So… are steroids being used more or less in rheumatoid arthritis nowadays…
Steroid Use in Rheumatoid Arthritis More Common
Nancy Walsh writing in Medpage Today reported that more patients with rheumatoid arthritis today are initiating treatment with glucocorticoids (GCs) early in the course of disease than was the case 20 years ago, a retrospective study found.
During the first year of disease, 68% of patients diagnosed with rheumatoid arthritis between 1995 and 2007 started GCs compared with 36% of those diagnosed between 1980 and 1994 (P<0.001), according to Ashima Makol, MD, and colleagues from the Mayo Clinic in Rochester, Minn.
However, the doses have remained similar, with mean starting doses of 8.7 mg/day and 10.3 mg/day in the later and earlier cohorts, respectively.
These findings may reflect shifting patterns of rheumatoid arthritis treatment, away from a “step-up” approach toward an early, aggressive, treat-to-target approach.
Comment: Personally, I think low dose prednisone is a good bridge to use.
What effect do arthritis drugs have on fertility? Coming up next…
RA Meds Can Lower Fertility
Nancy Walsh writing in Medpage Today reported the use of prednisone and nonsteroidal anti-inflammatory drugs (NSAIDs) may contribute to the subfertility common among women with rheumatoid arthritis, Dutch researchers found.
In a multivariate analysis, preconception use of prednisone was associated with a 39% reduction in the likelihood of pregnancy, according to Jenny Brouwer, a PhD candidate, and her colleagues at Erasmus Medical Center in Rotterdam.
And NSAID use preconception was associated with a 34% decreased chance of pregnancy, the researchers reported online in Annals of the Rheumatic Diseases.
Retrospective studies and registries have demonstrated that women with rheumatoid arthritis typically have a harder time conceiving than healthy women.
Comment: Another risk and benefit to consider.
A huge problem associated with Sjogren’s disease… next
Heart Attack Risk Increased in Sjogren’s Patients
Nancy Walsh writing for Medpage Today reported patients with Sjogren’s syndrome, an autoimmune condition characterized by inflammation of the tear ducts and salivary glands, had more than double the heart attack risk seen in the general population, a researcher reported here.
Compared with matched controls, patients with Sjogren’s syndrome had an incident rate ratio for myocardial infarction (MI) of 2.19 (95% CI 1.40-3.31), according to Antonio Avina-Zubieta, MD ,PhD, of the University of British Columbia in Vancouver.
Avina-Zubieta and colleagues also found a non-significant trend toward increased stroke risk among patients with the condition, he reported at the annual European Congress of Rheumatology meeting.
Comment: Very disturbing news and prompts the need for more aggressive treatment.
Disturbing news for men on statins… next
Older Men on Statins Found Less Physically Active
Reported in Healthday, this item…Among older, community-dwelling men, use of statins is associated with modestly lower levels of physical activity, according to research published in JAMA Internal Medicine.
David S.H. Lee, Pharm.D., Ph.D., of the Oregon State University in Portland, and colleagues assessed the association between statin use and physical activity among men, aged 65 years and older, who were participating in the Osteoporotic Fractures in Men Study.
Among 3,071 men (half of whom were statin users), statin users versus statin nonusers expended fewer metabolic equivalents and engaged in less moderate physical activity, less vigorous physical activity, and more sedentary behavior.
Comment: This study poses serious questions as to the cost benefit of using statins.
Another serious risk of low vitamin D… next
Low vitamin D levels increase risk of premature death
Science World Report
Reported in Science World Report,
A recent study conducted by researchers at the University of California, San Diego School of Medicine, found that inadequate levels of vitamin D can increase the risk of premature death. According to the study, published in the American Journal of Public Health, researchers found that participants with lower levels of vitamin D in their blood were up to two times more likely to die prematurely compared to those who had higher levels of the vitamin.
Comment: It is no secret that certain vitamins and minerals can play a critical role in our everyday health. This is a good look again at vitamin D.