News January 2004 Issue

In the News: 01/04

Write The Pain Away
An arthritis flare-up can be brought on by any number of factors—extreme stress, a disturbing event, personal loss or conflict—each of which can impact the immune system. One not-so-traditional way to lessen the pain of flare-ups is described in The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-Being (American Psychological Association). Co-editors Joshua Smyth, Ph.D., and Stephen Lepore, Ph.D., and their colleagues explored the effects of supervised journal writing on 50 rheumatoid arthritis patients. Participants were asked to visit researchers’ offices for three consecutive days and write for 20 minutes each day. Their assignment: Reflect on your most stressful event or experience, how it made you feel, and how it affects you today.

At first, patients found the writing challenging, but they began to see connections between past experiences and current anxiety. By writing about a stressful experience, explains Smyth, associate professor of psychology at Syracuse University, participants became emotionally involved with the event or issue they were describing, and by understanding their emotions they were able to remain calmer. This was found to lower their stress level, which in turn had the effect of reducing the frequency of flare-ups.

Said Smyth, “When patients returned to their rheumatologists, pain, stiffness, and loss of motion were shown to have improved. Further, the benefit of reduced stress was observed up to four months after writing.”

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New Drug Attacks RA, With Few Side Effects
A new experimental drug, CTLA4lg, has been found to neutralize the immune system T- cells that assault the body’s joints. In a study of 339 patients who had experienced little relief from methotrexate, the standard drug used to treat RA, 60 percent felt better after six months of using the new drug, some dramatically so. Only 35 percent of the patients on methotrexate alone felt better during the same time period.The new drug, which is injected by intravenous infusion, was given three times in one month, then once every month thereafter for five months. Patients who received it with methotrexate had no more side effects than those who were on methotrexate alone. Bristol-Myers Squibb, which developed the drug, expects to apply to the FDA next year for approval. Said Dr. Gary Firestein, chairman of the FDA’s arthritis advisory committee, “We’re very excited about it—but there’s still considerable work to be done.” The study was reported in the Nov. 13 New England Journal of Medicine.

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Comfort Just A Leech Away?
It may not sound like the most inviting of arthritis treatments, but researchers have found that leech saliva contains anti-inflammatory substances that could relieve arthritis symptoms. In a study of 24 patients with knee arthritis, Dr. Gustav Dobos and fellow researchers at the Kliniken Essen-Mitte medical center in Essen, Germany, compared a single treatment with four to six leeches with that of a 28-day regimen of topical diclofenac, a common arthritis treatment. Medicinal leeches were applied to painful areas of the knees for 70 minutes each day. After seven days, according to a report in the Nov. 4 Annals of Internal Medicine, pain scores had improved to a much greater extent in the leech-therapy group than in the diclofenac group. Moreover, improvements in function, stiffness and other arthritis symptoms were maintained through 91 days of follow-up. Although the treatment was reportedly safe and well tolerated, the authors noted that leech therapy does carry infectious risks.

The application of medicinal leeches was widely practiced in ancient times, but their modern-day use has been limited to the treatment of blood-clotting problems after surgery. Bottom line: Though no agent has similar lasting effects after a single administration, further research into the anti-inflammatory compounds of leech saliva could lead to the development of an analgesic agent that could safely be administered without the need for a leech bite.