Pharmacy Times

ARTHRITIS WATCH


Better Educated Patients More Likely to Choose Surgery

Canadian researchers have found that arthritis patients with higher levels of education are more open to having surgery that involves hip or knee joint replacement, compared with their lesser- educated counterparts. Income and gender did not play a role in the findings, which appear in the October 2006 issue of Arthritis & Rheumatism. The researchers believe that these findings emphasize the need for community-based education about arthritis treatments, including total joint arthroplasty (TJA).

The study included >2100 people aged 55 and older with disabling osteoarthritis (OA). At the beginning of the study, 48% of the patients had seen a physician for hip and/or knee problems in the past year. Twenty percent said that they were willing to have TJA.

After 7 years, almost 24% of the patients had undergone at least one TJA procedure; the rates were almost the same for both rural and urban patients (11.8% vs 12.1%).

The study found a significant relationship between higher education and those who had TJA. It also found that, among patients with similar levels of OA severity, TJA was nearly 4 times more common among those willing to consider the benefits of the surgery, compared with those who were unwilling or unsure about TJA.

New Family Link to RA Found

New research shows that women who have brothers who are affected by rheumatoid arthritis (RA) are more likely to develop the disease themselves. The finding adds to the growing evidence that genetics plays an important part in the progress of the autoimmune disorder, according to researchers. The findings were published in the October 2006 issue of Arthritis & Rheumatism.

Researchers at the University of California, San Francisco, looked at data from 1004 affected members of 467 families in which 2 or more siblings had RA. They compared features of the disease in both men and women. They found that women whose brothers were affected with RA were more likely to have high levels of an antibody associated with the disease. According to researchers, this information could be helpful in predicting the course of the disease.

These women, along with their affected brothers, also were more likely to have a gene called HLA-DRB1, a subtype of the genetic marker HLA-DR4, which is known to be associated with RA. Researchers hope that identifying genetic markers in families with a history of RA can help alert doctors and patients to determine who is at greater risk and how to treat them.

Got a BlackBerry Thumb?

According to the American Physical Therapy Association (APTA), many Americans now have a new workplace ailment—"BlackBerry Thumb." The term, coined from a popular brand of personal digital assistant (PDA), refers to a surprisingly common repetitive-stress injury that comes from overuse of handheld electronic devices. Too much time spent checking and composing e-mails, instant messaging, and accessing the Internet with PDAs can cause pain and/or numbness in the thumbs and joint of the hands.

Margo Miller, president of the APTA's Occupational Health Special Interest Group, says that "more and more, people are depending on [PDAs] to stay in touch with friends and family before and after the workday and on the weekends, as well as having access to work when they leave the office; that is where the heart of the problem lies." Most people who use PDAs are middleaged, and overuse can aggravate underlying arthritis. Problems also can develop into tendinitis or even osteoarthritis. The APTA suggests taking frequent breaks from the PDA, not typing for a few minutes at a time, supporting one's arms while using the PDA, and doing stretching exercises for the fingers and hands often.

Cancer Drug May Alleviate RA

The cancer drug Gleevec (imatinib mesylate), more commonly used to treat leukemia and other cancers, has been shown to help relieve the symptoms of rheumatoid arthritis (RA) in patients who suffer from both ailments. Researchers at Stanford University screened drugs that might help the estimated 50% of RA patients who do not respond to current therapies. They noted that there had been case reports of cancer patients being treated with Gleevec who also reported improvement in their RA symptoms while taking the drug. They tested Gleevec on cells taken from the joints of patients with RA and found that the drug shut down the cells' production of tumor necrosis factoralpha, a messenger molecule that drives RA-associated inflammation. The drug also halted the proliferation of fibroblasts, the cells that cause tumor-like growth in joint linings.

The researchers stated that, because many RA drugs are administered by injection, there has been a "tremendous need" for a therapeutic option in pill form. They suggest that doses of Gleevec lower than those used in cancer treatment would benefit RA patients while causing few side effects. The findings of their research were published in the October 2006 issue of the Journal of Clinical Investigation.