ARTHRITIS WATCH

Pharmacy Times, Volume 0, 0

Arthritis Could Increase Risk of Gout

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

The researchers sent out questionnaires to all patients aged30 years and older served by 2 general practices inNottingham. 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 aclinical assessment to verify the diagnosis and assess the distributionof 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 clinicallyconfirmed. A highly significant association was seen betweenthe 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 occasionalinstance of their knees "going out" or "giving way" whenthey walk or climb stairs. A recent study assured these individuals,however, that this is not necessarily an indication ofarthritis.

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

Of all the questioned participants, 278 experienced at least1 episode of knee buckling within the past 3 months; of these,217 experienced >1 episode and 35 fell during an episode. Theresearchers noted that the incidence of buckling was notrelated to the presence of knee arthritis—over half of thosewith buckling had no signs of arthritis on radiography testing.The findings were reported in the October 16, 2007, issue ofthe 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 liveras well. The autoimmune inflammatory disease has long beenassociated with a high risk of early death, but less informationhas been available as to whether or not survival rates forpatients with RA have improved over the past few years dueto improvements in treatment and diagnoses.

Researchers at the Mayo Clinic studied mortality trendsamong patients with RA and compared them with trendsamong the general public during 5 time periods: 1955-1964;1965-1974; 1975-1984; 1985-1994; and 1995-2000. During all5 periods, there was no significant change in survival rates forpatients with RA.

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

Relief Is Golden: Gold Salts Used to Ease RA Symptoms

Mohandas (Mahatma) Gandhi is creditedwith the saying, "It is health that is realwealth and not pieces of gold and silver."Individuals who experience the pains ofrheumatoid arthritis (RA) might soon beable to equate gold with health, asresearchers are discovering the mysteriesof the healing properties of gold,which, they say, could result in renewedinterest in the use of gold salts for thetreatment of RA and other inflammatorydiseases.

Although in the early 1900s the use ofgold salts to relieve RA pain came at thecost of delayed response and severe sideeffects, scientists are better understandingthe mechanism of the element andhow it works to reduce inflammation inthe cells.

Researchers from Duke UniversityMedical Center in Durham, NorthCarolina, studied the molecule HMBG1,which promotes inflammation, the mainprocess underlying the development ofRA. Higher amounts of the molecule existaround the synovial tissue and fluidaround joints where RA can occur. Theyfound that gold salts helped by interferingwith the activity of 2 other molecules thataid in the release of HMGB1.

The researchers hope that this knowledgecan help them "build new, safer-actinggold-based treatments" and encouragefurther studies. The results appear onthe Journal of Leukocyte Biology's Website, 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.