Pharmacy Times

ARTHRITIS WATCH

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Arthritis Meds May Guard the Heart

Patients with rheumatoid arthritis (RA) who prolong the use of arthritis medications, such as methotrexate and glu-cocorticoids, may protect the heart, researchers reported recently in Arthritis Research & Therapy. The international study included >4300 patients with RA from 15 countries.

Among the findings, the researchers identified a correlation between the presence of manifestations of RA outside the joints, such as inflammation of blood vessels, and heart attack. Men also carried a higher risk for any cardiovascular occurrence. After the adjustment, however, the researchers found that extended exposure to particular antiarthritis agents, for example, methotrexate, significantly reduced the odds of cardiovascular death.

"The practical consequence of our work," said researcher Dr. Antonio Naranjo, MD, "is that in patients with rheumatoid arthritis, especially in the most severe cases, there has to be control of both the classic cardiovascular risk factors and the inflammatory activity of the disease."



Hip, Knee Replacements Continue to Rise

The incidence of arthritis is increasing, which means the number of total hip and knee replacements and their cost to the US medical system also rise, according to findings reported in Arthritis Care & Research (April 2008).

Using the Nationwide Inpatient Sample, the researchers identified joint replacement cases across the country and analyzed increases in surgeries and costs between 1997 and 2004. The findings showed that in 2004 approximately 431,485 primary knee replacements were performed?a 53% increase from 2000. Additionally, between 1997 and 2004, hospital costs for joint replacement increased faster than the rate of inflation.

The researchers concluded that the results indicate a need for public health education to lower the number of overweight individuals?a factor in osteoarthritis?and to deal with arthritis earlier and for clinicians to prepare for the "upcoming demand of surgical loads and its economic burden on government and private insurance systems."



Work Disability for RA Falls

Current estimates indicate that fewer individuals with rheumatoid arthritis (RA) are leaving work due to disability, compared with 20 years ago. The researchers developed their findings using the National Data Bank longitudinal study of RA.

The participants (N = 5384) completed surveys every 6 months between January 2002 and December 2005. The researchers found that early work cessation was 12% in 2003 and 9% in 2004 and 2005. The prevalence of work cessation because of arthritis was lower, about 6% per year, and dropped slightly over the 3 years. The researchers stated that one of the reasons was improvements in RA treatment. The study was reported in the April 2008 issue of Arthritis Care & Research.



Pine Bark Eases OA Pain

A new study found that pycnogenol, an antioxidant plant extract from the bark of a French maritime tree, reduces osteoarthritis (OA) symptoms by 56%.

For the study, 156 patients with knee OA took 100 mg of the extract or placebo daily for 3 months and were assessed using different tools. The participants were allowed to continue taking their choice of pain medication, provided that they recorded every tablet in a diary for later evaluation.

The pycnogenol group also had a 55% improvement in joint pain, reduced pain medication use by 58%, and reduced stiffness by 53%. The findings were reported in the April 2008 issue of Phytotherapy Research.



Are Psoriasis and Psoriatic Arthritis Related?

Researchers have found 7 common DNA variations that raise the risk of an individual?s developing psoriasis. One of the variations links the skin condition and psoriatic arthritis to other autoimmune disorders. Up to 30% of individuals with psoriasis may also develop psoriatic arthritis.

For the study, the researchers looked at common variations in the DNA genome called single nucleotide polymorphisms (SNPs). They scanned >300,000 SNPs in the genomes of 223 patients with psoriasis, including 91 patients who had psoriatic arthritis, and compared them with those found in 519 healthy control patients. The findings, reported in the April 4, 2008, issue of PLoS Genetics, showed that several of the DNA variations found on chromosome 4 were strongly associated with psoriatic arthritis. These same variations also were associated with psoriasis and had been linked to type 1 diabetes, rheumatoid arthritis, Graves disease, and celiac disease.