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Exericse Good For RA? March 16, 2011

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Exericse Good For RA?
Visit http://www.arthritistreatmentcenter.com (more…)

More rheumatoid arthritis blues… March 9, 2010

Posted by nathanwei in Arthritis Medications, Arthritis Treatment, Rheumatoid Arthritis.
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I ran across this blurb.

Rheumatoid arthritis is not a benign disease.   Yet,  it remains one of those conditions that is not treated aggressively enough by many rheumatologists.

Here’s another reason why it should be…

People With RA May Have Shortened Life Expectancy.

MedPage Today (3/8, Walsh) reported that, according to a study published in the March issue of the journal Arthritis Care & Research, “individuals with rheumatoid arthritis (RA) have a shortened life expectancy compared with the general population.” Investigators analyzed data on 1,049 patients followed for 20 years. The researchers found that “the estimated all-cause standardized mortality ratio for patients with rheumatoid arthritis was 1.40 (95% CI 1.09 to 1.77), indicating a 40% increased risk of mortality compared with the general population,” with men faring “worse than women, having an age-adjusted hazard for mortality of 1.68 (95% CI 1.28 to 2.21),” and cardiovascular disease being “the most common cause of death.”

If you have RA, make sure you see somebody ASAP.

Surprise… surprise… oldies work just as well as the newbies! November 2, 2009

Posted by nathanwei in Arthritis, arthritis medication, Arthritis Medications, Arthritis Treatment, Rheumatoid Arthritis.
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A study from the recent ACR meeting in Philadelphia raised a few eyebrows. This study, described on the Medscape website, is outlined as follows…

The study, entitled the Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial, demonstrated that a triple-drug combination of older drugs (methotrexate, sulfasalazine, and hydroxychloroquine) worked just as well as the combination of methotrexate and a TNF-inhibitor in patients with rheumatoid arthritis.

Dr. Larry Moreland, the chief investigator of the group that performed the study commented, “”Most rheumatologists would have predicted that the biologic therapy [anti-tumor necrosis factor agent] would be better. We still need to see the x-ray results, which will be available in 2010, to see if either treatment [approach] is better.”

These findings raise obvious questions about the value of more expensive therapy with new biologic agents for  RA patients.   Dr. Moreland went on to say that biologic therapy might be better for specific subsets of patients, but exactly which subsets will have preferential benefit is currently unknown.

[NW note: I personally feel this study supports the need to examine synovial biomarkers  (signposts in the lining of the joints) in patients with RA.  By knowing what markers a patient has, we might be able to better predict what therapy a given patient will respond to.  This would cut down on guesswork, using the inappropriate drug, and facilitating an improved therapeutic outcome.]

Blogging From ACR October 21, 2009

Posted by nathanwei in Arthritis, arthritis medication, Arthritis Medications, Arthritis Treatment, health, hip, Hip Pain, knee, Knee Pain, Low back pain, nathan wei, Osteoarthritis, Psoriatic arthritis, Rheumatoid Arthritis, shoulder.
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I’ve been busy this past week serving as the official American College of Rheumatology Blogger for Medscape.  The meeting was held in my home town, Philadelphia.

Here’s the link:

http://www.medscape.com/public/blogs

Would welcome comments

Chinese herbal remedy works for rheumatoid arthritis August 18, 2009

Posted by nathanwei in Arthritis, Arthritis Treatment, prp, Rheumatoid Arthritis, Stem Cells.
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Researchers at the National Institutes of Health say thunder god vine, a Chinese herbal remedy, which has been used in China for centuries to treat a variety of inflammatory diseases, may benefit people with rheumatoid arthritis.

A study, recently published in the Annals of Internal Medicine, compared the efficacy and safety of a Chinese herb called thunder god vine [Tripterygium wilfordii Hook F (TwHF), also known as “lei gong teng”], and a conventional disease-modifying anti-rheumatic drug (DMARD) used for rheumatoid arthritis. Researchers randomly assigned 121 people with rheumatoid arthritis to take either 60 milligrams of the Chinese herb three times a day or 1 gram of sulfasalazine twice a day for 24 weeks.

Nearly half of the participants dropped out before the study was complete. But after 24 weeks of treatment, researchers found that a more people in the Chinese herbal remedy group experienced at least 20% improvement on a standard measure of rheumatoid arthritis symptoms compared with the sulfasalazine group.

Researcher Raphaela Goldbach-Mansky, MD and colleagues say the study was too short to show if thunder god vine also helped slow the progression of joint destruction from rheumatoid arthritis. But if further studies confirm these results in larger numbers of people, “thunder god vine may provide an affordable natural treatment option for rheumatoid arthritis.”

Comment: A much older study authored by Peter Lipsky also demonstrated the anti-inflammatory benefits of thunder god vine [Lipsky, P. E. and Tao, X. L. A potential new treatment for rheumatoid arthritis: thunder god vine. Semin.Arthritis Rheum. 1997;26(5):713-723]… so this isn’t really news.

In fact, it’s more of a curiosity than anything else.  The goal in rheumatoid arthritis (RA) is to help with both symptoms as well as disease progression. Sulfasalazine, the drug used as a comparator in the NIH study, doesn’t have good anti-inflammatory properties.  As a disease-modifier it’s pretty lame also.

Nonetheless, the take-home message is this:  Some herbal remedies do work for symptoms and they’re worth a try.  In the past, physicians, particularly academic types, would debunk these types of therapies as “snake-oil.”  As we learn more about the natural healing effects of herbs… and the natural healing powers we all possess (Examples would be PRP and stem cells), I think our ability to treat arthritis will improve significantly… and with fewer side-effects.   [A word of caution… don’t forget or nglect effective conventional therapies! ] NW.

Killing two birds with one stone… July 30, 2009

Posted by nathanwei in Arthritis Treatment, Rheumatoid Arthritis.
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Every so often a unique medicine comes along.  Denosumab is a drug that’s going to be used for both osteoporosis as well as rheumatoid arthritis.  Sort of like the old Doublemint gum commercial with the Doublement twins.  Double your fun.

It’s given by subcutaneous injection every six months so the dosing interval is attractive.  What the price tag attached to this invention is the big question.

This is an abstract that appeared in a recent journal…

Denosumab for joints and bones

Current Rheumatology Reports, 07/30/09

Lewiecki EM et al. – Denosumab suppresses bone turnover by inhibiting the action of RANKL on osteoclasts. [Editor’s note: osteoclasts are the cells that break down bone] Denosumab reduces bone turnover and increases bone mineral density in postmenopausal women with low bone mineral density, reduces fracture risk in women with postmenopausal osteoporosis, and inhibits structural damage in patients with rheumatoid arthritis when added to ongoing methotrexate treatment. It is generally well tolerated, with a good safety profile. Adverse and serious adverse events, including infections and malignancy, are similar in patients treated with denosumab or placebo.

When this drug will be approved by the FDA is still uncertain.