In The News: August 2013
AAOS Against HA for Knee OA, Decreases Acetaminophen Dosage
When recently revising its 2009 clinical practice guideline of osteoarthritis (OA) of the knee, the American Academy of Orthopaedic Surgeons (AAOS) clarified its stand on the use of intra-articular hyaluronic acid (HA). When reviewing 14 studies assessing HA injections for knee OA, the Academy concluded that the “treatment did not meet the minimum clinically important improvement thresholds.” The academy also reduced the recommended daily dosage of acetaminophen for knee OA from 4,000 mg to 3,000 mg, consistent with recommendations by the U.S. Food and Drug Administration (FDA).
High Doses of NSAIDs May Raise Risk for Heart Problems
Taking a high dose of non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of heart attacks, strokes and death by about one-third, according to a study published online in The Lancet (May 29, 2013). A review of nearly 650 randomized trials found that taking either 2,400 mg of ibuprofen or 150 mg diclofenac daily led to the increased heart danger. However, the study reports increased risk of heart attacks from individual NSAIDs is proportional to a patient’s underlying risk for heart attacks.
Statin Use Cuts Arthritis Risk in Half
A major, 10-year study has shown a daily dose of cholesterol-lowering drug statins to more than halve the chances of getting osteoarthritis (OA). The study published in the Journal of General and Internal Medicine (May 2013) reviewed more than 16,000 adults and found that people on the highest doses of statins—18.5 mg or more a day—had 60 percent lower OA rates than people not taking the drugs. The rate in reduction lessened to 20 percent when taking between 10 mg to 18.5 mg daily. Interestingly, those taking very low doses of statins seemed to be at higher risk of arthritis than patients not taking statins. The researchers said the findings suggest that OA may be more closely linked to heart disease than once thought. “Our work has shown that the risk factors for cardiovascular disease are also associated with OA,” the study’s authors report.
Glucosamine Supplements Linked to Risk of Eye Condition
The risk of developing glaucoma increases with the use of glucosamine supplements, according to a small study published as a research letter in JAMA Ophthalmology (May 23, 2013). In a review of 17 people, whose average age was 76 years, 11 participants had their eye pressure measured before, during and after taking glucosamine supplements. The remaining six had their eye pressure measured during and after they took the supplements. Overall, pressure inside the eye was higher when participants were taking glucosamine, but returned to normal after stopping use of the supplements, the study reports. The researchers admit limitations due to not having information on the dose or brand of glucosamine used, or for how long some of the participants were taking the supplements.
Dextrose Injections May Ease Knee OA
Injections of the sugar solution dextrose into the joint signicantly improved quality of life among patients with osteoarthritis in the knee, a randomized study showed. Patients who received the dextrose injections—a treatment known as prolotherapy—showed a 24 percent improvement on a knee-specific quality of life scale at one year, according to a study published in the May/June issue of Annals of Family Medicine. The research reviewed 90 adults with an average of five years of pain in one or both knees. Previous studies show conflicting evidence regarding the efficacy of prolotherapy injections, with limited evidence of its impact on joints. Further studies are needed to determine the impact of prolotherapy, particularly as it applies to knee OA.