JANUARY 01, 2007

Weight Training May Slow Progression of Knee OA

A new study that used highly standardized x-ray procedures showed that strength training with weights can help slow the progression of osteoarthritis (OA) in patients with OA of the knee. Researchers at Indiana University and Purdue University studied 221 patients who were divided into 4 groups; OA with pain, OA without pain, no OA with pain, and no OA without pain.

The patients were randomly assigned to partake in either strength training or range-of-motion training for 30 months. Strength was measured and x-rays were taken at the beginning of the study and again after 30 months. The participants were also asked to return for strength testing and pain assessment every 6 months after the first year.

The study results showed that all patients lost lower-extremity strength over the course of the study, but the loss was slower with the strength-training group. In patients who had OA at the start of the study, the average loss of joint space width was 37% less in the strength training group and occurred less often as well. During the final 6 months of the trial, the strength group also showed better joint function. (The findings were published in the October 2006 issue of Arthritis Care & Research.)

Leg Length May Raise Arthritis Risk

According to a study conducted by the University of North Carolina Thurston Arthritis Research Center, having one leg shorter than the other could raise an individual's risk of developing arthritis of the knee or hip. Individuals with a leg length difference of as little as 2 cm were more likely to have osteoarthritis (OA) in their right hip or either knee. The study also showed that their OA was more likely to be more severe. The findings were presented in November 2006 at the annual meeting of the American College of Rheumatology.

The researchers looked at 3161 patients who were enrolled in the Johnston County OA Project. Of these patients, 1785 had OA of the hip or knee, and 210 of them had legs of different lengths. The researchers found that patients with differing leg lengths were more likely to have hip OA, compared with patients with equal leg lengths (32.5% vs 26.1%), as well as knee OA (45.3% vs 29.0%). The researchers hoped that these findings will help them "predict who may develop OA and who may have symptoms that worsen, or have potential risk of disability."

A Shot in the Arm—or Leg—Could Relieve OA

A new study showed that Botox, the purified form of botulinum toxin type A typically used for reducing facial wrinkles, also has positive effects on the reduction of pain of osteoarthritis (OA) of the knee, as well as improving knee function. The cosmetic injection has shown promise in other medical areas as well, including excessive sweating, eye disorders, and certain neurological conditions. It is also being studied for the treatment of headaches, ringing in the ears, overactive bladder, and diabetic nerve pain.

Researchers at the Minneapolis Veterans' Affairs Medical Center are excited by the preliminary results. The study enrolled 37 patients with OA of the knee who are ineligible for joint replacement, and they were studied at 1-, 3-, and 6-month intervals after injections of either 100 units of botulinum toxin plus lidocaine or saline plus lidocaine. After 1 month, the patients with severe knee pain who received the Botox shot showed a 28% decrease in pain and a 25% improvement in function, compared with no response in patients who received the saline shot. The data were presented in November 2006 at the annual meeting of the American College of Rheumatology.

Drug Shows Promise in Kids with RA

Researchers at the Cincinnati Children's Hospital Medical Center have found that a medicine used to treat adults with rheumatoid arthritis (RA) has the potential to help children with the disease as well. Adalimumab, an antitumor necrosis factor agent, was used in a study of 171 children ages 4-17 with juvenile RA. The study began with all the children taking the medicine for 16 weeks, during which time 83% of them achieved a benefit of ACR Ped 30—meaning, of 6 disease elements deemed important by the American College of Rheumatology (ACR), at least 3 showed improvement of >30%.

During that time, 52% of the children qualified for an ACR Ped 70 result, and by the study's end, 1 in 5 had reached a benefit of ACR Ped 90, a "quite profound" benefit, according to researchers. An 88-week extension study continued to show improvement in the conditions of children taking adalimumab. Although the drug is currently not approved for use in the pediatric population, the researchers hoped that the results of this trial will prompt further research that could lead to a new indication for the drug. The study's results were presented recently at a press conference at the annual meeting of the American College of Rheumatology.