Fibromyalgia Worsens Psoriatic Arthritis



Fibromyalgia… it’s more than just minor aches and pains

Fibromyalgia Worsens Psoriatic Arthritis Outcomes

Caitlyn Fitzpatrick writing in MD reported on a recent study. Published in The Journal of Rheumatology, the researchers looked at 73 patients with psoriatic arthritis. Forty-two participants (57.5%) were females and the average age was nearly 52. Clinical disease activity was measured using multiple different scales.   Also, using the American College of Rheumatism criteria, fibromyalgia was diagnosed in 13 patients (17.8%) – 12 of which were female.

Twenty-six patients (43.3%) with just psoriatic arthritis met the criteria for minimal disease activity, however, none of the participants who had fibromyalgia did.

The big takeaway here is that the presence of fibromyalgia worsened all psoriatic arthritis disease activity scores.

Comment: Not surprising.  The association of fibromyalgia with all forms of inflammatory arthritis is not a good combination.


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Gel Relieves Ostoearthritis


Wow… a new development that may help erase osteoarthritis… next

Unique Gel Combats Inflammation

Jessa Gamble writing for the Atlantic reported researchers have created a gel that can attach to inflammation sites and slowly deliver drugs to combat a wide variety of ailments—ulcerative colitis, arthritis and mucositis, to name a few. Inflammation is part of the body’s immune response, bringing extra blood to an injured area, but in cases of chronic inflammation, the heat, pain, and swelling become a problem. Developed at the Laboratory for Accelerated Medical Innovation at the Brigham and Women’s Hospital, the hydrogel—a solid material with high water content—can carry a combination of drugs, and matches its drug release to the level of inflammation around it.

When the gel is injected into the joint of an arthritis patient, for example, it will only release its anti-inflammatory payload when the patient is experiencing a flare, a spike in pain and swelling. When it encounters healthy tissue, it stays intact and does not release its payload.

“There are lots of enzymes present in inflammation that can degrade the gel,” explains Jeff Karp, the principal investigator. That breakdown of the gel releases the drug it carries.

Comment: This looks promising… Stay tuned.


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Anxiety Reduces Response to Methotrexate



One very important determinant of response to methotrexate…

Anxiety Prior To Methotrexate Therapy May Result In Non-Response At 6 Months

Reported in Healio… patients with rheumatoid arthritis who experience anxiety prior to the start of methotrexate therapy may have non-response at 6 months due to poor adherence, according to results presented at the EULAR Annual Congress.

“From a long list of lifestyle, clinical and psychosocial predictors at baseline, BMI, smoking and DAS28 score were each shown to significantly predict non-response 6 months after patients had started treatment with methotrexate,” Suzan Verstappen, of the Centre for Musculoskeletal Research at the University of Manchester, United Kingdom, said in a press release. “Of particular interest, however, is the role of participant anxiety on starting treatment with methotrexate in predicting response, which is likely to be the result of its negative effect on adherence.”

Comment: the mind is a powerful influence


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Rheumatoid Arthritis and Gout Diverging



One arthritis disease is leading to more hospitalizations and the other is causing fewer… next

Costs For Gout And Rheumatoid Arthritis

Reported in ET Health World …While hospitalizations related to rheumatoid arthritis have dropped considerably over the past two decades, hospitalizations primarily associated with gout have increased dramatically. These results of a study described in a research letter in JAMA reflect improved management of rheumatoid arthritis patients and both an increased prevalence and persistent suboptimal care of gout.

Comment: I’m not surprised. While getting RA patients into remission is easier, identifying and treating gout patients is getting harder. Much of that could be attributed to the obesity epidemic.


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Marriage Reduces Heart Attack Deaths



Another advantage of marriage… next

Being married may improve your odds of surviving a heart attack

Linda Carroll reported on Today, being married may improve the likelihood of surviving a heart attack, a new study finds. And patients who are married are more likely to have a shorter stay at the hospital after a heart attack, according to the study presented at the British Cardiovascular Society (BCS) Conference in Manchester, U.K.

Out of almost a million British men and women, about 25,000 had a heart attack, said study co-author Nicholas Gollop, a doctoral research fellow in cardiology at the Norfolk and Norwich University Hospital. Based on the findings, if patients were divided by marital status, the married ones were 14 percent more likely to be alive than singles by the end of the study. Singles didn’t suffer the worst of it, however. Divorced patients were 6 percent more likely to die during the seven to eight years of follow-up, compared to never marrieds.

Comment: If my wife hears about this, I’ll never hear the end of it.


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Rheumatoid Arthritis Patients Screen for Hearing Loss



Can you hear me now… maybe not if you have rheumatoid arthritis… next

Screening Rheumatoid Arthritis Patients for Hearing Impairments is Vital

Rachel Lutz writing for MD reported rheumatoid arthritis (RA) patients should be screened for hearing impairments.

Researchers from Odense University Hospital in Denmark TK evaluated published clinical reports related to hearing impairment in patients with RA. Additionally, they aimed to determine possible pathologies and associated factors as well as new treatment modalities for RA patients with auditory deficit.

Patients with RA are at a higher risk for having a hearing impairment compared to healthy subjects over the course of the disease, the researchers extrapolated. The team also reported that the hearing impairment in RA patients appears to be a multifactorial condition, but they were unable to determine the mechanism of the injury and the relative risk factors.  Some of the factors include smoking, alcohol and noise, which can all deteriorate hearing abilities, they said. For RA patients more specifically, long term alcohol exposure could affect hearing loss and impact the cochlear function over time.

Comment: Interesting.


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Pain Predictor of Knee Osteoarthritis



Are there early warning signs of knee arthritis? Yup!

Persistent knee pain predicts structural arthritis early.

Sara Freeman writing in Rheumatology news reported on a study that showed that persistent knee pain is in important predictor of structural joint damage and could potentially be used to predict knee osteoarthritis earlier according to Dutch research reported at the World Congress on Osteoarthritis. The analysis found that women participating in the Rotterdam study who had knee pain on most days of the preceding month were more than 4 times more likely to develop knee osteoarthritis within 5 years on MRI than were those without frequent knee pain.

Comment: a key finding.


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Subcutaneous Methotrexate Delays Biologics



Delaying the use of biologics… one approach… next

Early Use Of Subcutaneous Methotrexate May Delay Need For Biologic Dmards

Reported in Healio, “In a large, Canadian cohort of early rheumatoid arthritis (RA) patients with moderate to high disease activity who were started on methotrexate, we found the use of subcutaneous methotrexate monotherapy was associated with a delayed start of biologics,” Stephanie K. Gottheil, MD, said at the EULAR Annual Congress. Gottheil and colleagues followed 1,189 patients until they started a biologic, were lost to follow-up or followed them until the end of the 36-month study. Researchers found patients treated with subcutaneous methotrexate monotherapy were half as likely to require biologics as patients who were treated with oral methotrexate monotherapy.

Comment: I don’t use a lot of subcutaneous methotrexate but this study my prompt me to use more.


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Anxiety Prior To Methotrexate Therapy May Result In Non-Response At 6 Months



One very important determinant of response to methotrexate…

Anxiety Prior To Methotrexate Therapy May Result In Non-Response At 6 Months

Reported in Healio… patients with rheumatoid arthritis who experience anxiety prior to the start of methotrexate therapy may have non-response at 6 months due to poor adherence, according to results presented at the EULAR Annual Congress.

“From a long list of lifestyle, clinical and psychosocial predictors at baseline, BMI, smoking and DAS28 score were each shown to significantly predict non-response 6 months after patients had started treatment with methotrexate,” Suzan Verstappen, of the Centre for Musculoskeletal Research at the University of Manchester, United Kingdom, said in a press release. “Of particular interest, however, is the role of participant anxiety on starting treatment with methotrexate in predicting response, which is likely to be the result of its negative effect on adherence.”

Comment: the mind is a powerful influence


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Fat Stem Cells for Knee Arthritis



More good news on the stem cell front… next

New Treatment Shows Promise for Crippling Knee Arthritis

Alan Mozes writing for Healthday reported on a small study that demonstrated that just one injection of stem cells can reduce pain and inflammation.

The idea is experimental: Extract stem cells from a patient’s own body fat — cells known for their ability to differentiate and perform any number of regenerative functions — and inject them directly into the damaged knee joint.

To explore the potential of stem cell therapy, the study authors focused on 18 French and German men and women, aged 50 to 75, all of whom had struggled with severe knee osteoarthritis for at least a year before joining the study.

Between April 2012 and December 2013, all of the patients first underwent liposuction to extract fat-derived samples of a specific type of stem cell. The researchers noted that these particular stem cells have been shown to have immune-boosting and anti-scarring properties, as well as the ability to protect against cell “stress” and death.

A third of the patients received a single “low-dose” injection of their own stem cells directly into their knee. Another third received a “medium-dose” injection, involving a little more than four times the amount of stem cells, while the remaining group received a “high-dose” injection packed with roughly five times as many stem cells as the medium-dose group.

After six months, the study team found that all three groups showed improvements in terms of pain, function and mobility.

However, only those in the low-dose group were determined to have “statistically significant” improvements in terms of both knee pain and function recovery.

Comment: this data is in keeping with other studies.


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