Saturday February 11, 2012
The New York Times reported on February 10, 2012 that methotrexate, a drug used to treat childhood leukemia (specifically, acute lymphoblastic leukemia) and rheumatoid arthritis, is in critical short supply. The supply of injectable methotrexate is not meeting the demand. Hospitals across the U.S. may deplete their existing stock within the next two weeks.
Ben Venue Laboratories was one of the largest suppliers of injectable preservative-free methotrexate, but the company suspended operations at its Ohio plant in November due to manufacturing and quality concerns. Four other drug manufacturers in the U.S. that also supply methotrexate are attempting to boost production and stave off the problem. The FDA is reportedly seeking a foreign supplier to provide emergency imports, too, until the situation improves in the U.S.
For rheumatoid arthritis patients, oral methotrexate is an alternative to injectable methotrexate for some patients. Discuss your concerns with your doctor and your pharmacist. Follow along with the FDA list of Current Drug Shortages. Information about the methotrexate shortage is on the list and was last updated 2/2/12. Another shortage, Voltaren gel 1% (Diclofenac Sodium Topical Gel), was posted to the list on 2/8/12 and may affect some arthritis patients.
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Thursday February 9, 2012
More information has surfaced about adverse effects associated with PPI drugs (proton pump inhibitors such as Nexium, Prevacid, Protonix, Aciphex). A study published in the January 31, 2012 issue of the British Medical Journal concluded that chronic use of PPIs is associated with increased risk of hip fracture, especially among women who smoked. The report backs the U.S. FDA's decision to revise labeling of PPI drugs to include information about increased risk of fracture among patients treated with high doses or treated with a PPI for one year or more.
On February 8, 2012, the FDA warned the public that the use of PPIs may be associated with an increased risk of Clostridium difficile-associated diarrhea (CDAD). Patients are being advised to "use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated."
What exactly are PPIs? Why are some arthritis patients who take NSAIDs (nonsteroidal anti-inflammatory drugs) also prescribed PPIs? Learn more in What Are PPI Drugs (Proton Pump Inhibitor)?
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Wednesday February 8, 2012
According to a report published online January 15, 2012 in the Journal of Rheumatology, the rates of joint surgery continue to decrease for rheumatoid arthritis patients, especially those who have been more recently diagnosed. Previous studies recognized declining rates of joint surgery among patients diagnosed with rheumatoid arthritis since 1985. In the study published online in January, researchers accessed medical records of patients diagnosed with rheumatoid arthritis from 1980-2007, using data from the Rochester Epidemiology Project, and evaluated whether the trend continued since 1995.
Of the 813 patients in the study, the proportion of patients needing rheumatoid arthritis-related joint surgery dropped between the two time frames, 1980-1994 and 1995-2007. The cumulative incidence of any joint surgery at 10 years after rheumatoid arthritis onset dropped from 27.3% to 19.5% between the time frames 1980-1994 and 1995-2007. The greatest reduction occurred in soft tissue surgeries, such as synovectomy, tendon repair, tendon transfer, meniscus repair, ligament release, and cartilage repair. Surgery on weightbearing joints (hips and knees) did not exhibit the big reduction between the time frames. The increased use of disease-modifying drugs (DMARDs) may account for decreased joint damage and consequently less need for joint surgery. It was also noted in the study results that joint reconstructive surgery was associated with increased mortality.
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Tuesday February 7, 2012
According to a Mayo Clinic study published in the February 2012 issue of Arthritis Care & Research, there is an association between body mass index (BMI) and severity of symptoms in fibromyalgia patients. There were 888 fibromyalgia patients involved in the study. Patients were asked to complete questionnaires about their symptoms and ability to function. Obesity (BMI more than 29) was common in half of the study group, while one-fourth were severely obese (BMI more than 35).
As BMI increased, fibromyalgia-related symptoms increased and quality of life decreased. There has been no definite causal link between obesity and fibromyalgia, but among people who have fibromyalgia, obesity may cause increased pain and decreased function. Weight management should be a goal for fibromyalgia patients.
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