Uric acid lowering therapy is important for patients with symptomatic gout. However, for certain groups there is a risk of treatment… next
HLA-B*5801 Testing Needed In Asians And Blacks With Gout
Dr. Jack Cush in Rheum Now reported on a study by Choi and colleagues who analyzed US hospitalizations (2009–2013) to assess the frequency and racial distribution of patients hospitalized with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) related to the use of urate-lowering (ULT) therapy (predominantly allopurinol). They found 606 hospitalizations while receiving ULT. There was an overrepresentation of Asians (27%) and Blacks (26%), and an underrepresentation of Whites (29%) and Hispanics (% too low to report).
These SJS/TEN events were 12 time more frequent in Asians, and 5 times more frequent in Blacks when compared to Whites (reference group).
The HLA-B*5801 allele has been strongly linked with the allopurinol hypersensitivity syndrome and has been found in higher frequency in certain populations, especially Koreans, Japanese, Thai and Han Chinese – and in some Europeans. This study demonstrates the potential use of HLA-B*5801 in U.S. Asians and Blacks.
Comment: Really important info to know when treating certain racial groups with gout.
Bruce Jancin writing in rheumatology News reported on a British study of more than 13,000 patients who underwent total knee replacement. A matched nonsurgical group was used as control. During the first month after knee replacement, there was an almost 9 fold increase in the risk of heart attack compared with the control group. At 3 months the risk was four times greater and at 6 months 2 times greater. Another finding was that the risk of venous thromboembolism- a blood clot that goes to the lungs- remained elevated for 5 years.
Comment: Wow… not good news for you if you want to have a knee replaced.
Tequila Could Be the Basis for a New Osteoporosis Treatment
Caitlyn Fitzpatrick writing in MD reported in addition to being the most important ingredient in margaritas, substances derived from tequila can play an important role in health.
Not only did new research find that Agave tequilana (or tequila agave) may help maintain bone health, but it could also be the basis for a new osteoporosis treatment. Mercedes López, PhD, led the project at the Center for Research and Advanced Studies (Cinvestav) in Mexico.
Using animal models, the researchers induced osteoporosis in mice by removing their ovaries. The animals were then given agave fructans (polymers that store carbohydrates in some fruits and vegetables). After eight weeks, femur samples were collected in order to assess the absorption of minerals and osteocalcin (a protein that indicates new bone production).
“It was found that mice that consumed this fructans synthesized nearly 50% more of such protein, in addition that the diameter of their bones was higher compared with the subjects which were not supplied with derivatives of the agave,” López explained.
New osteoporosis drugs work well but may worsen rheumatoid arthritis…
Anti-sclerostin osteoporosis drugs worsen RA
Jeff Evans writing in Rheumatology news reported antisclerostin antibodies increase bone mineral density and have done well in clinical trials in osteoporosis. However, they may have the opposite effect in rheumatoid arthritis according to a German study. Researchers showed these drugs accelerate joint damage in mouse models of rheumatoid arthritis.
Comment: Often, new drugs aimed at helping one condition can worsen another.
Changing your gut bugs may be the next step in the future of medicine…
Pharmaceutical companies considering potential of treating microbiome
Elizabeth Preston writing in STAT reported that “as scientists learn more about the microbiome’s role in conditions ranging from allergies to anxiety to cancer,” pharmaceutical companies are “paying close attention.” The goal of such research is to “treat or prevent some of our most intractable diseases” by “delivering drugs to the microbiome.”
The microbiome has generated a ton of interest in researchers across all disciplines. It will be interesting to see what happens over the next few years.