Osteoarthritis, also known as degenerative arthritis degenerative joint disease, OA, or osteoarthrosis, is a form of arthritis caused by inflammation, breakdown, and the eventual loss of cartilage in the joints - the cartilage wears down over time. Osteoarthritis is the most common type of arthritis. According to the National Health Service, UK, approximately 8.5 million people are affected by the condition. The Arthritis Foundation, USA, says that about 27 million Americans are affected. Osteoarthritis is a progressive disease; signs and symptoms gradually worsen over time. There is no cure. However, available therapies may help with pain and swelling (inflammation), as well as keeping the patient mobile and active. Experts say that patients who take steps to actively manage their osteoarthritis are more likely to gain control over their symptoms. Any joint in the body may be affected. However, the disease is most likely to affects the patient's: Hands Hips Knees Lower back Neck Osteoarthritis has three characteristics: Bony growths develop around the edge of joints.
Ewing sarcoma (EWS) is a bone tumor of unknown cellular origin that affects children and young adults. The protein CD99 is highly expressed in most cases of EWS, but its function in the disease is unknown. Now, Katia Scotlandi and colleagues, at SSN Emilia Romagna Istituto Ortopedico Rizzoli IRCCS, Bologna, Italy, have identified a crucial role for CD99 in the development of EWS and suggest that targeting CD99 or its downstream molecular pathway may be a new therapeutic approach for EWS. In the study, decreasing CD99 expression in human EWS cell lines reduced their ability to form tumors xenografted into mice. In vitro, it increased expression of H-neurofilament, a marker of neuronal differentiation. Consistent with this, an inverse correlation between CD99 expression and H-neurofilament expression, neural differentiation, and oncogenic transformation was observed in patient-derived EWS cells. The authors therefore conclude that CD99 prevents neural differentiation and suggest that blocking it might provide a new approach to treating EWS.
An investigational drug that inhibits serotonin synthesis in the gut, administered orally once daily, effectively cured osteoporosis in mice and rats reports an international team led by researchers from Columbia University Medical Center, in the Feb. 7 issue of Nature Medicine. Serotonin in the gut has been shown in recent research to stall bone formation. The finding could lead to new therapies that build new bone; most current drugs for osteoporosis can only prevent the breakdown of old bone. "New therapies that inhibit the production of serotonin in the gut have the potential to become a novel class of drugs to be added to the therapeutic arsenal against osteoporosis, " said Gerard Karsenty, M.D., Ph.D., chair of the Department of Genetics and Development at Columbia University College of Physicians and Surgeons, lead author of the paper. "With tens of millions of people worldwide affected by this devastating and debilitating bone loss, there is an urgent need for new treatments that not only stop bone loss, but also build new bone.
Denosumab is a targeted therapy to prevent bone loss. It stops progressive bone destruction and tumour spread in some patients with inoperable giant-cell tumour (GCT) of bone. An article published Online First in The Lancet Oncology reports this could change standard treatment practice. Breaking new ground, this work is the first to clearly show a promising systemic treatment option for this rare type of bone tumour. GCT can be limb and life threatening. It causes pain, impaired function and mobility. This condition is usually benign, and surgery is the standard treatment. However, GCT can become malignant after radiation therapy or several recurrences. In some cases, patients are unable to undergo surgery because of multiple lesions, location of the tumour (for example, the spine), or because of tumour spread. These patients have limited treatment options. Denosumab is a monoclonal antibody. It targets and disables RANK ligand which is a key mediator of osteoclast activity. It blocks the action of osteoclasts, the cells that break down bone.
People with anorexia nervosa, paradoxically, have strikingly high levels of fat within their bone marrow, report researchers at Children's Hospital Boston. Their findings, based on MRI imaging of the knees of 20 girls with anorexia and 20 healthy girls of the same age, appear in the February issue of the Journal of Bone and Mineral Research. "It's counter-intuitive that an emaciated young woman with almost no subcutaneous fat would be storing fat in her marrow, " says endocrinologist Catherine Gordon, MD, MSc, director of the Bone Health Program at Children's and the study's senior investigator. In the study, the knee MRI images were read by radiologists who were unaware of the patient's clinical status. Compared with controls, the patients with anorexia had markedly increased fat content -- visualized as "yellow marrow" -- and less than half as much healthy red marrow in their knees; this was seen both in the lower thigh bone (femur) and upper shinbone (tibia). The findings in these girls and young women, averaging 16 years of age, confirm previous observations in mice with clinical signs similar to anorexia nervosa, reported by study co-author Clifford Rosen, MD, of the Maine Medical Center.
Hospital for Special Surgery, (HSS), a world leader in orthopedics and rheumatology, announced its support of the Arthritis Foundation and Ad Council newly launched campaign, "Moving is the Best Medicine, " to raise awareness of osteoarthritis, increase public health education and support breakthrough research. "Like the Arthritis Foundation, we are focusing our extensive clinical and research resources on raising awareness of the potentially debilitating effects of osteoarthritis in this country, " said Stephen Paget, M.D., physician-in-chief and chair of the division of rheumatology at HSS. "We applaud the efforts of the Arthritis Foundation and the Ad Council as they begin a multi-year initiative to improve the understanding of osteoarthritis, and we join them with our commitment to identify better methods to diagnose, treat and prevent the disease, " Dr. Paget continued. Hospital for Special Surgery has the largest group of rheumatologists of any hospital in the country. With a focus on muscle, bone and joint pain, orthopedic surgeons, rheumatologists, physiatrists, radiologists and pain management specialists attend to 240, 000 patient visits annually.
The American Academy of Orthopaedic Surgeons (AAOS) recently approved and released an evidence-based clinical practice guideline on the Treatment of Distal Radius Fractures. A distal radius fracture - one of the most common fractures in the body - usually occurs as a result of a fall. For example, a fall may cause someone to land on his or her outstretched hands, breaking the larger of the two bones in the forearm, near the wrist. In 2007, more than 261, 000 people visited the emergency room due to a distal radius fracture. "The Academy created this clinical practice guideline to improve patient care for those sustaining a distal radius fracture, " stated David Lichtman, MD, chair of this guideline workgroup. "This serves as a point of reference and an educational tool for both primary care physicians and orthopaedic surgeons, streamlining possible treatment processes for this ever-so common problem, " he added. "While a wide range of treatment options are available, they should always be tailored to individual patients after discussions with their orthopaedic surgeons.
Denosumab Demonstrated Superiority Over Zometa R In Pivotal Phase 3 Head-to-Head Trial In Prostate Cancer Patients With Bone Metastases
Amgen (Nasdaq: AMGN) announced that a pivotal, Phase 3, head-to-head trial evaluating denosumab versus Zometa ® (zoledronic acid) in the treatment of bone metastases in 1, 901 men with advanced prostate cancer met its primary and secondary endpoints. Denosumab demonstrated superiority over Zometa for both delaying the time to the first on-study skeletal related event (SRE) ( fracture, radiation to bone, surgery to bone or spinal cord compression) (hazard ratio 0.82, 95 percent CI: 0.71, 0.95), and reducing the rate of multiple SREs (hazard ratio 0.82, 95 percent CI: 0.71, 0.94). Both results were statistically significant. Overall rates of adverse events and serious adverse events, including infections, were generally similar between the two arms. Osteonecrosis of the jaw was infrequent (22 patients receiving denosumab as compared with 12 patients receiving Zometa) and there was no statistically significant difference between treatment arms. As with previous studies in advanced cancer patients, hypocalcemia was more frequent in the denosumab arm.
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.
Auxilium Announces U.S. Food And Drug Administration Approval For XIAFLEXTM For The Treatment Of Dupuytren's Contracture
Auxilium Pharmaceuticals, Inc. (NASDAQ: AUXL), a specialty biopharmaceutical company, announced that it has received marketing approval from the U.S. Food and Drug Administration (FDA) for XIAFLEX™ (collagenase clostridium histolyticum), a novel, first-in-class, orphan-designated, biologic, for the treatment of adult Dupuytren's contracture patients with a palpable cord. The Company expects to begin shipping XIAFLEX to its distribution partners in early March in advance of a launch planned for late March. "We believe the approval of XIAFLEX represents a major breakthrough for patients suffering from the debilitating effects of Dupuytren's contracture, " said Armando Anido, Chief Executive Officer and President of Auxilium. "XIAFLEX is the first and only FDA-approved nonsurgical treatment for Dupuytren's contracture. I want to thank the employees of Auxilium and all of the clinical investigators who worked so hard to make this breakthrough a reality." The Company will market and sell XIAFLEX in the United States through a team of approximately 100 field sales managers and representatives, reimbursement specialists and managed market account directors.