You'd think folks who've had knee replacement surgery -- finally able to walk and exercise without pain -- would lose weight instead of put on pounds, but surprisingly that's not the case, according to a University of Delaware study. Researchers Joseph Zeni and Lynn Snyder-Mackler in the Department of Physical Therapy in UD's College of Health Sciences found that patients typically drop weight in the first few weeks after total knee arthroplasty (TKA), but then the number on the scale starts creeping upward, with an average weight gain of 14 pounds in two years. The study, which was sponsored by the National Institutes of Health, is reported in the Jan. 15 online edition of Osteoarthritis and Cartilage, the official journal of the Osteoarthritis Research Society International. The research involved 106 individuals with end-stage osteoarthritis who had knee replacement surgery, and an age-matched, healthy control group of 31 subjects who did not have surgery. Height, weight, quadriceps strength, and self-perceived functional ability were measured during an initial visit to UD's Physical Therapy Clinic, and at a follow-up visit two years later.
Investigators have identified a biomarker that could help doctors select patients with rheumatoid arthritis who will benefit from therapy with drugs such as Enbrel, a tumor necrosis factor (TNF)-antagonist drug. The study, led by researchers at Hospital for Special Surgery in collaboration with rheumatologists at University of Southern California, appears in the February issue of the journal Arthritis & Rheumatism. "While our study was performed on a relatively small group of patients and will need to be confirmed in a larger cohort, the data are promising and may be clinically significant for the medical management of patients, " said Mary K. Crow, M.D., director of Rheumatology Research and co-director of the Mary Kirkland Center for Lupus Research at Hospital for Special Surgery. "Treatment with these drugs is very expensive; the drugs can cost around $16, 000 or so per year. If you are going to use them, you would like to know that they are likely to work in your patient." Other well-known TNF-antagonists include Humira and Remicade.
A recent study by researchers from the Cleveland Clinic found that the overall mortality rate in the U.S. for all pediatric patients with rheumatic diseases was not worse than the age and sex-adjusted population. Furthermore, mortality rates were significantly lower than reported in previous studies of rheumatic diseases and conditions that are associated with increased mortality. Details of the study appear in the February issue of Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) estimates that 300, 000 children in the U.S. suffer from some form of arthritis or rheumatic disease. According to CARRA, childhood arthritis is the #1 cause of acquired disability in children and is the 6th most common chronic childhood disease. While rheumatic diseases present well-known risks to health, function, and quality of life, several conditions - juvenile rheumatoid arthritis, childhood systemic lupus erythematosus, dermatomyositis, various vasculitides, and systemic sclerosis are associated in various studies with a small but significant increase in mortality.
A recent study by researchers from the University of Pittsburgh found that workers with rheumatoid arthritis (RA) were comparable to non-impaired individuals in keyboarding speed. Individuals who were trained in touch typing demonstrated faster typing speeds than those using a visually-guided ("hunt and peck") method, regardless of impairment. Researchers also noted slightly impaired mouse skills in workers with RA. Results of this study appear in the February issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology. According to the U.S. Census Bureau the number of workers using computers increased from 46% in 1993 to 56% in 2003 with figures expected to continue climbing higher. For workers with RA the capacity to use computers may be limited by impairment in hand range of motion (ROM) and strength caused by inflammation of their joints due to the disease. Prior studies have shown that workers with RA have higher rates of work disability, premature work cessation, and reduced hours on the job.
European Commission Approves Orencia R Abatacept In Combination With Methotrexate For Children With Moderate To Severe pJIA
Bristol-Myers Squibb Company (NYSE: BMY) announced that on 20 January 2010, the European Commission approved ORENCIA ® (abatacept) in combination with methotrexate for the treatment of moderate to severe active polyarticular juvenile idiopathic arthritis (pJIA) in paediatric patients six years of age and older who have had an insufficient response to other DMARDS, including at least one TNF inhibitor.1 Disease-modifying treatment options for children with pJIA have been extremely limited to date. ORENCIA, in combination with methotrexate (MTX), offers another treatment option for children six years of age and older with pJIA, filling an unmet need. ORENCIA has not been studied in children under six years old. ORENCIA is designed to act early in the immune cascade by selectively modulating T-cells to reduce downstream inflammatory responses.2, 3 The AWAKEN Study The approval of ORENCIA in pJIA is based on findings from the double-blind, randomised controlled study AWAKEN (Abatacept Withdrawal study to Assess efficacy and safety in Key Endpoints in juvenile idiopathic arthritis Not responding to current treatment) which evaluated the efficacy and safety of ORENCIA in patients six to 17 years of age with moderate to severe active pJIA who had an inadequate response to one or more disease-modifying anti-rheumatic drugs (DMARDs), such as MTX or tumour necrosis factor (TNF) antagonists.
Researchers from University Hospital in Umea, Sweden, have identified several cytokines, cytokine-related factors, and chemokines that increase significantly prior to rheumatoid arthritis (RA) disease onset. These findings confirm those of earlier studies which suggest that the risk of developing RA can be predicted and disease progression may be prevented. Complete findings of this study are published in the February issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology. Rheumatoid arthritis is a chronic autoimmune disease characterized by joint inflammation involving the synovial (lubricating fluid of the joints) tissue and eventually leading to destruction of cartilage and bone. The cause leading to disease development and progression is not completely understood, although various cells of the immune system and of synovial origin are suggested to be involved. Numerous cytokines are expressed and are functionally active in the synovial tissue once the disease has developed.
The links between autoimmune diseases, infections, genetics and the environment are complex and mysterious. Why are people who live near airports more susceptible to autoimmune diseases like rheumatoid arthritis and lupus? How do hormones in meat trigger the onset of a disease? Our immediate environment interacts with our genetic programming and can determine if we will succumb to an autoimmune disease, says rheumatologist Prof. Michael Ehrenfeld of Tel Aviv University's Sackler School of Medicine, who is seeking to unravel those mysteries. Prof. Ehrenfeld recently published a report in Autoimmune Reviews on how "Spondylo-arthropathies, " a group of common inflammatory rheumatic disorders, appear to be triggered by environmental factors. He has also done research on how the dry-eye and mouth disease "SjГ gren's syndrome" can be triggered by environmental influences. Minimizing the risks "The onset of autoimmune diseases is a mixture of genetics, which you can't change, and environmental factors, which in some cases you can, " says Prof.
Final draft guidance published today (Thursday 21st January 2010) by the National Institute for Health and Clinical Excellence (NICE) will enable another therapy to be considered for some people in England, Wales and Northern Ireland suffering with rheumatoid arthritis. In the draft, certolizumab pegol is now recommended as a treatment option for some patients with the disease. Rheumatoid arthritis (RA) is a long-term disease in which joints in the body become inflamed, causing pain, swelling and stiffness. It often affects the small joints of the hands and the feet, and usually both sides equally and symmetrically. Around 400, 000 people in the UK have RA and people of all ages can develop the disease. Over twice as many women as men suffer from the condition. Certolizumab pegol is a type of treatment known as a TNF (tumour necrosis factor) inhibitor. It is recommended for the same use as the other TNF inhibitors: adalimumab, etanercept and infliximab, as outlined in existing NICE technology appraisal guidance 130.
Researchers at Geisinger Medical Center recently received funding totaling more than $44, 000 from a Geisinger Health System (GHS) - NYU Langone Medical Center (NYULMC) collaborative project focusing on personalized healthcare. The grant, titled "Expanding Comparative Effectiveness Research in Orthopedics by Capturing Uniform Measures of Patient-Reported Functional Outcomes at Two Institutions", will permit Geisinger to administer electronic questionnaires to patients with osteoarthritis (OA) via new, touch-screen monitors in its orthopaedic clinics. Results from these questionnaires will allow physicians to track patient-reported outcomes, which are critical in developing evidence-based protocols in OA management. "There is an urgent need to create evidence-based guidelines to assist health care providers in managing osteoarthritis. By integrating an electronic questionnaire into patient visits, we can collect valuable data regarding the effectiveness of our treatments and use that feedback to determine what's working well and what we can improve, " said Wade Smith, Chairman, Orthopaedics, Geisinger Health System.
MorphoSys Enrolls First Patient In Phase 1b 2a Clinical Trial For MOR103 Program In Rheumatoid Arthritis
MorphoSys AG (FSE: MOR; Prime Standard Segment, TecDAX) announced that it has enrolled the first patient in its Phase 1b/2a clinical trial of its lead drug MOR103. The Company's lead development program, MOR103, is a fully human HuCAL antibody directed against GM-CSF (granulocyte macrophage-colony stimulating factor), being developed in the area of inflammatory diseases, such as rheumatoid arthritis (RA), where current treatment options are inadequate. "We are very pleased that our Phase 1b/2a study in patients with rheumatoid arthritis has now started according to plan, " commented Dr. Arndt Schottelius, Chief Development Officer. "This is an important step for MorphoSys, since we will test an antibody from our growing proprietary pipeline for the first time in patients. We have thus made significant progress in bringing a potential future drug with a promising new mechanism of action closer to patients. The past year saw a major expansion of MorphoSys's development team and capabilities.