In The News: December 2009
Addiction Drug May Help Relieve Fibromyalgia Pain
Low doses of naltrexone—an inexpensive agent used for years to treat drug addiction—has helped reduce pain and fatigue in women with fibromyalgia, a debilitating disorder marked by chronic musculoskeletal pain. According to a recent study in Pain Medicine, 10 female patients were taken off their current fibromyalgia medication, then administered a placebo for two weeks, then put on naltrexone for eight weeks. The drug reduced symptoms by 30 percent compared to placebo. It also worked better for some than for others; six out of the 10 were strong respondents, with at least a 50 percent reduction in symptoms. How the drug works is not known, but researchers suggest that naltrexone may quiet a hyperactive immune system. Naltrexone has another advantage—doses of the drug cost about $40 a month. Though the study was small, it was considered scientifically sound. If more research is promising, said researchers, naltrexone may eventually compete with higher-priced fibromylagia drugs now on the market.
TENS: Effectiveness for Knee OA Is Questioned
Despite nearly two decades of research on transcutaneous electrical nerve stimulation (TENS) for the treatment of knee osteoarthritis (OA), there is little evidence that it reduces pain or physical disability. According to Swiss researchers reporting in the Cochrane Database of Systematic Reviews, results from 18 trials that included 813 patients were reviewed. In assessing physical disability, 29 of 100 patients who received TENS responded to the treatment, compared to 26 of 100 patients who received artificial TENS treatment or took their usual treatments. Researchers said that although some patients who underwent the treatment showed some improvement, it did not appear to be any greater than that experienced by those who received placebo treatment. Researchers also said the data were available for only a few small trials, and many of the trials were of poor quality, with several failing to make mention of adverse side effects. To clarify the effectiveness of TENS as an OA treatment, they suggested, larger trials are needed.
Wrist-Fracture Patients Less Likely to Undergo Osteoporosis EvaluationA recent study in the Journal of Bone and Joint Surgerysuggests a disparity between the way wrist-fracture patients and patients with a spine or hip fracture are managed and evaluated. The large-scale study, conducted among women in Korea, reviewed the incidence of fractures around the hip, spine and wrist in patients age 50 and older and the frequencies of bone-density scans of osteoporosis, along with the use of medications for its treatment. Findings showed that only 2.8 percent of those who had a distal radial fracture of the wrist underwent a bone mineral density scan, and only 22.9 percent were prescribed osteoporosis medication. Researchers said that although the health systems in the U.S. and Korea are different, physicians treating fractures are the initiators of osteoporosis care in both countries, adding that women who break a wrist should know about their further fracture risks and the need to be treated accordingly.
New Biologic Drug Effective for RA
Abatacept (marketed as Orencia), a new biologic drug that blocks the action of the body’s T cells, immune cells that cause joint inflammation, is effective in the treatment of rheumatoid arthritis (RA), according to the Cochrane Database of Systematic Reviews. Researchers analyzed data from seven trials comprising 2,908 patients whose symptoms were studied after one year of taking the drug or a placebo. Compared to those on a placebo, abatacept patients were nearly two times as likely to achieve a 50 percent improvement in symptoms, including pain and the number of tender or swollen joints. Those who took the injectible drug also experienced improvements in physical ability. Further, there was no progression in joint damage in those who took abatacept after 12 months’ follow-up. However, the risk of serious infections increased if the drug was given in combination with other biologics. Researchers said although abatacept is an expensive drug, if the benefits are evident it may be of interest to those with RA who fail standard therapy or other biologic treatments.