Foundation Launches New Rheumatoid Arthritis Screening Program

NJ Today

 

The Arthritis Foundation announced today the start of a new pilot program designed to improve the early diagnosis of rheumatoid arthritis (RA). The goal of the program is to decrease the number of people with inflammatory arthritis who become disabled due to the lack of early diagnosis and treatment.

The foundation has set up a toll-free number, 1-866-720-4297, to offer New Jersey-area residents the ability to take a specially designed screening questionnaire to help them learn if they need follow up care from a health care provider who specializes in rheumatoid arthritis treatments.

“The Arthritis Foundation wants to assist people living with joint symptoms to learn if they need further treatment to prevent disability from inflammatory arthritis,” said Dr. Patience White, Vice President, Public Health with the Arthritis Foundation. “There are new effective treatments for rheumatoid arthritis relief so making the diagnosis and starting appropriate treatment early is crucial to preventing permanent joint damage.”

The Arthritis Foundation offers the following additional facts about rheumatoid arthritis:

    * Rheumatoid arthritis (RA) is an auto-immune disease which affects 1.3 million people in the U.S.

    * There are 2.5 times as many women as there are men with RA.

    * Onset of RA is usually middle-age, but it often occurs in the 20s and 30s.

   * The Arthritis Foundation reports that thirty to forty percent (30-40%) of people with RA experience work loss within five years of diagnosis. Within 10 years this figure doubles to sixty percent (60%).

New Mutant Genes Linked to Rheumatoid Arthritis

Reuters

A large study of European populations has uncovered seven new clusters of defective genes which may be responsible for rheumatoid arthritis, a painful and disabling disease that affects mainly the joints.

The paper was published in Nature Genetics on Monday together with findings of a separate study in Japan, which identified one of the seven genetic clusters as possibly causing the chronic inflammatory disease among Japanese.

"The findings leverage us to better understand the basic biology of rheumatoid arthritis (RA), with the goals of developing new targets for therapy and new biomarkers for diagnosis and prognosis," wrote research scientist Eli Ayumi Stahl at the Brigham and Women's Hospital in Boston in the United States, who led the study on European populations.

The study was also intended "to develop better genetic tests for RA risk, especially in people already at risk (such as arthritis patients or relatives of patients with autoimmune disorders)," Stahl told Reuters.

RA affects about 1 percent of the world's population. Apart from the joints, it may affect the skin, heart, lungs, kidneys and blood vessels. Many end up with deformed hands and feet, resulting in loss of functions and movement. There are few alternatives in the way of rheumatoid arthritis relief.

In the European study, Stahl and colleagues repeated six previous studies involving 5,539 patients, analyzing their genes using the latest technology. They shortlisted 34 genetic variants which they considered most suspect in causing RA.

They then checked if those genetic defects were found in another batch of 6,768 RA patients in Canada, North America, the Netherlands and Britain. Ten of the 34 variants figured most prominently in this replication phase.

"Ten of the 34 variants tested were validated in the replication phase of our study. Three were previously implicated in RA, leaving the 7 new ones mentioned above," Stahl wrote.

"This is more RA risk variants discovered in a single study than any other study to date, underscoring the importance of large-scale studies and the collaborations that enable them in order to make progress in unraveling common, complex diseases."

"Our results further suggest that many more RA risk variants remain to be definitively identified," Stahl added.

In the Japanese study, researchers led by Yuta Kochi at the RIKEN Center for Genomic Medicine in Yokohama, Japan, analyzed genes of 7,039 RA patients and identified a common genetic mutant near the CCR6 gene.

The CCR6 gene was also identified in the European study.

What you Should Know about Arthritis

Maitland Observer

 

More than 46 million adults in the U.S. report being diagnosed with some form of arthritis. Although often considered a disease affecting only the older population, close to 300,000 children under the age of 18 have some form of arthritis as well, which represents about one in every 250 kids.

In honor of May being designated as National Arthritis Month, we recently sat down with local fellowship trained joint specialist and orthopaedic surgeon, Dr. Samuel S. Blick, M.D., of the Orlando Orthopaedic Center in Winter Park to answer some of the more common questions he hears regarding the joint disorder.

Q: How do I know if I have arthritis and it's not just something that will go away in a day or two?

A: Arthritis is inflammation of one or more joints, which generally results in pain, swelling, stiff joints and, thus, limited movement. There are more than 100 different types of arthritis, one of the most common being osteoarthritis, or a type of arthritis that is caused by the breakdown and eventual loss of the cartilage joints. Usually, it's diagnosed with X-rays.

Q: Besides being an inflammation, what else should I know about the disease?

A: More than 70 percent of individuals in North America affected by arthritis are over the age of 65, however it can affect people of all ages. Arthritis is more common in women than men at all ages and affects all races, ethnic groups and cultures. Genetics, injury and weight also play a role.

Q: What are some risk factors or behaviors I can avoid to keep it from getting worse?

A: Neither rheumatoid arthritis nor osteoarthritis can be completely prevented; you can reduce the risks by becoming physically active while avoiding impact exercise. Instead, focus on low resistance muscle strengthening. Weight loss and a healthier diet may help as well.

Q: Sometimes my arthritis pain is too much to handle. What are some things I can do relieve pain at home quickly?

A: The best remedy for at home arthritis pain relief should be to ice the joint, take an over-the-counter pain reliever such as Tylenol and get plenty of rest. You may also want to try gently massaging the affected area as well.

Q: If I wanted to get rid of the pain for good, what are my options? Does joint replacement work?

A: There is no complete cure for arthritis other than joint replacement at this time. In fact, all other arthritis treatments are temporary whereas success rate for total knee and hip replacement is about 95 percent.

Blood Test May Predict Rheumatoid Arthritis

CNN

A simple blood test may allow doctors to identify a debilitating form of arthritis years before any symptoms appear, which may help to stop the disease in its tracks, new research suggests.

Rheumatoid arthritis (RA), which affects an estimated 1.3 million Americans, is an autoimmune disease that attacks the joints, causing inflammation, pain, swelling and stiff joints. Early diagnosis and treatment are key to preventing long-term joint damage, but the warning signs of rheumatoid arthritis are often easily confused with those of other diseases and conditions.

Now, a new study reports that markers of inflammation that can be detected in the bloodstream rise long before symptoms of the disease. This finding holds out the possibility that doctors can one day treat rheumatoid arthritis before it starts to take a toll on the patient. Treating rheumatoid arthritis early and aggressively with a combination of drugs provides the best odds of preventing joint damage.

The study "moves the whole field along," says rheumatologist Dr. Lionel Ivashkiv, M.D., an associate chief scientific officer at the Hospital for Special Surgery, in New York City. "In the future, in combination with other tests and risk factors--such as genetics, smoking, and family history--we can maybe predict who is at high risk for developing RA."

In the new study, which appears in the February issue of Arthritis & Rheumatism, researchers in Sweden analyzed the blood samples of 342 people, 86 of whom went on to develop rheumatoid arthritis up to five years after giving blood. Overall, the people who ultimately developed rheumatoid arthritis had higher levels of proteins and other substances involved in inflammation in their blood compared to those who didn't develop the disease.

Rheumatoid arthritis drugs target some of the inflammatory markers that were elevated, such as tumor necrosis factor (TNF).

When all 30 of the markers that the researchers measured are taken into account, the test would correctly predict 86 percent of the time the individuals who would ultimately require rheumatoid arthritis relief, according to the study.

"When a patient with RA comes in now, their immune system is on fire," says Dr. Richard Keating, M.D., a professor of rheumatology at the University of Chicago. "The researchers are working backwards and trying to figure out what started the fire. This will help unlock the pathway involved in how this disease occurs, and may open up new early treatment opportunities."

Dr. Eric Matteson, M.D., the chairman of the rheumatology department at the Mayo Clinic College of Medicine, in Rochester, Minnesota, calls the new findings "a step in the right direction," but says that it is premature to conclude that a blood test can predict who will develop rheumatoid arthritis with any degree of certainty.

Many of the inflammatory markers measured in the study are not specific to rheumatoid arthritis, Matteson points out. They reflect "general immune system activation," he explains, and could indicate a host of other inflammatory autoimmune diseases (such as lupus or psoriasis), or even a viral infection.

Still, he says, "It is exciting to think that...we could be alerted to the fact that [people] may go on to develop RA or another autoimmune disease."

Blood tests that accurately identify the warning signs could eventually help doctors tailor rheumatoid arthritis treatments to individual patients, Matteson adds. If researchers are able to pinpoint the blood markers of rheumatoid arthritis, doctors could use that information to assess the severity of individual cases and predict which medications are likely to be most effective for which patients, he says. (This approach is already used to treat other diseases, including some types of cancer.)

However, Ivashkiv stresses, the blood testing used in the study is not likely to be used by arthritis doctors in the near term. "It is another way of trying to identify patients with early RA, but it is not practical yet," he says.

FDA Approves New Rheumatoid Arthritis Drug

Food Consumer

The Food and Drug Administration has approved Actemra for the treatment of rheumatoid arthritis (RA), biotechnology company Genentech, Inc. announced this week.

Actemra is indicated for the treatment of adult patients with moderately to severe RA who have had inadequate response to existing rheumatoid arthritis treatments.

"The FDA approval of Actemra marks a major step forward in the treatment of RA, providing a new option for patients with this very serious d isease," said Hal Barron, chief medical officer for Genentech and the parent company, the Roche Group, according to a company statement.

Rheumatoid arthritis is a chronic, progressive inflammatory disease of the joints and tissues resulting in intense pain, joint destruction and a variety of other complications.

The ailment is not the same as arthritis, according to WebMD, but is an auto-immune disease, meaning the body's immune system is mistakenly attacking the tissues it is supposed to protect.

Actemra blocks the effects of a protein, IL-6, which causes the inflammation of joints and tissues, according to study investigator Dr. Mark Genovese, Professor of Medicine at Stanford University Medical Center.

"For many RA patients, treatment with existing therapies does not resolve the painful and debilitating symptoms of the disease," said Genovese. "Data from the clinical development program clearly establish Actemra and its unique mechanism of action as an important new option for RA patients who experience continued disease symptoms despite treatment with existing therapies."

Actemra has been studied in five multi-national studies involving more than 4,000 participants, the largest clinical development program for RA to date, according to Genentech.

The rheumatoid arthritis medication has been approved for use in Japan, the European Union, India, Brazil, Switzerland and Australia.

Worldwide, it is estimated that 1 percent of the population has RA, with about 1.3 million people affected in the United States alone.  RA affects 5 to 6 percent of Native Americans, while people from the Caribbean or of African descent have very low incidence of the disease.

RA is most likely to strike people at the age of 35 to 50 years of age, but it can also occur in children, teenagers, and the elderly.

When Joints Take A Turn For The Worse

The Times Of India

Joint pain is often associated with old age. However, now, the young are also suffering from this as inactive lifestyles take hold. If the pains are resulting from arthritis, winter can prove to be a testing time for the sufferer, because low temperature causes the condition to worsen, said doctors.

They added that earlier, the season caused an increase in the number of old people complaining of joint pains, but now, the young were also being affected by the condition as they did not exercise much and tended to avoid other physical activity.

They stated that the young adult category had seen an increase in patient numbers by 20%.

“Generally, more women are prone to joint pains especially emerging from osteo-arthritis. The second major cause for this in women’s case tends to be rheumatoid arthritis. As the age of people contacting this condition is falling, it is leading to a lot of concern. Cold weather also causes more people to be affected. It also slows down the healing process for surgical stitches,” said Dr Harpreet Singh Gill, senior consultant and head of orthopaedics department, Apollo hospital.

He added that earlier, the average age of patients receiving rheumatoid arthritis treatments tended to be 50 and now many of them were in their 30s, with women being the worst-affected group. He stated that the way prevent the condition was having a good diet and exercising properly. Dr Gill added that on an average, 20 young women came to the OPD daily with these problems, while the number used to be just two or three a few years back. “Squatting too much, having an inactive lifestyle or being deficient in vitamin D are the main causes and the major modes of treatment are physiotherapy, lifestyle modification and medication,” he added.

Associate professor at Dayanand Medical College and Hospital, Dr Sanjeev Mahajan, said that the young could easily avoid the condition with more physical activity, which they were quite capable of. “Early diagnosis and change in lifestyle are effective in arthritis pain management,” he added. He mentioned that arthritis-related swelling tended to get worse as weather got cold. Dr Jagdip Madan, orthopaedician at Guru Teg Bahadur Hospital, said that young women were getting arthritis and the reason for that could be genetic or having a generally negligent attitude towards joints. Dr Madan said that in his hospital, about 15 to 20 young women came for treatment daily, which was quite a lot as arthritis was a problem encountered mostly in sexagenarians.

OxyPharma Announces Positive Results In Arthritis Treatment

Pharma Live

Swedish drug development company OxyPharma today announced the preliminary results of its phase II clinical trial of Rabeximod, an orally administered disease-modifying anti-rheumatic drug (DMARD) for treatment of moderate or severe active rheumatoid arthritis. The study demonstrated clear therapeutic effects of Rabeximod in patients with rheumatoid arthritis, resulting in a significant effect on key biological and disease variables after 16 weeks.

The study was designed to reveal an effect of Rabeximod at 12 weeks (primary endpoint), based on the assumption of a similar onset of action as other disease-modifying anti-rheumatic drugs. Treatment with Rabeximod was given during 12 weeks to 224 patients with moderate or severe active rheumatoid arthritis that were not fully responsive to prior treatment withmethotrexate , with clinical follow-up visits through week 16. Patients, all on a stable dose of methotrexate, were randomized to one of three dosing regimens of Rabeximod (6.25 mg, 15 mg, or 37.5 mg once daily) or placebo. Principal Investigator was Professor Lars Klareskog, Head of Rheumatology Unit at Karolinska University Hospital, Stockholm, Sweden.

Rabeximod showed a delayed onset of action, which resulted in a significant therapeutic effect of the dosing regimen seen at 16 weeks rather than at the 12 week endpoint. At 16 weeks, the 15 mg Rabeximod dose group exhibited statistically significant (p<0.05) effects for seven of the key secondary endpoints of treatment: ACR20, DAS28 response rate, pain, subject global assessment, physician global assessment, number of swollen joints and number of tender joints. At 12 weeks, none of the treatment groups demonstrated a significant effect on the ACR20 response rate, which was the primary endpoint of the study.

The study also demonstrated a good safety profile of Rabeximod. The incidence of adverse events in the Rabeximod 6.25 mg, 15 mg and placebo groups were similar. Skin disorders were the most frequently reported adverse event, with the highest incidence in the 37.5 mg Rabeximod group, all rated mild to moderate in severity. No adverse synergistic effect was seen with methotrexate.

Based on the efficacy and safety results, 15 mg Rabeximod administered once daily appears to be the most optimal dose. These results indicate that the treatment duration of 12 weeks in the study was too short to reach an optimal clinical effect of Rabeximod in combination with methotrexate. The full potential of Rabeximod in the treatment of patients with rheumatoid arthritis will be revealed in studies designed with a longer duration of treatment.

“This is the first clinical trial evaluating the effect of Rabeximod for the treatment of moderate or severe rheumatoid arthritis”, said Ulf Björklund, CEO, OxyPharma. “The study suggests that Rabeximod causes a beneficial modification of disease activity with a delayed onset of its therapeutic benefits. The results thus indicate that a three month treatment period was not sufficient to observe the full therapeutic effect of the drug. This outcome is what can be expected with a disease-modifying anti-rheumatic drug where the effect appears slowly and lasts longer, especially since the compound has a long half-life. As the main variables are statistically significant at week 16, OxyPharma is confident that studies with longer treatment duration will prove oral Rabeximod to be an effective, convenient and safe drug for commercialization”.

Partnering Strategy “The management and the board of OxyPharma consider the results very encouraging for further development of Rabeximod. We have therefore decided to invite pharmaceutical companies for partnering discussions. OxyPharma is in the process of appointing an advisor to assist in this process”, said Mr. Björklund.

Rheumatoid Arthritis Market Estimates of the value of the global rheumatoid arthritis market vary between USD 6 and 13 billion annually. The market growth is significant. There are presently no effective, safe and oral drugs for rheumatoid arthritis treatments.

About Rabeximod: Rabeximod is an orally available small molecule that is first-in-class and classified as a disease-modifying anti-rheumatic drug. Its mechanism of action is an interaction with the inflammatory tissue type A cells, often described as macrophages. In vitro data on human peripheral blood cells show that Rabeximod suppresses the differentiation of monocytes into pro-inflammatory macrophages but not anti-inflammatory macrophages. The inflammatory macrophage is the central orchestrator of the inflammatory response leading to tissue destruction and clinical symptoms. Thus, the macrophages is a key cell in immune presentation of antigens and plays a role in both the initiating phase of the inflammation as well as in perpetuating the inflammatory process.

The commercial use of Rabeximod and related compounds as a rheumatoid arthritis medication is covered by strong patents.

Change In Diet, Exercise Can Help Alleviate Arthritis Symptoms

Chicago Tribune

Dr. Sunil John has watched many of his patients with osteoarthritis improve with some simple lifestyle changes like exercising more, eating less and taking over-the-counter pain medications.

That might be a surprise to people who think taking it easy is a better answer to the pain and stiffness in their joints that accompany osteoarthritis –– sometimes known as degenerative joint disease. But exercise and weight loss can be the best medicine for arthritis pain management, according to rheumatologists, who deal with joint, soft tissue and connective tissue problems.

"It's important to be active, and weight reduction is very important because, obviously, with more weight there's more stress on the joints," said John, a rheumatologist at Advocate Medical Group who is affiliated with Advocate South Suburban Hospital in Hazel Crest. "It improves the activities of daily living."

John said physical therapy tailored to the specific joint problem can help ease pain and increase range of motion. He also recommends a low-impact exercise like swimming, which does not put pressure on joints and increases blood flow to ligaments, muscles and tendons. Heat therapy also can help, he said.

In addition to over-the-counter pain relievers, some research has shown that glucosamine medication and chondroitin sulfate, a dietary supplement, may slow the progression of cartilage loss. Some doctors also give cortisone shots to help reduce inflammation and alleviate pain.

Dr. Monica Aloman said she often shows her osteoarthritis patients simple stretching exercises for the thigh, neck, fingers and shoulder rotator cuffs, and refers them for physical therapy.

Aloman, a rheumatologist who works at Advocate Christ Medical Center in Oak Lawn, said she cautions patients about weight-bearing impact exercises that could "further aggravate the cartilage destruction."

"Physical therapy is the mainstay of improving symptoms in the long term, but basically there is no (cure) for this," Aloman said.

Several area hospitals offer seminars on osteoarthritis, which affects roughly 27 million Americans, according to the Centers for Disease Control and Prevention. Advocate Christ Medical Center held a seminar in September on osteoarthritis therapy and medication, and Silver Cross Hospital in Joliet held a program on rheumatoid arthritis –– a chronic inflammatory condition that affects about 1.3 million Americans –– this month. The Arthritis Foundation also sponsors lectures on arthritis and has a "Life Improvement Series," which includes aquatic therapy, exercise and self-help programs to increase mobility and reduce pain and stiffness.

Rheumatoid arthritis mainly affects joints, though the disease also can attack many other organs and sometimes also features high fevers and fatigue. Certain medications can slow progression of the disease and prevent joint deformities, and physical and occupational therapy are also effective rheumatoid arthritis treatments, experts said.

"Osteoarthritis is a localized problem you can get with aging or when you overuse your joints like avid sports people do. ... In other words, a mechanical problem," John said. "Rheumatoid is an autoimmune disease with an overactive immune response or an immune response not working as it should."

Patients with rheumatoid arthritis often are prescribed disease-modifying anti-rheumatic drugs, or DMARDs, which are immunosuppressants that help reduce inflammation and slow disease progression, as well as over-the-counter and prescription pain medications, and calcium and vitamin D to prevent bone loss.

Aloman said inflamed finger joints should be splinted and recommends ultrasound therapy, which uses high-energy sound waves to ease the pain of affected areas.

Before deciding on a treatment regimen for arthritis patients, rheumatologists said, the type of arthritis must be determined.

Aloman said patients with osteoarthritis find their pain aggravated by activity and weight-bearing exercise but relieved with rest, whereas those with rheumatoid arthritis often have high fevers and unexplained fatigue, prolonged morning stiffness and swelling of the hands and fingers. She said rheumatoid arthritis affects mainly women who are older than 40, though it also may strike men.