News August 2007 Issue

In The News: 08/07

Got Gout? Bring on the Java

Drinking four or more cups of coffee per day can significantly reduce the risk of gout in men. Researchers at the University of

British Columbia and Harvard Medical School analyzed data on 50,000 men ages 40 to 75 with no history of gout and found, after 12 years, that 757 of the participants had developed gout—but the risk was lower for those who drank more coffee. The risk was 40 percent lower for those who drank four to five cups a day and, although there may be other health consequences, 59 percent lower for men who drank six or more cups per day.

Coffee gets you on edge? Try decaf—participants who drank decaffeinated coffee also had less risk of developing gout. The consumption of caffeine from other sources, such as tea, soft drinks, and energy drinks, was not shown to have any effect on the incidence of gout, leading researchers to conclude that the benefit of coffee must be from an ingredient other than caffeine. Chlorogenic acid, they suggest, is a strong antioxidant included in coffee and may be responsible for reducing the risk of gout.

Carpal Tunnel Pain Eased by One-Time Injection

A single corticosteroid injection in the wrist can provide at least a month of relief and help patients with severe carpal tunnel

syndrome avoid surgery. So concludes a review of 12 studies involving 671 participants by Canadian researchers at the University of Ottawa.

In one trial, a single local corticosteroid injection was found to provide improvement in symptoms at one month when compared to a single systemic injection. Another trial, which compared local injection to taking an oral corticosteroid, found greater improvement among those who received the injection for as long as three months after treatment. Yet another study showed that symptoms did not improve significantly more in the injection group at two months compared to treatment with anti-inflammatory drugs and splinting.

The study’s authors concluded that although long-lasting pain relief has not been universally demonstrated, there is building evidence that local corticosteroid injection works beyond one month.

 

Knee Alignment No Predictor of OA

A little bow-legged? A tad knock-kneed? Although knee alignment may serve as an indicator of knee osteoarthritis or its progression, it is not a predictor of OA. According to a recent study by Boston

University researchers, abnormalities in knee alignment are typically a consequence and not a primary cause of OA. In a nine-year study involving 110 patients with osteoarthritis in their knees and 356 patients with healthy knees, researchers found knee alignment was not associated with the development of knee OA. What to conclude? Forget strategies to realign the knee joint as a preventative of OA. Instead, "modify the modifiable," said the study’s authors. "Address the major factors that predispose to OA—particularly obesity." The study appeared in the April issue of

Arthritis & Rheumatism.

 

TNF-Alpha Blockers for RA Raise Risk of Infection

If you take a tumor necrosis factor (TNF)-alpha blocker (Remicade, Enbrel, Humira) to control your rheumatoid arthritis, you’re up to four times more likely to develop a serious bacterial infection than if you use only methotrexate (Trexall, Rheumatrex).

Based on a 17-month University of Alabama study of 5,326 patients—roughly half of whom were taking TNF-alpha blockers, and half of whom were taking methotrexate—researchers found that infection-related hospitalization rates were 2.7 percent for the TNF-alpha blocker group and 2.0 percent for the methdotrexate-only group. Though the difference in the number of infections between the two groups was relatively low, the study’s authors suggest that the dramatic effectiveness of TNF-alpha therapy for most RA patients needs to be balanced against the potential for increased infection.