Friday January 27, 2012
Doctors typically prescribe arthritis medications to help manage symptoms and slow disease progression. There are several categories of arthritis medications: NSAIDs (nonsteroidal anti-inflammatory drugs), analgesics (pain medications), DMARDs (disease-modifying anti-rheumatic drugs), biologics, and corticosteroids.
I don't know anyone who likes to take medication or wants to take it, but people with arthritis tend to be compliant with their treatment regimen. With the best of intentions, they take their prescribed medication hoping it will be effective. It almost becomes robotic. You take your medications or self-inject or go for an infusion on a specified schedule. But, when is the last time you stopped to think about how well your medications are working? Are they working? Did they used to work better and now don't seem quite as effective? How can you tell? Read more in Arthritis Medications - Are They Working?
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Thursday January 26, 2012
According to a study funded by NIAMS (National Institute for Arthritis and Musculoskeletal and Skin Diseases) and published online January 26, 2012 in Arthritis Care & Research, two in five adults with rheumatoid arthritis (42%) are inactive. It's a common misconception that medication and rest alone help to control rheumatoid arthritis symptoms. Not only do many patients believe that, doctors actually recommended rest to their rheumatoid arthritis patients up until the 1980s. More current research supports regular, moderate physical activity or exercise for people with arthritis to help maintain joint flexibility, range of motion, balance, muscle strength -- and to decease joint pain.
While evidence now backs an active rather than sedentary lifestyle for people with rheumatoid arthritis, many patients still don't buy it and many doctors don't take the time to encourage it. In the study, inactivity was defined as participating in no moderate-to-vigorous physical activity periods of 10 minutes or more within a 7-day period. Not only were 42% classified as inactive, 53% of study participants lacked strong motivation to participate in physical activity and 49% lacked strong belief in the benefits.
Researchers concluded that physical inactivity among rheumatoid arthritis patients is a public health concern. Motivation needs to be addressed and the benefits of exercise promoted. Interestingly, just one day before the study was published, I wrote an article for our About.com Osteoarthritis site entitled "How You Can Start to Exercise With Osteoarthritis". The points made in the article apply to patients with any type of arthritis, including rheumatoid arthritis. Check it out.
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Sunday January 22, 2012
The immune system is a complex network of cells, tissues, and organs that work harmoniously to defend the body against foreign invaders. The immune system operates like a sophisticated communications system. When a foreign invader enters the body, the immune system is alerted.
When the immune system malfunctions and attacks its own tissues rather than foreign invaders, autoimmune diseases develop. Autoimmune diseases include rheumatoid arthritis, lupus, and other rheumatic conditions. Learn more about The Immune System - How It Works.
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Wednesday January 18, 2012
The American College of Rheumatology published an issue of Hotline on January 18, 2012 over concerns regarding concomitant use of Krystexxa (pegloticase) and urate-lowering drugs, such as allopurinol and Uloric (febuxostat), in gout patients. Krystexxa was FDA approved for the treatment of chronic gout refractory to conventional treatment. During clinical trials, it was determined that antibodies to Krystexxa were common in patients treated with the drug. It was also noted that high titer antibody (i.e., high levels of the antibody) were linked to loss of response to Krystexxa and an increased risk of infusion reactions, including anaphylaxis.
In December 2011, the manufacturer of Krystexxa sent a letter to advise healthcare providers against concomitant use of Krystexxa and other urate-lowering drugs. Although Krystexxa was used in clinical trials as monotherapy (the only drug given), post-marketing surveillance revealed the issue of concomitant use in clinical practice. It is recommended that gout patients who are successfully treated with conventional urate lowering drugs should stick with those before considering Krystexxa. Also, urate lowering drugs should be discontinued before using Krystexxa and should not be re-started while Krystexxa is being used. Krystexxa should be used with caution in patients with congestive heart failure. Patients who have G6PD deficiency should not use Krystexxa.
Obtaining a routine serum urate level a few days before an infusion of Krystexxa can help identify patients who may be losing their response to the drug and who may be at risk for an infusion reaction. If pre-treatment serum urate is greater than 6 mg/dl, your doctor may suggest discontinuing Krystexxa.
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