perioperative dosing of glucocorticoids…
These researchers investigated whether rituximab, an anti-B cell therapy, improves symptoms of fatigue and oral dryness in patients with primary Sjögren’s syndrome (SS). The multicenter, randomized, double-blind, placebo-controlled, parallel-group trial included a health economic analysis. There were no significant improvements in any outcome measure with rituximab except for unstimulated salivary flow. The study concludes that rituximab is neither clinically effective nor cost effective in this patient population…
Most SLE clinical trials continue standard background medications being taken by patients at entry, based on assumptions that this minimizes the risk of serious flares and that immunologic interference is minimal. These assumptions are not evidence based, but eliminating polypharmacy in trials studying patients with active lupus remains controversial. These researchers tested the withdrawal of immunosuppressants to make SLE trial results more interpretable…
(Reuters Health)—A new study finds that as many as four in 10 people may develop hand osteoarthritis. Among women, researchers found the lifetime risk was 47% while for men it was about 25%. Obese people also had 11% higher lifetime risk than those who were not obese. Hand osteoarthritis can cause disability and problems with…
Disease outcomes in rheumatoid arthritis (RA) have improved dramatically since the introduction of biologic agents and improved treatment strategies. Nevertheless, the majority of patients still require prolonged, if not lifelong, therapy. Therefore, the ultimate goal would be to prevent RA. This study analyzed the effect of a one-year course of methotrexate in high-risk UA patients (studied in a previous trial) after post-randomization exclusion of patients without a high risk of developing RA…