News April 2014 Issue

In The News: April 2014

Osteoarthritis Connected to Cardiovascular Disease
The most common cause of all joint aches and pains is being linked to heart health as well. In a study published in Arthritis Care & Research (Dec. 2013), researchers suggest that patients with osteoarthritis (OA) of the hip or knee—some 10 to 12 percent of the world’s population—are at heightened risk for cardiovascular disease (CVD). In a large, longitudinal study of more than 40,000 patients, men older than 65 with OA had a 15 percent increased risk for hospitalization for CVD. Additionally, those women in the study older than 65 had a 17 percent increase of CVD risk, and those younger than 65 had a 26 percent increase. While this study was not designed to explain the link between OA and CVD, chronic inflammation, muscle weakness, reduced mobility, and use of nonsteroidal anti-inflammatory drugs (NSAIDs) are common in individuals with OA and are associated with risk factors for CVD.

Depression Increasingly Common Among RA Patients
According to a report by the National Rheumatoid Arthritis Society (NRAS), people living with rheumatoid arthritis (RA) are twice as likely to be depressed than those without the disease. Depression often goes unreported in RA patients because many of the symptoms, such as fatigue or poor sleep, can often be attributed to the disease itself, the researchers state. The study reviewed 322 patients with severe RA who were waiting to be placed on biologic treatments. Results of their findings focused on the current measure of the disease through a test called DAS28, which produces a score that estimates the number of swollen joints in the body as well as inflammation levels. Because DAS28 is a somewhat “subjective” assessment because patients who take the test self-report how they feel, the researchers found that these measures were more likely to be influenced by mood and other psychological factors.

Avocado-Soy Pill May Help Hip OA
The combination of avocado and soybean extract in a supplement form showed promise as a structure-modifying treatment for hip osteoarthritis (OA), according to a study published in Annals of the Rheumatic Diseases (Feb. 2014). While the study’s primary endpoint of change in joint space width showed no significant differences between patients taking 300 mg of avocado-soybean unsaponifiables (ASU) to those taking a placebo, a secondary analysis showed promise. The second endpoint demonstrated that by the third year, the difference in narrowing of joint spacing between the groups taking the supplement and those who did not was statistically significant, with a relative risk reduction for the worsening of joint spacing being 20 percent for those taking the pill. Further research is needed to determine the effectiveness of the supplement.

Naproxen May Be Safer on the Heart
The pain medication naproxen (Aleve®) may be safer on the heart than other popular nonsteroidal anti-inflammatory drugs (NSAIDs), according to the U.S. Food and Drug Administration (FDA). As reported online (Jan. 28, 2014), the FDA completed a safety review, which showed that naproxen may have a lower risk of heart attack and stroke than other NSAIDs, such as ibuprofen medications in the same class, including Advil® and Motrin®. The FDA does not recommend changing naproxen’s warning label to suggest it has a better cardiovascular risk profile. Currently, the PRECISION Trial (Prospective Randomized Evaluation of Celecoxib Integrated Safety Vs Ibuprofen Or Naproxen) is gathering evidence to answer the question of overall benefit versus the risk of celecoxib, ibuprofen and naproxen when compared to two most commonly prescribed traditional (non-selective) NSAIDs in the treatment of arthritis pain.