More than 8,700 top rheumatologists convened recently in Washington, D.C. for the 2006 annual meeting of the American College of Rheumatology in which they discussed cutting-edge advances in diagnosing and treating all types of arthritis. Highlights include:
Two new studies suggest that treating RA early and aggressively may change its course. About 2.1 million Americans have RA, a chronic autoimmune disease mainly characterized by inflammation of the lining of the joints, that can lead to long-term joint damage, chronic pain, loss of function and disability. In one study, Dutch researchers found that treating individuals who have early evidence of arthritis with the drug methotrexate can possibly prevent the disease from progressing to full-blown RA. And in a second study, investigators report that early treatment with methotrexate plus the tumor necrosis factor-alpha inhibitor infliximab (Remicade) may result in a drug-free remission.
The first study- called PROMPT- comprised 110 people from an early arthritis clinic in the Netherlands who received methotrexate or placebo for one year. People who received methotrexate showed less X-ray damage to the joints after 30 months compared to their counterparts who received placebo. They were also less likely to develop RA, but only if they tested positive for an antibody known as anti-CCP. Anti-CCP antibodies are blood markers that may predict the development of RA.
The second study, the BeSt study, found that after two years, 55 percent of people treated with methotrexate plus Remicade were able to stop Remicade without relapsing and then taper off their use of methotrexate. By the third year, a substantial number of patients who had stopped taking Remicade were able to stop taking methotrexate and remained disease-free.
Shots of botox may decrease the pain of knee OA and potentially prevent or forestall the need for knee replacement surgery. In the study, injecting Botox directly into the knee joint relieved pain and improved function among people with severe knee OA after one month. Researchers plan to follow patients for six months to see how long the results last. Often referred to as the "wear-and-tear" form of arthritis, OA affects nearly 21 million Americans. It is characterized by the breakdown of the joint's cartilage. As a result, the bones rub against each other causing stiffness, pain and loss of movement in the joint.
The seizure drug Lyrica (pregabalin) may offer extended pain relief for people with fibromyalgia, a chronic pain syndrome marked by widespread aches, pains, stiffness, fatigue and trouble sleeping. There is no FDA-approved treatment for fibromyalgia.
History of fracture after age 45, signs of osteoporosis and low bone mass, advancing age, and poor/fair self-rated health can all help predict postmenopausal women's fracture risk. Self-reported loss of height and depression also predicted fractures, according to a long-term study of more than 170,000 women in the U.S.
Got gout? You may want to consider relocating if you live in a hot and humid climate. High temperature and high humidity both up the risk of experiencing a recurrent gout attack. In fact, the risk of recurrent attacks increased by almost twofold when the maximum daily temperature increased from 0-53° F to 87-105° F. A similar magnitude of increased risk also was found when the humidity increased from the dew point of 4-32°F to 64-77°F.