Less Smoking Linked to Lower Antibody Levels in Modern Rheumatoid Arthritis Patients

MedicalResearch.com Interview with:

Pr Gilles Boire, M.D., M. ScService de rhumatologie Département de médecine Faculté de médecine et des sciences de la santé Université de Sherbrooke

Prof. Boire

Pr Gilles Boire, M.D., M. ScService de rhumatologie
Département de médecine
Faculté de médecine et des sciences de la santé
Université de Sherbrooke

MedicalResearch.com: What is the background for this study?

Response: Rheumatoid arthritis (RA) patients are heterogeneous at initial presentation, in response to treatments and according to their outcomes. No clinical features and very few biomarkers, except autoantibodies such as anti-Cyclic Citrullinated Peptides/Proteins (CCP), identify patients with divergent prognostic trajectories.

To help improve early prognostic classification, we initiated 20 years ago the single center longitudinal observational Early Undifferentiated PolyArthritis (EUPA) study of consecutive patients presenting with recent-onset inflammatory polyarthritis, 90% of which fulfill classification criteria for RA at baseline. Our registry includes 739 very early RA patients (median symptom duration 3.6 months), rapidly treated to joint remission (i.e. 0/66 swollen joint) and followed over 5 years. Each patient visit is linked to biosamples and to sequential radiographs scored according to the modified Sharp/van der Heijde method. As we had the clinical impression that clinical features of recruited patients were evolving, we compared patients from 3 periods (1998-2004; 2005-2010; 2011-2017).  Continue reading

Number of Knee Arthroscopic Procedures Declines

MedicalResearch.com Interview with:

Dr-David-Howard

Dr. Howard

Prof. David H. Howard PhD
Department of Health Policy and Management
Emory University
Atlanta, GA 30322

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: There is a lot of skepticism that physicians respond to evidence, especially when trials report that widely-used, separately-reimbursed procedures are not effective.

Physicians are reluctant to abandon treatments. This study shows that in the case of knee arthroscopy, evidence has made a difference. The use of knee arthroscopy declined by 23% in Florida between 2002 and 2015. This change occurred despite increases in the prevalence of osteoarthritis.  Continue reading

More Weight Loss Linked To Greater Decrease in Knee Arthritis Pain

MedicalResearch.com Interview with:

Wake Forest professor of Health and Exercise Science Steve Messier, Friday, June 15, 2018.

Prof. Messier

Professor Steve Messier
Director of the J.B. Snow Biomechanics Laboratory
J.B Snow Biomechanics Laboratory
Wake Forest University

MedicalResearch.com: Why did you undertake this study?

Response: This was a secondary analysis of the Intensive Diet and Exercise for Arthritis (IDEA) clinical trial originally published in JAMA in 2013, Volume 310, Number 12, pages 11263-1273.

We were interested to see if losing 20% of your body weight had any additional benefits compared to a 10% weight loss that we previously have shown to be beneficial.

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Synovial tissue profiling in autoantibody positive at risk individuals reveals gene signatures associated with later development of rheumatoid arthritis

MedicalResearch.com Interview with:

Dr. Lisa van Baarsen PhD Principal Investigator at the Amsterdam Rheumatology and Immunology Cente Academic Medical Center the Netherlands.

Dr. van Baarsen

Dr. Lisa van Baarsen PhD
Principal Investigator at the Amsterdam Rheumatology and Immunology Cente
Academic Medical Center
the Netherlands 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The discovery that autoantibodies can be present years before the onset of clinical symptoms of rheumatoid arthritis (RA) enables us to study autoantibody positive individuals who are at risk of developing RA. In patients with established disease the target tissue of RA, the synovial joints, is characterized by cellular infiltration and inflammation. Moreover, successful therapy decreases this synovial inflammation. In the past, our department already showed (PMID: 21177292; PMID: 24574210) that in autoantibody positive at risk individuals there is no overt cellular infiltration present in the synovium.

In the current study we performed a so called discovery-based approach to investigate at a genome-wide gene expression level (using microarrays) whether the synovium is altered at a molecular level before onset of rheumatoid arthritis.

Our molecular and microscopic studies on synovial biopsies obtained from autoantibody positive individuals indeed revealed interesting differences between those at risk individuals who developed disease after follow up and those who did not. Continue reading

Premature Mortality in Rheumatoid Arthritis Reduced With Early Treatment

MedicalResearch.com Interview with:
Maarten Boers, MSc, MD, PhD

Professor of Clinical Epidemiology
Department of Epidemiology and Biostatistics
VU University Medical Center–F wing MedFac
Amsterdam, Netherlands

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Mortality in rheumatoid arthritis is increased. Recent (short-term) studies suggest the situation is improving, but in studies with long (>10-year) follow up the increased mortality persists.

We have been following a trial cohort of rheumatoid arthritis patients treated right from the beginning of disease (the COBRA trial) for 23 years and now, for the first time, show normal mortality compared to the general population.

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Which NSAID for Knee Pain Works Best?

MedicalResearch.com Interview with:
“dog” by Neil Mullins is licensed under CC BY 2.0Deborah S. Cummins, PhD

Director, Research, Quality and Scientific Affairs
American Academy of Orthopaedic Surgeons
On behalf of the researchers:
David Jevsevar, MD, MBA; Gregory A. Brown, MD, PHD, and Deborah S. Cummins, PhD

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is estimated that individuals have a 45% risk of developing knee osteoarthritis (OA) in their lifetime. As a result of the shifting demographics of the US, where an increasing percentage of the population is older than 65, the burden of knee OA will continue to increase. To help deal with this burden, effective nonsurgical treatments are needed to manage knee OA symptoms associated with pain and function before surgical intervention becomes necessary. To determine which non-surgical options are best, we performed a network meta-analysis exploring mixed treatment comparisons for nonsurgical treatment of knee osteoarthritis in order to effectively rank the various nonsurgical treatment options from best to worst.

Our network meta-analysis suggests that the single most effective nonsurgical treatment for improving knee function is function is naproxen, followed by diclofenac, celecoxib, and ibuprofen. When considering pain and function together, our data suggest that naproxen is the most effective treatment followed by IA corticosteroid injection.

The single most effective short-term (4-6 weeks) treatment for decreasing pain is intra-articular (IA) corticosteroid injection, followed by ibuprofen, IA platelet rich plasma, and naproxen. Additionally, intra-articular hyaluronic acid injections never achieved a rank in the top five treatments for pain, function, or combined pain and function. An analysis of 12 articles also found that HA is not significantly different than IA placebo in effect.

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Knee Pain Improved After Bariatric Surgery For Obesity

MedicalResearch.com Interview with:

Jonathan Samuels, MD Associate Professor of Medicine Division of Rheumatology NYU Langone Health

Dr. Jonathan Samuels

Jonathan Samuels, MD
Associate Professor of Medicine
Division of Rheumatology
NYU Langone Health

MedicalResearch.com: What is the background for this study?

 Response: A high percentage of obese patients have painful knee osteoarthritis, and have difficulty losing weight as well as treating the knee pain with a self-perpetuating cycle.

 MedicalResearch.com: What are the main findings?

Response:  Patients who lost weight with their laparoscopic banding surgeries also experienced marked improvement of their knee pain. We found a significant correlation between the degree of improvement in the body mass index and reduction of knee pain in our cohort.

In addition, the patients who experienced the most relief from weight loss surgeries had their procedures at earlier ages, as well as those who never had a traumatic knee injury nor developed osteoarthritis in other joints.

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Hand Osteoarthritis: Hydroxychloroquine No More Effective Than Placebo

MedicalResearch.com Interview with:
Dr Sarah Kingsbury PhD
Osteoarthritis Strategic Lead
Deputy Section Head, Musculoskeletal Medicine and Imaging
Leeds Institute of Rheumatic and Musculoskeletal Medicine
University of Leeds

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Osteoarthritis of the hand is a painful and disabling condition, estimated to effect up to 31 per cent of people aged over 70. It can stop people from carrying out everyday activities and can limit their quality of life. The first-line pharmacological treatments for hand osteoarthritis, including paracetamol and non-steroidal anti-inflammatory drugs, are often not effective and are associated with side effects. Doctors have used hydroxychloroquine, an established treatment for rheumatoid arthritis, as an off-label alternative, supported by increasing evidence that inflammation is a factor in osteoarthritis. Until now, there has not been a large-scale study into whether using hydroxychloroquine works.

HERO was a 12 month randomised, double-blind, placebo controlled, pragmatic trial, designed with a view to replicate anecdotal reports of hydroxychloroquine use in clinical practice, and  powered to detect a moderate effect equivalent to that for NSAIDs in this population. The study involved 248 patients at 13 NHS hospitals in England: all had the condition for at least 5 years, had changes to the joints in their hands consistent with osteoarthritis and reported moderate to severe pain on at least half of the days in the previous three months to the study commencing.

Participants were randomised 1:1 to either hydroxychloroquine or placebo and followed up at 3 monthly intervals for 12 months. The study found that patients initially reported a small reduction in the severity of pain before the improvement plateaued. However, a similar amount of change was seen in both the group receiving hydroxychloroquine medication and the group taking the placebo.

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No Mortality Benefit From Weight Gain in Rheumatoid Arthritis

MedicalResearch.com Interview with:

Jeffrey A. Sparks, M.D., M.M.Sc. Assistant Professor of Medicine Division of Rheumatology, Immunology and Allergy Department of Medicine Brigham and Women’s Hospital Harvard Medical School

Dr. Sparks

Jeffrey A. Sparks, M.D., M.M.Sc.
Assistant Professor of Medicine
Division of Rheumatology, Immunology and Allergy
Department of Medicine
Brigham and Women’s Hospital
Harvard Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We compared women diagnosed with rheumatoid arthritis (RA) during follow-up in the Nurses’ Health Study and matched women without RA during the same index time period. Women with RA had higher mortality than women without RA. In both groups, those that had severe weight loss (>30 pounds), had the highest mortality after the early RA/index period. Weight gain in the early RA period was not associated with mortality for either group.

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Treatment With Tremfya® (Guselkumab) Improved Psoriatic Arthritis Symptoms Through One Year

MedicalResearch.com Interview with:

Atul A. Deodhar, MD, MRCP, FACP, FACR Professor of Medicine Division of Arthritis & Rheumatic Diseases Medical Director, Rheumatology Clinics Medical Director, Immunology Infusion Center Oregon Health & Science University (OHSU) 

Dr. Deodhar

Atul A. Deodhar, MD, MRCP, FACP, FACR
Professor of Medicine
Division of Arthritis & Rheumatic Diseases
Medical Director, Rheumatology Clinics
Medical Director, Immunology Infusion Center
Oregon Health & Science University (OHSU) 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Phase 2, randomized, double-blind, placebo–controlled, multicenter trial was designed to evaluate the efficacy and safety of guselkumab (Tremfya®) compared with placebo in adults with active psoriatic arthritis, despite having received treatment with standard-of-care therapies, including anti-tumor necrosis factor (TNF)-alpha agents.

In an observed analysis presented at ACR 2017, more than 70 percent of patients receiving guselkumab achieved at least a 20 percent improvement in signs and symptoms of disease (ACR 20) at week 56.  Findings also showed that improvements in tender and swollen joints, skin clearance, pain and physical function, and patient-reported quality of life outcomes reported at week 24, were maintained through week 56 in patients receiving guselkumab maintenance therapy (subcutaneous injections every eight weeks).  Continue reading

Oral Glucosamine Found No More Effective Than Placebo For Osteoarthritis Pain

MedicalResearch.com Interview with:

Jos Runhaar, PhD Erasmus MC Department of General Practice Rotterdam The Netherlands

Dr. Runhaar

Jos Runhaar, PhD
Erasmus MC
Department of General Practice
Rotterdam
The Netherlands 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Most international guidelines report an overall lack of efficacy of glucosamine for osteoarthrits. We however know that it is a very heterogeneous disease. Therefore, it is possible that there are certain subgroups of osteoarthritis patients that actually might have effect from glucosamine; for instance subgroups based on different pathologies underlying the clinical presentation, different co-morbidities, or different disease stages.

For investigating efficacy in subgroups large sample sizes are needed, and certain methodological techniques are necessary, to get a valid and robust answer. Several years ago, a group of renowned international osteoarthritis researchers started the OA Trial Bank especially for investigating these subgroup effects of osteoarthritis treatments and collect individual patient data of worldwide-performed intervention studies in osteoarthritis patients. When using the individual patient data of multiple studies, it brings us the large sample size and allows us to use the right methods. We do these subgroup analyses in the OA Trial Bank for many different interventions, not just for glucosamine. The subgroup analyses for glucosamine and for corticosteroid injections are published, the others are ongoing (for instance exercise, orthoses and topicals) or planned and still waiting for funding.

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Pharmaceutical Grade Chondroitin Sulfate As First-Line Treatment of Osteoarthritis

MedicalResearch.com Interview with:

Jean-Yves Reginster M.D.,PH.D. Professor of Epidemiology, Public Health and Health Economics Head of the Bone and Cartilage Metabolism Unit University of Liège

Dr. Reginster

Jean-Yves Reginster M.D.,PH.D.
Professor of Epidemiology, Public Health and Health Economics
Head of the Bone and Cartilage Metabolism Unit
University of Liège

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Whereas several recommendations, issued by scientific societies, recommend to use Symptom-Modifying Slow Acting Drugs (SYSADOAs) for the symptomatic and structural management of osteoarthritis, no medication is currently registered, in this particular indication, by the European Medicines Agency (EMA) or by the Food and Drug Administration (FDA).

This study is the first study, conducted, with a SYSADOA which fully complies with the requirements of the EMA for the assessment of drugs to be used in the treatment of osteoarthritis, i.e. a six-month duration, two co-primary endpoints (pain and function) and a three-arm design, with a placebo and an active comparator. The main findings are that pharmaceutical grade chondroitin sulfate provides an improvement in pain and function, which is greater than placebo and not distinguishable from celecoxib, a non-steroidal anti-inflammatory drug currently licensed for the symptomatic management of osteoarthritis.

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Lifetime Risk of Symptomatic Hand Osteoarthritis Higher in Whites

MedicalResearch.com Interview with:

Jin Qin, ScD, MS Epidemiologist Centers for Disease Control and Prevention Chamblee, GA 30341

Dr. Jin Qin

Jin Qin, ScD, MS
Epidemiologist
Centers for Disease Control and Prevention
Chamblee, GA 30341 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The hand is one of the sites most commonly affected by osteoarthritis (OA) but is often understudied compared with knee and hip OA. Many people with hand OA have significant symptoms, impaired hand strength and function, and disability in activities of daily living, like using a smart phone or a computer keyboard, and opening a jar. Lifetime risk is the probability of developing a condition over the course of a lifetime.

In this study, we estimated that 40% of adults will develop symptomatic hand OA in their lifetimes. Nearly one in two women (47%) and one in four men (25%) will develop the condition. Whites have a 41% lifetime risk, compared with 29% for blacks. The lifetime risk among individuals with obesity is 47%, which is 11 percentage points higher than those without obesity.

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Noisy Knees May Indicate Risk of Osteoarthritis

MedicalResearch.com Interview with:

Grace H. Lo MD MSc Department of Medicine, Baylor College of Medicine Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey Medical Center, Houston, TX

Dr. Grace H. Lo

Grace H. Lo MD MSc
Department of Medicine, Baylor College of Medicine
Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety
Michael E. DeBakey Medical Center, Houston, TX

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Osteoarthritis is the most common form of arthritis. Many people who have signs of osteoarthritis on x-rays do not necessarily complain of pain. Presently, there are no known strategies for preventing the development of pain in this group of people.

This study suggests that if these people have noisy knees (otherwise known as “crepitus”), they are at higher risk for developing pain within the next year compared to the people who do not have noisy knees. Future studies that target people who have x-ray signs of osteoarthritis, who do not complain of pain, but do report noisy knees, hold the promise of identifying interventions that can prevent knee pain.

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Earlier Onset of Arthritis in More Recent Generations Linked to Obesity

MedicalResearch.com Interview with:

Elizabeth Badley PhD Professor Emeritus Dalla Lana School of Public Health, University of Toronto Director: The Arthritis Community Research and Evaluation Unit and Head, Division of Health Care and Outcomes Research Krembil Research Institute Toronto Western Hospital Toronto, Ontario

Dr. Elizabeth Badley

Elizabeth Badley PhD Professor Emeritus
Dalla Lana School of Public Health, University of Toronto
Director: The Arthritis Community Research and Evaluation Unit and
Head, Division of Health Care and Outcomes Research
Krembil Research Institute
Toronto Western Hospital
Toronto, Ontario 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The aging of the baby boomer population is focusing attention on the health experience of this sector of the population.  Arthritis is one of the most frequent chronic health problems in the population.  Our research question was to investigate whether the prevalence of arthritis differs between generations (also called birth cohorts) and what might be associated with any differences. Using data collected in a longitudinal Canadian population health survey between 1994 and 2011, we looked at 4 generations: the World War II generation born 1935-1944, older baby boomers born 1945-1954, younger baby boomers born 1955-64, and Generation X born 1965-1974.
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Musculoskeletal Symptoms May Mark Onset of Arthritis in Psoriasis Patients

MedicalResearch.com Interview with:

Lihi Eder MD PhD Rheumatologist, Women’s College Hospital Scientist, Women’s College Research Institute Assistant Professor of Medicine, University of Toronto Toronto, ON, Canada

Dr. Lihi Eder

Lihi Eder MD PhD
Rheumatologist, Women’s College Hospital
Scientist, Women’s College Research Institute
Assistant Professor of Medicine, University of Toronto
Toronto, ON, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There significant delays in the diagnosis of psoriatic arthritis (PsA) among patients with psoriasis. Many patients with psoriasis experience musculoskeletal symptoms. The majority of them do not have PsA, but other non-inflammatory conditions such as fibromyalgia or osteoarthritis.

In this study, we aimed to assess whether the presence and the degree of musculoskeletal symptoms in psoriasis patients predict the development of psoriatic arthritis. We analyzed a cohort of 410 psoriasis patients who were followed over a period of 9 years. These patients did not have arthritis at baseline. The patients were assessed annually by a rheumatologist for signs of PsA. A total of 57 patients developed psoriatic arthritis during the follow-up period.
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Weak Thigh Muscles Contribute to Knee Arthritis in Women

MedicalResearch.com Interview with:

Adam Culvenor, PT, PhD

Dr. Adam Culvenor

Adam Culvenor, PT, PhD
Research Fellow,Institute of Anatomy
Paracelsus Medizinische Privatuniversität
Strubergasse Salzburg, Austria

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Thigh muscle weakness, particularly of the knee extensors (quadriceps), is a common feature of people with knee osteoarthritis. Thigh muscle weakness could be a consequence of knee osteoarthritis, or precede knee osteoarthritis development. There is conflicting evidence regarding the role of thigh muscle weakness as a risk factor for incident knee osteoarthritis in both men and women. Thigh muscle specific strength is a measure of muscle quality incorporating both the capacity of the muscle to produce force as well as muscle structure (ie. size, cross-sectional area), and preliminary data suggests this may be a more relevant measure of strength in relation to knee osteoarthritis development.

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Intestinal E. coli Linked to Arthritis in Inflammatory Bowel Disease

MedicalResearch.com Interview with:

Randy Longman, M.D. / Ph.D. Assistant Professor of Medicine Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease Weill Cornell Medicine Division of Gastroenterology and Hepatology Joan and Sanford I. Weill Department of Medicine Department of Microbiology and Immunology New York, NY 10021

Dr. Randy Longman

Randy Longman, M.D. / Ph.D.
Assistant Professor of Medicine
Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease
Weill Cornell Medicine
Division of Gastroenterology and Hepatology
Joan and Sanford I. Weill Department of Medicine
Department of Microbiology and Immunology
New York, NY 10021 

MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Inflammatory bowel disease is not limited to intestinal inflammation.  Up to 1/3 of patients with active disease suffer from extra-intestinal manifestations.

The most common extra-intestinal manifestations in IBD is joint inflammation or spondyloarthritis.  Peripheral joint spondyloarthritis  carries a prevalence of 20% in Crohn’s Disease and 10% in Ulcerative Colitis, predominantly affecting joints of the lower limbs.  It has long been suggested that gut bacteria can drive this systemic joint inflammation, but microbial targets have not been characterized.

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45 Minutes of Exercise Per Week Maintains Function in Adults With Arthritis

MedicalResearch.com Interview with:

Dorothy D. Dunlop Ph.D. Professor of Medicine and Preventive Medicine Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine Center for Healthcare Studies Chicago, IL 60611

Dr. Dorothy Dunlop

Dorothy D. Dunlop Ph.D.
Professor of Medicine and Preventive Medicine
Northwestern University Feinberg School of Medicine
Institute for Public Health and Medicine
Center for Healthcare Studies
Chicago, IL 60611 

MedicalResearch.com: What is the background for this study?

 

  • We know is being active is good for health.
  • Good evidence supports the current federal guidelines of doing 150 minutes of moderate physical activity each week to prevent serious conditions such as heart disease
  • But only 1 in 10 older US adults with arthritis in their lower limb joints (e.g., knees) meet federal physical activity guidelines
  • Inadequate physical activity is a major public health concern because It can lead to poor function, which threatens a person’s ability to live independently.

These issues motivated our study to investigate the minimum time commitment needed to improve function (or sustain high function) for adults with lower joint osteoarthritis.

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Juvenile Arthritis: TNF Inhibitor Use Doesn’t Appear To Increase Malignancy Risk

MedicalResearch.com Interview with:

Timothy Beukelman, MD, MSCE Associate Professor of Pediatrics Division of Rheumatology and Division of Clinical Immunology & Rheumatology University of Alabama at Birmingham

Dr. Timothy Beukelman

Timothy Beukelman, MD, MSCE
Associate Professor of Pediatrics
Division of Rheumatology and
Division of Clinical Immunology & Rheumatology
University of Alabama at Birmingham

MedicalResearch.com: What is the background for this study?

Response: In 2009 the US FDA issued a boxed warning about malignancies reported in children treated with TNF inhibitors but their analysis did not account for a possible malignancy risk from other medications of from the Juvenile idiopathic arthritis (JIA) disease process itself.

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Non–TNF-Targeted Biologic Found Superior to Second Anti-TNF Drug to Treat Rheumatoid Arthritis in Patients With Insufficient Response to a First Anti-TNF Drug

MedicalResearch.com Interview with:
Jacques-Eric Gottenberg, MD, PhD Department of Rheumatology National Reference Center for Systemic Autoimmune Diseases Strasbourg University Hospital, Université de Strasbourg Strasbourg, FranceJacques-Eric Gottenberg, MD, PhD
Department of Rheumatology
National Reference Center for Systemic Autoimmune Diseases
Strasbourg University Hospital, Université de Strasbourg
Strasbourg, France

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is no recommendation for the choice of the second biologic in patients with rheumatoid arthritis and insufficient response to a first anti-TNF, which is a common situation in our daily practice (approximately one third of patients treated with anti-TNF). We therefore conducted the first randomized trial to date to investigate the best strategy in such a setting.

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Patients with Psoriatic Arthritis are at Increased Risk of Cardiovascular Disease

MedicalResearch.com Interview with:

Lihi Eder, MD, PhD Assistant Professor of Medicine, University of Toronto Scientist, Women’s College Research Institute,Room 6326 Women’s College Hospital Toronto, ON, Canada

Dr. Lihi Eder

Lihi Eder, MD, PhD
Assistant Professor of Medicine
University of Toronto
Scientist, Women’s College Research Institute,Room  6326
Women’s College Hospital
Toronto, ON, Canada 

MedicalResearch.com: What is the background for this study?

Dr. Eder: Psoriasis is a chronic immune-mediated skin disease affecting 2-3% of the general population. Psoriatic arthritis (PsA) affects 15-30% of patients with psoriasis. Until recently, only few studies assessed the risk of developing cardiovascular events in patients with PsA and while most studies found a higher cardiovascular risk in these patients, others reported cardiovascular rates that were similar to the general population.

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Osteoarthritis Raises Risk of Cardiovascular Death

MedicalResearch.com Interview with:

Nicola Veronese, MD University of Padova Department of Medicine (DIMED)-Geriatrics Section Padova, Italy

Dr. Nicola Veronese

Nicola Veronese, MD
University of Padova
Department of Medicine (DIMED)-Geriatrics Section
Padova, Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Veronese: Osteoarthritis (OA) is the most common rheumatic disease. Although an increasing research is showing that OA, particularly of lower limbs, is associated with an increased risk of cardiovascular diseases (CVD) the association with overall mortality seems to be less clear. Continue reading

Vitamin D Supplements Did Not Slow Knee Cartilage Loss in Osteoarthritis

MedicalResearch.com Interview with:

Changhai Ding, MBBS, MMED, MD Australian Research Council Future Fellow Associate Director (International), Menzies Institute for Medical Research Professor, University of Tasmania, Australia Honorary Professor, University of Sydney, Australia

Dr. Changhai Ding

Changhai Ding, MBBS, MMED, MD
Australian Research Council Future Fellow
Associate Director (International), Menzies Institute for Medical Research
Professor,  University of Tasmania, Australia
Honorary Professor, University of Sydney, Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Ding: Vitamin D can reduce bone turnover and cartilage degradation, thus potentially preventing the development and progression of knee osteoarthritis. Observational studies suggest that vitamin D supplementation is associated with benefits for knee osteoarthritis, but current evidence from clinical trials is contradictory.

We  conducted a randomised clinical trial in Hobart, Tasmania and Melbourne, Victoria in Australia. We randomly assigned 413 patients with symptomatic knee osteoarthritis and low 25-hydroxyvitamin D to receive monthly treatment with oral vitamin D3 (50,000 IU; n = 209) or an identical placebo (n = 204) for 2 years.

Of 413 enrolled participants (average age, 63 years; 50 percent women), 340 (82 percent) completed the study. Vitamin D supplementation significantly increased blood 25-hydroxyvitamin D levels over 2 years compared with placebo treatment; however, vitamin D supplementation, compared with placebo, did not result in significant differences in change in MRI-measured tibial cartilage volume or a measure of knee pain over 2 years. There were also no significant differences in change of tibiofemoral cartilage defects or change in tibiofemoral bone marrow lesions.

Post-hoc analyses indicated that vitamin D supplementation might improve knee physical function and reduce another measure of knee pain and increases in bone marrow lesion.

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Immunotherapy with IL-17 Blocker Secukinumab Improves Ankylosing Spondylitis

MedicalResearch.com Interview with:
Prof. dr. D.L.P. Baeten MD
Clinical Immunology and Rheumatology
Academic Medical Center
University of Amsterdam
Amsterdam, The Netherlands

Medical Research: What is the background for this study? What are the main findings?

Prof. Baeten: Ankylosing spondylitis is a debilitating rheumatic condition which affects young adults and with NSAIDS and TNF inhibitors as only therapeutic option. Over the last years, we generated evidence that IL-17 is an important inflammatory mediator in this condition. In the two studies reported here in the NEJM, we demonstrate that IL-17 inhibition with secukinumab has a very profound and long-lasting effect on signs and symptoms as well as inflammation in ankylosing spondylitis patients, even in those patients that failed a TNF blocker before.

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