ARTHRITIS WATCH

Pharmacy Times, Volume 0, 0

Gender Could Be a Key Predictor ofRA Remission

Women with rheumatoid arthritis (RA) have a lowerchance of remission than men, according to research publishedin the January 2007 edition of the Annals of theRheumatic Diseases. The Swedish study involved about 700adults, average age 58 years, who had been recently diagnosedwith RA. Two thirds of the participants were women,and they tended to be younger than the men. After 2 years,the RA had gone into remission in <4 of 10 participants; theresults were similar after 5 years. Only about 1 in 5 were inremission at both time points, however.

The researchers noted that, at 2 years, only one third ofthe women were in remission, compared with half of themen. At 5 years, the gap grew slightly; less than 31% of thewomen were in remission, compared with 52% of the men.At both time points, men were twice as likely to be in remissionas women. Women with RA did not have more severedisease states than the men at study start; however, as thestudy progressed, the women's condition deteriorated fasterthan the men's.

Older Athletes'Bones Strengthen with Impact Sports

Older athletes who take part in running, basketball, andother high-impact sports may have stronger bones as aresult, according to the results of a study at the Universityof Pittsburgh Medical Center. Bone mineral density (BMD)measurements for those who participated in impact sportswere significantly higher than those who took part in low-impactsports, such as swimming and cycling. The results ofthe study were presented in February 2007 at the 74thAnnual Meeting of the American Academy of OrthopaedicSurgeons in San Diego, Calif.

The study looked at 298 athletes who competed in the2005 Senior Olympic Games in Pittsburgh, Pa. The athletes,aged 50 to 93 years, completed a health-history questionnaireand underwent ultrasound to measure BMD. Thosewho took part in high-impact sports scored noticeably higheron BMD T-scores than those who did not, even after factoringin age, sex, obesity, and osteoporosis medication.

"The costs associated with caring for people with osteoporosisand fractures caused by frail bones are rising as thepopulation ages. Our study implies that persistent participationin impact sports can positively influence bone healtheven in the oldest athletes," concluded the researchers.

Low-dose Steroids Can ReduceRA Damage

According to a new review of evidence by researchers atthe Liverpool Women's Hospital in England, low doses ofsteroids can inhibit joint damage when used in the earlyphases of rheumatoid arthritis (RA). The evidence supportsthe combining of steroids with standard medications for RAin the first 2 years after initial diagnosis. The steroids studiedin the review were glucocorticoids and included the antiinflammatoryprednisone, usually prescribed in the earlymonths after RA diagnosis to relieve the discomfort of thedisease until slower-acting medications begin to protect thejoints. The review appeared recently in The Cochrane Library.

The systematic review involved 15 studies that included atotal of 1414 patients. Most studies involved the patientsreceiving low doses of glucocorticoid pills along with disease-modifying medicines for 1 to 2 years. Periodic x-rayswere taken throughout the study to monitor the extent ofjoint erosion and other damage. All the studies but oneshowed reduced progression of joint damage in thosepatients taking the steroids.

Heavy Patients with Knee OA Need Not Fear Exercise

Overweight patients who have osteoarthritis(OA) of the knee andchoose to take on regular exercise programsare encouraged to keep up withthem. Some fear that the exercise mayaggravate their OA, but recent studieshave shown that exercise has nonoticeable negative effect on knee OAin overweight patients.

One study from the Boston UniversitySchool of Medicine looked at 1279 participantsfrom the Framingham Offspringcohort who were questionedabout recent regular physical activityand knee pain, and then received x-raysof their knees about 1 to 2 years later.About 10 years later, they were summonedfor a follow-up, which includedsimilar x-rays and questions. An analysisof the results showed no relationshipbetween self-reported activity and thedevelopment or progression of kneeOA. Although the overweight patientsdid have an increased risk of developingOA, their physical activity did not add tothis risk.

Another study at Erasmus MedicalCenter, Rotterdam, Netherlands, wasan overview of 37 studies that determinedthe predictive factors of the progressionof knee OA. Researchersfound 3 studies that showed no strongevidence to link regular exercise withthe progression of knee OA. Both studiesappeared in the February 2007issue of Arthritis Care & Research.