ARTHRITIS WATCH

Published Online: Friday, February 1, 2008

Arthritis Could Increase Risk of Gout

A study reported in the October 2007 issue of the Annals of the Rheumatic Diseases stated that arthritis could trigger the deposit of uric acid crystals in joints, which causes gout. A number of case reports and hospital-based case series have linked gout with the presence of arthritis in the same joints, according to researchers from the University of Nottingham in the United Kingdom.

The researchers sent out questionnaires to all patients aged 30 years and older served by 2 general practices in Nottingham. The questionnaire assessed a history of gout (physician-diagnosed or episodes suggestive of the disease) and medication use for each patient.

The patients who showed the possibility of gout attended a clinical assessment to verify the diagnosis and assess the distribution of joints affected by acute attacks of gout and arthritis. A total of 4249 completed questionnaires were returned, and, from these, 359 patients came to the clinic for gout assessment. From that population, 164 cases of gout were clinically confirmed. A highly significant association was seen between the site of acute attacks of gout and the presence of arthritis.


Knee Buckling Not Always Arthritis-based

Many middle-aged and older adults experience an occasional instance of their knees "going out" or "giving way" when they walk or climb stairs. A recent study assured these individuals, however, that this is not necessarily an indication of arthritis.

Researchers from the Boston University School of Medicine interviewed 2351 men and women aged 36 to 94 years and asked them whether they had experienced knee buckling or "giving way" and whether it led to falling. They were also asked about knee pain and limitations in function. The participants were tested for the presence of arthritis in the knee as well.

Of all the questioned participants, 278 experienced at least 1 episode of knee buckling within the past 3 months; of these, 217 experienced >1 episode and 35 fell during an episode. The researchers noted that the incidence of buckling was not related to the presence of knee arthritis—over half of those with buckling had no signs of arthritis on radiography testing. The findings were reported in the October 16, 2007, issue of the Annals of Internal Medicine.


Mortality Rates Still Higher for Patients with RA

Rheumatoid arthritis (RA) not only affects a patient's joints, but it takes a progressive toll on the heart, kidneys, and liver as well. The autoimmune inflammatory disease has long been associated with a high risk of early death, but less information has been available as to whether or not survival rates for patients with RA have improved over the past few years due to improvements in treatment and diagnoses.

Researchers at the Mayo Clinic studied mortality trends among patients with RA and compared them with trends among the general public during 5 time periods: 1955-1964; 1965-1974; 1975-1984; 1985-1994; and 1995-2000. During all 5 periods, there was no significant change in survival rates for patients with RA.

The investigators then confirmed their findings by calculating and comparing mortality rates using person-year methods. They found that between 1965 and 2000, while the mortality rates of the general populace tended to drop, the rates of patients with RA remained stable. The findings emphasized the urgent need to find methods that will work to lower the risk of excess mortality consistently associated with RA. The findings were reported in the November 2007 issue of Arthritis & Rheumatism.


Relief Is Golden: Gold Salts Used to Ease RA Symptoms

Mohandas (Mahatma) Gandhi is credited with the saying, "It is health that is real wealth and not pieces of gold and silver." Individuals who experience the pains of rheumatoid arthritis (RA) might soon be able to equate gold with health, as researchers are discovering the mysteries of the healing properties of gold, which, they say, could result in renewed interest in the use of gold salts for the treatment of RA and other inflammatory diseases.

Although in the early 1900s the use of gold salts to relieve RA pain came at the cost of delayed response and severe side effects, scientists are better understanding the mechanism of the element and how it works to reduce inflammation in the cells.

Researchers from Duke University Medical Center in Durham, North Carolina, studied the molecule HMBG1, which promotes inflammation, the main process underlying the development of RA. Higher amounts of the molecule exist around the synovial tissue and fluid around joints where RA can occur. They found that gold salts helped by interfering with the activity of 2 other molecules that aid in the release of HMGB1.

The researchers hope that this knowledge can help them "build new, safer-acting gold-based treatments" and encourage further studies. The results appear on the Journal of Leukocyte Biology's Web site, www.jleukbio.org.

F A S T   F A C T : Symptoms for rheumatoid arthritis usually begin between ages 40 and 60, but the disease can develop at any age.




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