Pharmacy Times

ARTHRITIS WATCH


Gender Could Be a Key Predictor of RA Remission

Women with rheumatoid arthritis (RA) have a lower chance of remission than men, according to research published in the January 2007 edition of the Annals of the Rheumatic Diseases. The Swedish study involved about 700 adults, average age 58 years, who had been recently diagnosed with RA. Two thirds of the participants were women, and they tended to be younger than the men. After 2 years, the RA had gone into remission in <4 of 10 participants; the results were similar after 5 years. Only about 1 in 5 were in remission at both time points, however.

The researchers noted that, at 2 years, only one third of the women were in remission, compared with half of the men. At 5 years, the gap grew slightly; less than 31% of the women were in remission, compared with 52% of the men. At both time points, men were twice as likely to be in remission as women. Women with RA did not have more severe disease states than the men at study start; however, as the study progressed, the women's condition deteriorated faster than the men's.

Older Athletes'Bones Strengthen with Impact Sports

Older athletes who take part in running, basketball, and other high-impact sports may have stronger bones as a result, according to the results of a study at the University of Pittsburgh Medical Center. Bone mineral density (BMD) measurements for those who participated in impact sports were significantly higher than those who took part in low-impact sports, such as swimming and cycling. The results of the study were presented in February 2007 at the 74th Annual Meeting of the American Academy of Orthopaedic Surgeons in San Diego, Calif.

The study looked at 298 athletes who competed in the 2005 Senior Olympic Games in Pittsburgh, Pa. The athletes, aged 50 to 93 years, completed a health-history questionnaire and underwent ultrasound to measure BMD. Those who took part in high-impact sports scored noticeably higher on BMD T-scores than those who did not, even after factoring in age, sex, obesity, and osteoporosis medication.

"The costs associated with caring for people with osteoporosis and fractures caused by frail bones are rising as the population ages. Our study implies that persistent participation in impact sports can positively influence bone health even in the oldest athletes," concluded the researchers.

Low-dose Steroids Can Reduce RA Damage

According to a new review of evidence by researchers at the Liverpool Women's Hospital in England, low doses of steroids can inhibit joint damage when used in the early phases of rheumatoid arthritis (RA). The evidence supports the combining of steroids with standard medications for RA in the first 2 years after initial diagnosis. The steroids studied in the review were glucocorticoids and included the antiinflammatory prednisone, usually prescribed in the early months after RA diagnosis to relieve the discomfort of the disease until slower-acting medications begin to protect the joints. The review appeared recently in The Cochrane Library.

The systematic review involved 15 studies that included a total of 1414 patients. Most studies involved the patients receiving low doses of glucocorticoid pills along with disease- modifying medicines for 1 to 2 years. Periodic x-rays were taken throughout the study to monitor the extent of joint erosion and other damage. All the studies but one showed reduced progression of joint damage in those patients taking the steroids.

Heavy Patients with Knee OA Need Not Fear Exercise

Overweight patients who have osteoarthritis (OA) of the knee and choose to take on regular exercise programs are encouraged to keep up with them. Some fear that the exercise may aggravate their OA, but recent studies have shown that exercise has no noticeable negative effect on knee OA in overweight patients.

One study from the Boston University School of Medicine looked at 1279 participants from the Framingham Offspring cohort who were questioned about recent regular physical activity and knee pain, and then received x-rays of their knees about 1 to 2 years later. About 10 years later, they were summoned for a follow-up, which included similar x-rays and questions. An analysis of the results showed no relationship between self-reported activity and the development or progression of knee OA. Although the overweight patients did have an increased risk of developing OA, their physical activity did not add to this risk.

Another study at Erasmus Medical Center, Rotterdam, Netherlands, was an overview of 37 studies that determined the predictive factors of the progression of knee OA. Researchers found 3 studies that showed no strong evidence to link regular exercise with the progression of knee OA. Both studies appeared in the February 2007 issue of Arthritis Care & Research.