News April 2013 Issue

In The News: April 2013

Vitamin D Little Help for Arthritis Pain

Those suffering from knee pain due to osteoarthritis shouldn’t put their hopes in Vitamin D as the answer to their aching joints, according to a new study. Once touted as a super nutrient, previous research suggested that high levels of vitamin D in the blood of those with the joint disorder benefited from a slower progression of symptoms. Now, this latest research overturns the theory. Published in the Journal of the American Medical Association, the study gave a high amount of vitamin D to the treatment group, at least 2,000 international units (IU) per day, which is far higher than the recommended daily amount of 600 to 800 IU. A review included 146 patients with knee osteoarthritis who took a daily dose of vitamin D or a vitamin-free placebo for two years. Doses were increased to as high as 8,000 IU daily in some patients. In the end, those who took the vitamin D supplements had similar changes in their knee cartilage volume—a measure of the progression of osteoarthritis – and had the same improvement in pain compared to those who took placebos. Vitamin D and calcium remain important nutrients for bone health, and your levels should be checked to make sure you’re in a healthy range. If your physician recommends vitamin D and calcium supplementation, understand that it’s for overall bone health and not for relieving the symptoms of arthritis.

Tag, You’re It: First Genome-Wide Study Finds Gene Tags in RA Risk

Groundbreaking research out of John Hopkins University has identified epigenetic changes as referees of genetic risk for developing rheumatoid arthritis (RA). In one of the first genome-wide studies to look for both genes and their regulatory “tags” in RA patients, researchers have found a clear role for the tags in mediating genetic risk of the autoimmune disorder. The new study is based on epigenetics, or the study of how a variety of basic cellular and developmental processes influenced by external environment factors and behavior may alter a person’s genes. Published in Nature Biotechnology, the study describes how scientists were able to spot tagged DNA sequences by pulling apart the tagging events that result from RA from those that help cause it. This may be important for the understanding of the development of RA because it helps link whole-genome genetic sequencing to diseases that have no single or direct genetic cause, according to its authors. Ultimately, the team identified 10 DNA sites that were tagged differently in RA patients and whose tagging seemed to affect risk for RA. This finding may guide future treatment that could directly target the liable genes and/or their tags.

Arthritis Drugs May Activate Shingles

Commonly used anti-tumor necrosis factor (anti-TNF) medications appear to significantly increase the risk of developing shingles in those patients who take them for the treatment of rheumatoid arthritis (RA). In a review of agents such as infliximab (Remicade) or adalimumab (Humira), the incidence of shingles among patients on anti-TNF treatment was 1.6 per 100 patient-years, compared with an incidence of 0.8 per 100 patient-years among those receiving traditional disease-modifying anti-rheumatic drugs (DMARDs). Published in the Annals of the Rheumatic Diseases, the observational study looked at 11,881 recipients of anti-TNF therapy including etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira), with a focus on infections occurring during the first three years of treatment. The study used 3,673 patients treated with conventional DMARDs as controls in comparisons of serious soft tissue infections, all cases of shingles and severe shingles. A total of 269 serious skin and soft tissue infections were reported in the anti-TNF group, compared to 29 in the DMARD group. These results should prompt physicians to consider administering the vaccine before starting anti-TNF treatment, according to the study’s authors.