News March 2003 Issue

In the News: 03/03

Smokers And Divorced At Greater Risk For Arthritis?
It’s been well established that age, obesity and physical inactivity can contribute to the onset or severity of arthritis. But researchers at Atlanta’s Centers for Disease Control and Prevention now have found that arthritis appears to occur more commonly in people who are separated, divorced, or who have smoked. The findings, published in the Journal of Rheumatology and based on surveys of 17,556 people who had been diagnosed with arthritis or ongoing joint pain, showed that people who were divorced or separated were 30 percent more likely than married people to have arthritis, while every-day smoking was associated with a 60 percent increased risk of the disease. Although Dr. Charles Helmick, who authored the study, could provide no reason for smoking’s relationship to arthritis, he indicated there may be links between a disrupted homelife and arthritis. Specifically, he suggested that severe arthritis may put stress on a marriage, leading to separation and divorce. Alternatively, the stress of a marriage breakup could also aggravate the disease.

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Aspirin May Counteract Coxib Advantage
Taking an aspirin a day may be good advice to keep your blood thinned and pumping efficiently, but if you’re currently taking a selective COX-2 inhibitor such as celecoxib (Celebrex) or rofecoxib (Vioxx), aspirin may also negate the advantages these drugs provide–namely protection of the gastrointestinal tract. That is the conclusion drawn by the FDA (on rofecoxib) as well as by Dr. Mark Fendrick of the University of Michigan (on all COX-2 inhibitors). Dr. Fendrick, who has developed a matrix to guide physicians in the selection of arthritis drugs, recommends taking a proton pump inhibitor (PPI) or other gastroprotective agent, such as misoprostol (Cytotec), to restore protection of the GI tract. And in this case, Fendrick claims, a patient at risk of GI damage may as well take a traditional NSAID instead of one of the more costly coxibs.

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New Arthritis Drug May Cause Serious Side Effects
Bextra, introduced early last year as a new arthritis treatment, has been found to produce severe, although rare, side effects. Pharmacia, Bextra’s manufacturer, had reported to the FDA about life-threatening skin reactions to the drug, including inflammation of the mucous membranes of the mouth, throat, intestinal tract, eyelid membranes, as well as toxic epidermal necrolysis, a condition in which skin dies. The FDA has ordered that the drug’s label be changed to warn about these reactions, in addition to warning people against taking the drug if they are allergic to sulfa-containing products.

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Pain By The Clock
Does it seem that your arthritis pain acts up at only certain times of day? Early studies have concluded that pain patterns appear to be synchronized with the body’s biological rhythm, which governs sleep and other functions. In a recent study at the Mayne Medical School in Brisbane, Australia, patients with osteoarthritis of the hand kept a diary for 10 days to document their pain throughout the day. Researchers found that creakiness was least in late afternoon, a few minutes after 4 p.m., and dexterity was best just shortly before 4 p.m. Lesson: Record your own pain pattern, then plan activities around it.

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Forteo Approved For High-Fracture-Risk Osteoporosis Patients
A new drug designed to stimulate new bone formation by increasing the number and action of bone-forming cells has been given the nod by the FDA. Called Forteo, it is aimed primarily at people who are prone to osteoporosis-related fractures or are intolerant of other osteoporosis treatments. Until recently, the only approved osteoporosis therapy consisted of antiresorptives, which work mainly to slow bone loss by reducing the number of bone-removing cells. It is claimed Forteo stimulates the formation of new bone by increasing the number and action of bone-forming cells. The drug is currently available only in injectible form.