Author Interviews, Baylor College of Medicine Houston, Merck, Rheumatology / 07.05.2017

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 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. (more…)
Author Interviews, Rheumatology, Weight Research / 27.03.2017

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  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. (more…)
Author Interviews, Dermatology, Rheumatology / 01.03.2017

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 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. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Rheumatology / 14.02.2017

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Gastrointestinal Disease, Infections, Microbiome, Rheumatology, Science / 11.02.2017

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  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. (more…)
Author Interviews, Exercise - Fitness, Rheumatology / 10.01.2017

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  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. (more…)
Author Interviews, Cancer Research, Immunotherapy, Pediatrics, Rheumatology / 16.11.2016

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 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. (more…)
Author Interviews, JAMA, Pharmacology, Rheumatology / 23.09.2016

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. (more…)
Author Interviews, Dermatology, Heart Disease, Rheumatology / 04.05.2016

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  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. (more…)
Author Interviews, Heart Disease, Rheumatology / 22.04.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, JAMA, Rheumatology, Vitamin D / 10.03.2016

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 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. (more…)
Author Interviews, Immunotherapy, NEJM, Rheumatology / 24.12.2015

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. (more…)
Author Interviews, Rheumatology, UCSF, Weight Research / 07.12.2015

MedicalResearch.com Interview with: Alexandra S. Gersing, MD Department of Radiology and Biomedical Imaging University of California, San Francisco Medical Research: What is the background for this study? What are the main findings? Dr. Gersing:  This study is part of a larger NIH-funded project focusing on the effects of weight change in individuals at risk for and with osteoarthritis. Our group has previously shown that weight gain causes substantial worsening of knee joint degeneration in patients with risk factors for osteoarthritis and now we aimed to show that weight loss could protect the knee joint from degeneration and osteoarthritis. Osteoarthritis is one of the major causes of pain and disability worldwide; and cartilage plays a central role in the development of joint degeneration. Since cartilage loss is irreversible, we wanted to assess whether lifestyle interventions, such as weight loss, could make a difference at a very early, potentially reversible stage of cartilage degradation and whether a certain amount of weight loss is more beneficial to prevent cartilage deterioration. To measure these early changes we used a novel Magnetic Resonance Imaging (MRI) technique, called T2 mapping, which allows us to evaluate biochemical cartilage degradation in the patient on a molecular level. The most relevant finding of this study is that patients with more that 10% of weight loss benefited significantly more from losing weight compared to the obese controls that did not lose weight or only lost little weight. (more…)
Author Interviews, Biomarkers, Rheumatology / 13.11.2015

MedicalResearch.com Interview with: Ron Rogers Executive Vice President, Corporate Communications Spokesman, Myriad Genetics, Inc. Salt Lake City, Utah 84108 Medical Research: What is the background for the MBDA test? What types of biomarkers are included in the score? Response: Vectra DA is an advanced blood test for adults with rheumatoid arthritis (RA). It helps you and your doctor better understand your rheumatoid arthritis disease activity.  Vectra DA blood test for RA gives physicians a more complete look at your disease activity by measuring 12 markers of RA disease activity. Some other tests, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR or “sed rate”), only measure one marker. Vectra DA test scores can help track your disease activity over time with an objective measure that complements your doctor’s exam and your own assessment.  Patients with high Vectra DA scores have 7-fold higher risk for rheumatoid arthritis-related joint damage than patients with low or moderate Vectra DA scores. You can learn more about the specific biomarkers at: http://vectrada.com/health-care-professionals/biomarkers/ (more…)
Author Interviews, Exercise - Fitness, Rheumatology / 06.10.2015

Anja Bye, PhD, Senior Researcher Cardiac Exercise Research Group (CERG) K.G. Jebsen Center of Exercise in Medicine National Council of Cardiovascular Disease Department of Circulation and Medical Imaging Medical Faculty Norwegian University of Science and TechnologyMedicalResearch.com Interview with: Anja Bye, PhD, Senior Researcher Cardiac Exercise Research Group (CERG) K.G. Jebsen Center of Exercise in Medicine National Council of Cardiovascular Disease Department of Circulation and Medical Imaging Medical Faculty Norwegian University of Science and Technology Medical Research: What is the background for this study? What are the main findings? Dr. Bye: The background was that we know that this type of training is superior to exercise at lower intensities in cardiovascular risk reduction in several patients groups. As it was not tested in patients with rheumatic disease, we set out to determine if this type of exercise would be tolerated in these patients, and of they would experience the same benefits on the cardiovascular system as other patients groups, and healthy young and elderly individuals. Hence the main goal was not to treat the rheumatic disease, but to study whether the exercise training would be tolerated, as we assumed they would have equal benefits from this type of exercise as everyone else. I think the most interesting findings were that all of the participants were capable of participating in this type of high-intensity exercise program, without reporting any negative side-effects. Of course the great increase in VO2max, and  the trend towards a reduction in the inflammation after the exercise intervention was very interesting. (more…)
Author Interviews, Genetic Research, Heart Disease, PNAS, Rheumatology / 27.07.2015

MedicalResearch.com Interview with: Philippe Bouillet, PhD Walter and Eliza Hall Institute Parkville, Vic Australia Medical Research: What is the background for this study? What are the main findings? Dr. Bouillet: This study was initiated when we discovered mice that developed rheumatoid arthritis as a result of what was obviously a spontaneous dominant genetic mutation. Using several approaches, we identified the mutation as the insertion of a mobile genetic element called retrotransposon into the regulatory sequences of the gene encoding tumor necrosis factor (TNF). The mutation caused excessive amounts of TNF to be produced, a known cause of rheumatoid arthritis. The surprise came when some mice with the mutation died prematurely and suddenly with from heart disease. We showed that excess TNF also led to inflammation of the aortic and mitral valves, causing aortic regurgitation. Depending on the genetic background of the mice, the disease could also culminate in aortic aneurysm and death. We also investigated the regulatory region of the TNF gene and identified novel regulators and a new genetic element that normally make sure that levels of serum TNF are kept within reasonable limits, high enough to ensure its numerous physiological functions, low enough to prevent its harmful effects such as those described here. (more…)
Author Interviews, BMJ, Pain Research, Rheumatology / 03.04.2015

Gustavo C Machado, PhD student The George Institute for Global Health, Sydney Medical School University of Sydney Sydney AustraliaMedicalResearch.com Interview with: Gustavo C Machado, PhD student The George Institute for Global Health, Sydney Medical School University of Sydney Sydney Australia (Editor’s note: Paracetamol isalso known as acetaminophen) MedicalResearch: What is the background for this study? What are the main findings? Response: Back pain and osteoarthritis are the two major musculoskeletal conditions affecting people worldwide, and paracetamol is the most used over the counter medicine to treat these conditions. Recent debates on the efficacy and safety of paracetamol prompted us to conduct a systematic review of literature on the efficacy of this medication. In our study we included all available clinical trials that compared paracetamol to placebo, and our conclusions are based on data from more than 5,300 patients with low back pain and hip or knee osteoarthritis. We found that paracetamol is ineffective for low back pain and provides small and not clinically important benefits to patients with osteoarthritis. (more…)
Author Interviews, Rheumatology / 01.04.2015

Adam Culvenor Ι B.Physio(Hons), PhD Division of Physiotherapy School of Health & Rehabilitation Sciences The University of QueenslandMedicalResearch.com Interview with: Adam Culvenor Ι B.Physio(Hons), PhD Division of Physiotherapy School of Health & Rehabilitation Sciences The University of Queensland Medical Research: What is the background for this study? Dr. Culvenor: Knee injury, such as anterior cruciate ligament (ACL) rupture, is a well-recognised risk factor for the accelerated development of knee osteoarthritis (OA). Previous studies report high rates of knee osteoarthritis with radiographs (x-rays) more than 5-10 years following ACL injury and reconstruction (ACLR). However, once OA becomes well-established and visible on radiographs, management options are limited. Potential therapies may be better placed to target the early stages of disease when management strategies, such as optimising knee load, may be more efficacious. Magnetic resonance imaging (MRI) enables the assessment of early osteoarthritis features affecting any joint tissue. Yet, MRI has not previously been used to assess early knee OA within the first year following ACLR. Medical Research: What are the main findings? Dr. Culvenor: Of the 111 patients who were one year following an anterior cruciate ligament  rupture, the prevalence of early knee OA assessed with MRI was much higher than previously recognised. Medial and lateral tibiofemoral osteoarthritis was observed in 6% and 11%, respectively, while 17% had patellofemoral OA. These patterns of early OA are similar to previous radiographic findings; the patellofemoral joint is at particular risk of OA. Specifically, the femoral trochlea was the region most affected by bone marrow lesions, cartilage lesions and osteophytes. The prevalence of structural pathology was much higher than the uninjured control group of similar age and activity level, highlighting the impact of knee trauma (injury and/or surgery). (more…)
Author Interviews, Biomarkers, Rheumatology / 24.03.2015

Dr Naila Rabbani Reader of Experimental Systems Biology Protein Damage and Systems Biology Research Group, Division of Metabolic & Vascular Health, Warwick Medical School, University of Warwick, Clinical Sciences Research Laboratories, University Hospital U.K.MedicalResearch.com Interview with: Dr Naila Rabbani Reader of Experimental Systems Biology Protein Damage and Systems Biology Research Group, Division of Metabolic & Vascular Health, Warwick Medical School, University of Warwick, Clinical Sciences Research Laboratories, University Hospital  U.K. Medical Research: What is the background for this study? What are the main findings? Dr Rabbani: We performed a study to investigate biochemical markers indicative of early-stage decline in joint health and development of early-stage osteoarthritis OA), rheumatoid arthritis (RA) and other inflammatory joint disease. The main finding was that by combining measures of three substances in blood - citrullinated protein (CPs), antibodies to CPs and hydroxyproline we could detect and discriminate between early-stage osteoarthritis and rheumatoid arthritis. (more…)
Author Interviews, Genetic Research, Nature, Rheumatology / 06.02.2015

psoriasis_kneesMedicalResearch.com Interview with: Professor Anne Barton FRCP PhD and Dr John Bowes PhD Centre for Musculoskeletal Research and Centre for Genetics and Genomics, The University of Manchester, Manchester UK Medical Research: What is the background for this study? Response: Psoriatic arthritis (PsA) is an inflammatory condition causing pain and stiffness in joints and tendons. Approximately one third of patients with psoriasis will go on to develop PsA resulting in a reduction in their quality of life caused by increasing disability and additional health complications. A key area of research within the Arthritis Research UK Centre for Genetics and Genomics in the Centre for Musculoskeletal Research is the identification of risk factors for the development of Psoriatic arthritis; this will allow us to understand the underlying cause of disease and ultimately help identify psoriasis patients at high risk of PsA, allowing early treatment to be introduced to reduce the impact of PsA. Our study focuses on the identification of genetic risk factors for Psoriatic arthritis; we compared the frequency of genetic variants, referred to as single nucleotide polymorphisms (SNPs), between large numbers of DNA samples from patients with PsA and healthy control samples. When the frequency of the SNP is significantly different between cases and controls, the SNP is said to be associated with risk of developing Psoriatic arthritis and this association is interpreted as being important in the disease process. Medical Research: What are the main findings? Response: When we analysed the data from the study we found a new association to SNPs on chromosome 5, and when we investigated these SNPs for association with skin-only psoriasis, we did not find any evidence for association. In addition, we also found SNPs that were specifically associated with Psoriatic arthritis at a gene on chromosome 1. This gene is known to be associated with psoriasis, but our results show that there are different SNPs associated with PsA and psoriasis at this gene. Hence, our results identify new SNPs that are specifically associated with PsA. In addition, identifying which cells are the key drivers of inflammation in Psoriatic arthritis will help us to focus on how the genetic changes act in those cells to cause disease. Our results show that many of the PsA associated SNPs occur in regions of the genome that are important in the function of CD8+ cells,  an important cell type in the immune system. (more…)
Author Interviews, Rheumatology / 02.02.2015

A/Prof Rana Hinman PhD Australian Research Council Future Fellow Centre for Health Exercise & Sports Medicine Department of Physiotherapy School of Health Sciences The University of Melbourne, Carlton, Victoria, AustraliaMedicalResearch.com Interview with: A/Prof Rana Hinman PhD Australian Research Council Future Fellow Centre for Health Exercise & Sports Medicine Department of Physiotherapy School of Health Sciences The University of Melbourne,  Carlton, Victoria, Australia Medical Research: What is the background for this study? Response: It has been well established that hip and knee osteoarthritis (OA) is a major causes of musculoskeletal disease burden worldwide. There is currently no cure and joint replacement is typically reserved for advanced disease. Non-operative management strategies are the mainstay of osteoarthritis treatment. Clinical guidelines recommend the use of aerobic and/or resistance exercises, hydrotherapy and weight loss for those who are overweight for people with hip or knee osteoarthritis. Little is known about how often these treatments are used, and whether treatment use differs for those with hip osteoarthritis compared to those with knee osteoarthritis. Medical Research: What are the main findings? Response: The use of non-drug non-operative interventions was generally low amongst the entire cohort of people with hip or knee osteoarthritis. Although half reported making efforts to lose weight, very few were undertaking muscle strengthening, hydrotherapy or aerobic exercises, all of which are strategies most strongly endorsed by international guidelines. 12% of the cohort had never used any of the interventions listed in our survey. Interestingly, use of five treatments was significantly higher among people with knee osteoarthritis than those with hip osteoarthritis, suggesting people with knee osteoarthritis may be more likely to try non-drug non-operative treatments than those with hip osteoarthritis, however there is no clear explanation for this. (more…)
Author Interviews, Rheumatology, Statins / 12.01.2015

Dr Geeske Peeters Postdoctoral Research Fellow School of Public Health The University of Queensland AustraliaMedicalResearch.com Interview with: Dr Geeske Peeters Postdoctoral Research Fellow School of Public Health The University of Queensland Australia Medical Research: What is the background for this study? What are the main findings? Dr. Peeters: The hypothesis we set out to investigate was that statin use is associated with reduced joint pain/stiffness and consequently improved physical functioning and quality of life. This hypothesis was based on findings from previous studies suggesting that statin use may prevent the development of radiographic osteoarthritis. However, in contrast with this hypothesis, results from this large study did not demonstrate an association between statin use and reduced onset of joint pain or stiffness. Moreover, statin use did seem to be associated with an increased risk of functional limitations and poorer self-reported health, especially in the middle-aged women. (more…)
Baylor College of Medicine Houston, Rheumatology / 20.11.2014

Dr. Grace Hsiao-Wei Lo Baylor College of Medicine Assistant Professor, Section of Immunology, Allergy and Rheumatology, Department of Medicine, Baylor College of Medicine Faculty, Immunology, Allergy, and Rheumatology Section, Michael E. DeBakey VA Medical CenterMedicalResearch.com Interview with: Dr. Grace Hsiao-Wei Lo Baylor College of Medicine Assistant Professor, Section of Immunology, Allergy and Rheumatology,  Department of Medicine, Baylor College of Medicine Faculty, Immunology, Allergy, and Rheumatology Section, Michael E. DeBakey VA Medical Center Medical Research:What is the background for this study? What are the main findings? Dr. Hsiao-Wei Lo: Controversy exists regarding whether running is harmful versus beneficial to the knee.  There is concern that chronic repetitive loading of the knee could physically damage structures within the knee.  Alternatively, runners have a lower body mass index, which we know is protective of knee osteoarthritis.  Limitations of prior studies evaluating the relationship between running and osteoarthritis include that they have been small studies and they have focused on those participating in a high level or an elite level of running which may not be very generalizable.  Addressing the question of whether running is associated with osteoarthritis is of particular relevance given that recent CDC guidelines recommend that all adults participate in regular physical activity, as there is definitive evidence that increased physical activity is associated with reduced cardiovascular events and mortality. To address this question, we used data from a multicenter observational study, the Osteoarthritis Initiative (OAI). Of 2,683 participants, 56 percent were female, the mean age was 64.5 and the mean BMI was 28.6.  Twenty-nine percent of the participants reported that they ran at some time in their lives. Patients had knee X-rays, were given symptom assessments, and were asked to complete the Lifetime Physical Activity Questionnaire (LPAQ), identifying the top three most frequently performed physical activities (≥ 10 times in life) they performed at different age ranges throughout their life. Age ranges included 12-18, 19-34, 35-49, and 50 years or older. Knee X-rays were taken and then scored for evidence of radiographic OA using the Kellgren-Lawrence (KL) grade scale. Participants with KL grades of two or higher were considered as having radiographic OA (ROA). The researchers also measured if participants had frequent knee pain. Researchers considered a participant to have symptomatic OA (SOA) if they had at least one knee with both ROA and frequent knee pain. Anyone with a total knee replacement was classified as having frequent knee pain, ROA and SOA. After collecting all the data, the researchers reported that runners, regardless of the age when they ran, had a lower prevalence of knee pain, ROA and SOA than non-runners. For people who had run at any time in their lives, 22.8 percent had SOA compared to 29.8 percent of non-runners. People with the lowest BMI scores were the most likely to report being habitual runners. Regular running, even at a non-elite level, not only does not increase the risk of developing knee osteoarthritis but may protect against it, the researchers concluded.  (more…)
Antibiotic Resistance, Author Interviews, Pharmacology, Rheumatology / 19.11.2014

MedicalResearch.com Interview with: Dr. Daniel B Horton, MD Division of Pediatric Rheumatology Department of Pediatrics Nemours Dupont Pediatrics Wilmington, Delaware
Medical Research: What is the background for this study? What are the main findings? Dr. Horton: The reasons why children develop juvenile arthritis (JIA) are unclear. To date, genetic variation accounts for only a minority of disease incidence, and no environmental factor has consistently been associated with juvenile arthritis. There is growing understanding about the role of microbiome disturbance in the development of multiple diseases, including obesity, inflammatory bowel disease, and rheumatoid arthritis. Exposure to antibiotics, a known disruptor of the human microbiome, has been linked to pediatric conditions including inflammatory bowel disease, asthma, and obesity. We showed that antibiotic prescriptions are associated with the development of new JIA diagnosis in a large general pediatric population, after accounting for history of infection and other relevant factors. This association is stronger for those who have received multiple courses of antibiotics and appears specific for antibacterial antibiotics, such as penicillins and sulfa drugs. (more…)
Author Interviews, Orthopedics, Pediatrics, Rheumatology / 06.11.2014

Professor Flavia Cicuttin School of Public Health and Preventive Medicine Monash University and Alfred Hospital Melbourne, AustraliaMedicalResearch.com Interview with: Professor Flavia Cicuttin School of Public Health and Preventive Medicine Monash University and Alfred Hospital Melbourne, Australia Medical Research: What is the background for this study? What are the main findings? Prof. Cicuttin: Previous research found that low birth weight and preterm birth have been linked to hypertension, cardiovascular disease, insulin resistance and reduced bone mass in adulthood.  Given these adverse outcomes related to birth weight and preterm birth we set out to investigate if low birth weight and preterm birth also played a role in increase risk of joint replacement surgery as adults. We found that  low birth weight and preterm birth were associated with a 2-fold increased risk of hip but not knee replacement surgery. (more…)
Author Interviews, Rheumatology / 19.07.2014

Ling Zhao Ph. D. Associate Professor College of Acupuncture-Tuina, Shanghai University of Traditional Chinese Medicine, ChinaMedicalResearch.com Interview with: Ling Zhao Ph. D. Associate Professor College of Acupuncture-Tuina, Shanghai University of Traditional Chinese Medicine, China Medical Research: What are the main findings of the study? Dr. Zhao: In our study, we found that a 6-week course of moxibustion treatment (i.e., a modality of traditional acupuncture using burning moxa to warm and stimulate the acupoint) significantly reduced pain and improved function in patients with knee osteoarthritis compared to a credible placebo control. Our findings suggest that this ancient modality might be a useful adjunctive treatment for knee osteoarthritis. We also found that our sham device is credible for a double-blind randomized clinical trial assessing this traditional treatment modality. (more…)
Author Interviews, NEJM, Rheumatology / 21.06.2014

Bethanie Wilkinson, Ph.D. Pfizer 445 Eastern Point Rd. Groton, CT 06340MedicalResearch.com Interview with Bethanie Wilkinson, Ph.D. Pfizer 445 Eastern Point Rd. Groton, CT 06340   MedicalResearch: What are the main findings of the study? Dr. Wilkinson: ORAL Start showed that XELJANZ (tofacitinib citrate) 5 and 10 mg twice daily (BID), taken by itself without methotrexate (MX), inhibited the progression of structural damage and reduced the signs and symptoms of rheumatoid arthritis (RA), and was statistically significantly superior to methotrexate on these measures at Month 6 (primary endpoint) and at all measured time points up to 24 months in patients with rheumatoid arthritis who had not previously received methotrexate or therapeutic doses of methotrexate.  XELJANZ is not indicated in patients who had not previously received methotrexate.
  •  Both doses of XELJANZ met the study’s co-primary efficacy endpoints of mean change from baseline in van der Heijde modified Total Sharp Score (mtss) [0.18 and 0.04 (both P<0.001) for tofacitinib 5 and 10 mg BID, respectively, versus 0.84 for MTX], and ACR70 response rates [25.5% and 37.7% for tofacitinib 5 and 10 mg BID (both P<0.001) versus 12.0% for MTX], at Month 6.
  • These results were sustained at all measured time points up to 24 months.
(more…)
Author Interviews, BMJ, Karolinski Institute, Rheumatology / 06.06.2014

MedicalResearch.com Interview with: Karen Hambardzumyan Research Assistant Karolinska Institute Department of Medicine, (ClinTRID) D1:00, Karolinska University Hospital Solna Stockholm MedicalResearch: What are the main findings of the study? Answer: One of the difficulties with rheumatoid arthritis (RA) treatment is unpredictable treatment outcome at the individual patient level. The course might be mild or severe independently of the therapy. To identify subgroups of patients who will benefit from specific therapy strategies is one of the goals for today’s rheumatologists. We have investigated a Multi-Biomarker Disease Activity (MBDA) score in patients from the Swedish Farmacotherapy (SWEFOT) clinical trial, where early rheumatoid arthritis patients were included/studied. The main finding was the usefulness of the MBDA score for prediction of those patients who will not get joint damage detected by X-rays (radiographic progression) during one year follow-up. This MBDA score, developed by Crescendo Bioscience (South San-Francisco, CA, USA) is based on serum levels of 12 different protein biomarkers and can categorize patients into 3 groups: patients with low, moderate and high disease activity. Ninety-seven percent of patients who had low or moderate MBDA score before treatment onset, did not experience radiographic progression during one year follow-up. This finding could contribute to a personalised approach to the RA patients for the optimal therapy choice. (more…)
Author Interviews, Exercise - Fitness, General Medicine, JAMA, Rheumatology / 21.05.2014

Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 AustraliaMedicalResearch.com Interview Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 Australia MedicalResearch: What are the main findings of the study? Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment.  (more…)
Author Interviews, Rheumatology / 02.11.2013

Dr. Laura Coates Division of Rheumatic and Musculoskeletal Disease Chapel Allerton Hospital Chapeltown Road Leeds NIHR Clinical Lecturer at the University of LeedsMedicalResearch.com Interview with: Dr. Laura Coates Division of Rheumatic and Musculoskeletal Disease Chapel Allerton Hospital Chapeltown Road Leeds NIHR Clinical Lecturer at the University of Leeds
MedicalResearch.com: What are the main findings of the study? Answer: The TICOPA study showed that treating patients with early psoriatic arthritis to an objective target with regular review improved patient's clinical outcome both in terms of arthritis and skin psoriasis.  There was an increase in adverse events in the tight control arm but only 4 serious infections seen in the tight control arm that were thought to be related to treatment (2 cases of cellulitis, 2 cases of chest infection). (more…)