Pharmacy Times
Volume 0

Better Educated Patients More Likely to Choose Surgery

Canadian researchers have found that arthritis patients withhigher levels of education are more open to having surgery thatinvolves hip or knee joint replacement, compared with their lesser-educated counterparts. Income and gender did not play a rolein the findings, which appear in the October 2006 issue ofArthritis & Rheumatism. The researchers believe that these findingsemphasize the need for community-based education aboutarthritis treatments, including total joint arthroplasty (TJA).

The study included >2100 people aged 55 and older with disablingosteoarthritis (OA). At the beginning of the study, 48% ofthe patients had seen a physician for hip and/or knee problemsin the past year. Twenty percent said that they were willing tohave TJA.

After 7 years, almost 24% of the patients had undergone atleast one TJA procedure; the rates were almost the same forboth rural and urban patients (11.8% vs 12.1%).

The study found a significant relationship between highereducation and those who had TJA. It also found that, amongpatients with similar levels of OA severity, TJA was nearly 4times more common among those willing to consider the benefitsof the surgery, compared with those who were unwillingor unsure about TJA.

New Family Link to RA Found

New research shows that women who have brothers whoare affected by rheumatoid arthritis (RA) are more likely todevelop the disease themselves. The finding adds to the growingevidence that genetics plays an important part in theprogress of the autoimmune disorder, according to researchers.The findings were published in the October 2006issue of Arthritis & Rheumatism.

Researchers at the University of California, San Francisco,looked at data from 1004 affected members of 467 families inwhich 2 or more siblings had RA. They compared features ofthe disease in both men and women. They found that womenwhose brothers were affected with RA were more likely tohave high levels of an antibody associated with the disease.According to researchers, this information could be helpful inpredicting the course of the disease.

These women, along with their affected brothers, also weremore likely to have a gene called HLA-DRB1, a subtype of thegenetic marker HLA-DR4, which is known to be associatedwith RA. Researchers hope that identifying genetic markers infamilies with a history of RA can help alert doctors and patientsto determine who is at greater risk and how to treat them.

Got a BlackBerry Thumb?

According to the American PhysicalTherapy Association (APTA), manyAmericans now have a new workplaceailment—"BlackBerry Thumb." The term,coined from a popular brand of personaldigital assistant (PDA), refers to a surprisinglycommon repetitive-stress injurythat comes from overuse of handheldelectronic devices. Too much timespent checking and composing e-mails,instant messaging, and accessing theInternet with PDAs can cause painand/or numbness in the thumbs andjoint of the hands.

Margo Miller, president of the APTA'sOccupational Health Special InterestGroup, says that "more and more, peopleare depending on [PDAs] to stay intouch with friends and family beforeand after the workday and on theweekends, as well as having access towork when they leave the office; that iswhere the heart of the problem lies."Most people who use PDAs are middleaged,and overuse can aggravate underlyingarthritis. Problems also candevelop into tendinitis or even osteoarthritis.The APTA suggests taking frequentbreaks from the PDA, not typingfor a few minutes at a time, supportingone's arms while using the PDA, anddoing stretching exercises for the fingersand hands often.

Cancer Drug May Alleviate RA

The cancer drug Gleevec (imatinib mesylate), more commonlyused to treat leukemia and other cancers, has been shown tohelp relieve the symptoms of rheumatoid arthritis (RA) inpatients who suffer from both ailments. Researchers at StanfordUniversity screened drugs that might help the estimated 50% ofRA patients who do not respond to current therapies. Theynoted that there had been case reports of cancer patients beingtreated with Gleevec who also reported improvement in theirRA symptoms while taking the drug. They tested Gleevec oncells taken from the joints of patients with RA and found that thedrug shut down the cells' production of tumor necrosis factoralpha,a messenger molecule that drives RA-associated inflammation.The drug also halted the proliferation of fibroblasts, thecells that cause tumor-like growth in joint linings.

The researchers stated that, because many RA drugs areadministered by injection, there has been a "tremendous need"for a therapeutic option in pill form. They suggest that doses ofGleevec lower than those used in cancer treatment would benefitRA patients while causing few side effects. The findings oftheir research were published in the October 2006 issue of theJournal of Clinical Investigation.

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