News September 2003 Issue

In the News: 09/03

Finally, A Cure For RA?
Latest results from trials involving tumor necrosis factor (TNF) inhibitors infliximab (Remicade) and etanercept (Enbrel), when used in combination with methotrexate, have rheumotologists talking about the possibility of a cure for rheumatoid arthritis. In one trial, in which infliximab was used with methotrexate to treat patients with early RA, nearly a third of the subjects went into remission. Another trial, conducted with patients with more established RA and using etanercept in combination with methotrexate, turned up similar results. Both studies suggested that the two-drug combination appeared not only to halt RA progression but even to heal some patients with the disease. However, experts attending the European Congress of Rheumatology in June, where the trial results were announced, cautioned that the cost of using these biologic agents is high and longer-term research is needed to determine their success as an RA cure. Scheduled to begin in 2004 is a year-long study developed by a coalition of international rheumatologists, billed as one of the most ambitious ever on RA. It will include 1,000 patients, 100 international treatment centers, and 48 months’ follow-up.

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Arthritis Meds May Elevate Blood Pressure, Heart Attack Risk
A report in the April Journal of Rheumatology warns of the potentially serious consequences of elevated blood pressure among arthritis sufferers who use anti-inflammatory drugs. Regular use of anti-inflammatorys can raise blood pressure, either directly or by interfering with blood-pressure-lowering medications. Using government health-survey findings and heart-disease data from the Framingham Heart Study, researchers estimated that in the course of a single year a mere 1-point increase in systolic blood pressure among arthritic Americans would lead to an additional 7,100 cases of ischemic heart disease and stroke. A 3-point increase, according to researchers, would result in more than 21,000 additional cases. Bottom line: If you’re being treated for arthritis and high blood pressure, your blood pressure should be monitored frequently. And if you’re being treated for either condition by more than one doctor, they should agree on the most effective combination of medications.

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Lube That Knee
If a squeaky hinge can be cured with a drop of oil, a stiff or squeaky joint, like the knee, should benefit from a little lubrication, right? The procedure, called viscosupplementation, involves injecting hyaluronic acid, a natural lubricant found in a joint’s synovial fluid, into the knee joint. People with osteoarthritis have a lower-than-normal concentration of hyaluronic acid in their joints, so viscosupplementation may be the answer. The procedure, according to experts at the American Academy of Orthopaedic Surgeons, has been shown to relieve pain in many patients who fail to get relief from analgesic drugs. The treatment involves receiving three to five shots over a period of several weeks. Pain relief can last for several months and injections may also stimulate the body to produce more of its own hyaluronic acid. The downside: It doesn’t work for everyone, and it’s expensive. Best advice: Discuss the option with your doctor.

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Synthetic Bone Scaffold Speeds Healing
University of Toronto researchers have developed a new way of speeding the process of bone healing—by developing a synthetic scaffold that provides a framework for growing bone tissue. The scaffold, made of a polymer used in sutures, simulates the structure of natural bone. Bone marrow cells, dribbled into the scaffold’s pores, differentiate into osteoblasts, the strong, mineral-like cells of mature bone. The marrow cells take up residence in the scaffold and begin multiplying. As they mature, the scaffold itself slowly dissolves. Result: The new bone grows naturally without the need of chemical growth stimulants, which tissue engineers have had to rely on in the past.