Pharmacy Times

Arthritis Watch


Smoking, Quitting Raise Problems for RA

Patients with rheumatoid arthritis (RA) who are heavy smokers seem to have more loss of muscle mass, compared with individuals who smoke less or not at all. The researchers also noted that the patients with RA are more likely to gain weight when they stop smoking, according to a study reported in Arthritis Research & Therapy (May 2008).

The study involved 392 patients (102 = male and 290 = women) who had RA for 4 to 18 years and were 63 years old on average. Of the participants, 69 were current smokers, 147 were former smokers, and 176 never smoked. The researchers found that current smokers had a significantly lower body mass and body fat, compared with former smokers and nonsmokers. Heavy smokers also had the lowest muscle mass values, compared with the other 2 groups. The findings also indicated that 50% of former smokers were obese, compared with 39% of nonsmokers and 30% of current smokers.

The researchers suggested that the findings be confirmed in a study that tracks the impact of smoking, over time.


Cod Oil Cuts Back NSAID Use

A small study found that taking 10 g of cod liver oil a day lowered the need for nonsteroidal anti-inflammatory drugs (NSAIDs) by 30%. The goal of the study was to find an alternative treatment after concerns about increased risk of side effects with NSAIDs, such as heart attacks and strokes, were raised.

For the study, published recently in Rheumatology, the patients were either given cod liver oil or placebo and after 12 weeks were asked to gradually cut back the use of NSAIDs. Nearly 60 patients completed the 9-month trial.

The results showed that 39% of the participants taking cod liver oil reduced their daily dose of NSAIDs, compared with 10% in the placebo group. The researchers noted that reduction in drug use was not linked with any worsening of pain or the disease.


Cane Takes Load Off Arthritic Knees

Older adults with knee arthritis may benefit from using a cane to reduce some of the weight on their knees, according to a study reported in Arthritis Care & Research (May 15, 2008).

The study included 40 men and women over age 50 with medial knee osteoarthritis. Researchers used a 6-camera motion analysis system to study each patient?s gait—both barefoot and wearing comfortable shoes. Of the patients, 20 also had their gait assessed while using a cane on the opposite side of the painful knee. The researchers found that when the 20 patients used a cane, it reduced the force on the inner side of the knee joint with each step, and that walking shoes put additional stress on the joint, compared with walking barefoot.


Breast-feeding Reduces RA Risk

A European study found that women who breast-fed their babies for 13 months or longer were half as likely to get rheumatoid arthritis (RA).

The findings were based on a comparison of 136 women with RA and 544 women of similar age without the condition. The researchers also found that breast-feeding for up to 12 months made women 25% less prone to having RA.

The study results, reported in Annals of the Rheumatic Diseases (May 2008), support previous research connecting breast-feeding to a lower risk of the disease. As with other studies, however, the researchers could not determine the exact reason why.


Environmental Factors May Cause Arthritis

Researchers have found that environmental factors are linked with the onset of inflammatory arthritis in patients with psoriasis. Psoriatic arthritis is "inflammatory arthritis on a background of preexisting or future development of psoriasis," wrote researchers in the May 2008 issue of the Annals of Rheumatic Diseases. For the study, the investigators compared 98 patients who developed inflammatory arthritis within the past 5 years with a control group of 163 patients with psoriasis but not arthritis. The results showed that exposures before the onset of arthritis that positively correlated with the condition included trauma requiring medical care (14.9% for patients with psoriatic arthritis vs 7.9% of controls) and recurrent oral ulcers (25.3% vs 8.9%).

Patients with psoriatic arthritis also were more pone to have had a bone fracture that required hospital admission, compared with the control group (50% vs 9%).

F A S T   F A C T: As the US population ages, the number of individuals who have physician-diagnosed arthritis is projected to increase to 67 million by 2030.