News March 2006 Issue

In the News: 03/06

Abatacept, Rheumatoid Arthritis Fighter, Gets Green Light

The U.S. Food and Drug Administration (FDA) has approved abatacept (Orencia), the newest member of a family of biologic agents formulated to shut down T cell activity, for the treatment of rheumatoid arthritis. The drug is designed for patients with moderate to severe RA who have not responded satisfactorily to either disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, or tumor necrosis factor (TNF) blockers (Enbrel, Remicade, Humira). Abatacept works by arresting a signal required to activate T cells, a key factor in the inflammation process. By contrast, other types of biologics block interleukin-1 or tumor necrosis factor-alpha later in the inflammation process. Based on clinical trials of more than 2,600 patients, abatacept was shown, after six months of use, to not only relieve RA pain symptoms but also to improve physical function in patients who did not respond to DMARDs or TNF blockers. Given by 30-minute intravenous infusion in a dose based on patient weight once every four weeks, abatacept can be used alone or in combination with DMARDs but is not recommended for use in conjunction with TNF blockers (increased infections can result). The most frequent patient side effects occurring during the trials were infection, headache, nausea, and upper respiratory tract infection.

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Back Pain? Take A Hike

Despite what is presumed to be conventional wisdom—if you experience back pain, do back exercises to relieve it—researchers at the University of California have found that simply going for a hike, bike ride, or swim can do more to alleviate back pain than can specific exercises for the back. The study tracked 681 people with lower back pain who participated in recreational physical activities or chiropractic or medical care in a managed-care setting. After 18 months, researchers found those who took part in recreational activities at least three hours a week had lower scores for back pain, disability, and psychological distress. By contrast, back exercise was directly linked to lower back pain and related disability. The study’s findings were reported in the American Journal of Public Health.

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Pain Relief With Mirrors

You may be able to ease pain simply by taking a good look at yourself. Researchers at the University of Bath in England have found a novel method of pain relief for people who suffer from repetitive strain injury or complex regional pain syndrome (CRPS)—mirrors. In a study appearing in a recent issue of New Scientist, eight patients with CRPS (which occurs in many people who fracture their arm, shoulder, or wrist) were placed in front of mirrors in a position in which they could see only the healthy half of their body, along with another reflection of the same half. With the painful arm hidden, it appeared that the patients had two healthy arms. Told to concentrate on the image and believe that what they saw was real, six of the patients were completely cured of their pain. Researchers believe the pain—or absence of it—results from a mismatch in the way the brain perceives the body and the body’s actual condition. Though outside experts found the study interesting, given the fact that it included only eight participants, further research was recommended.

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Link Found Between OTC Pain-Killer and Hypertension, Liver Failure

If you take an overly generous dose of acetaminophen (Tylenol, Percocet) for pain relief, you may be increasing your risk of developing hypertension. A study of 5,123 women age 34-77, as reported in a recent issue of Hypertension, found older women who took more than 500mg of acetaminophen daily had 1.93 times the risk of developing hypertension as women who did not use the pain-reliever, and in younger women the risk was nearly double. If that news wasn’t surprising enough (acetaminophen is the most widely used analgesic in the U.S.), another study has found that the pain-reliever has become the most common cause of acute liver failure in the U.S. In fact, the percentage of liver failure due to acetaminophen has nearly doubled in six years, according to a report in Hepatology. Reason: unintentional overdosing—it accounted for half the cases of liver failure—which researchers said is due to patients taking several different products containing acetaminophen, a combination of prescription products and narcotics, and the fact that individuals in the study were taking more tablets than the recommended maximum of 4,000mg (4g) daily.