News May 2014 Issue

In The News: May 2014

Hand Arthritis Eased with Nighttime Finger Splints
Inexpensive splints worn nightly can reduce the pain of hand osteoarthritis (OA), according to a study published in the journal Rheumatology (Feb. 2014). In the study, researchers tested custom-made splints on patients who suffered painful and deforming hand OA. Of the 23 participants who completed the study, 74 percent reported reduced pain after wearing splints for three months. Additionally, their average pain was lower three months after they stopped wearing the splints. A separate study reported hand pain was halved for patients who wore a long and rigid splint every night for a year.

Medical Marijuana: Evidence Lacking Regarding Benefit
Rheumatologists should not recommend the use of medical marijuana for chronic pain relief, state researchers in Arthritis Care & Research (March 3, 2014). Included in the reasons for this direction are acute and chronic risks, a lack of evidence for efficacy and the absence of data on appropriate dosing, the study indicates. Twenty states have legalized medical marijuana, resulting in increased requests for use of the drug for pain relief. Surveys have suggested that arthritis pain is one of the most common reasons patients use medical marijuana. Yet, evidence for efficacy in rheumatologic disease is limited.

Restless Sleep Linked to Widespread Pain
A bad night’s sleep may be responsible for widespread pain among people over 50, reports a study in the journal Arthritis & Rheumatology. Researchers collected data from 4,326 people over age 50 to analyze their psychosocial and physical health, lifestyle and levels of pain. In the beginning, all patients were free of widespread pain, while 2,764 reported some pain and 1,562 reported no pain. When following up three years later, researchers discovered that 19 percent of participants had developed new widespread pain. After adjusting for osteoarthritis, the study found that those who experienced non-restorative sleep, anxiety, poor physical health or cognitive complaints were more likely to have developed widespread pain.

FDA Approves Sodium Hyaluronate Injection for Knee OA
The Food and Drug Administration (FDA) approved sodium hyaluronate (Monovisc®) single-injection supplement to relieve pain and improve joint mobility in patients with knee osteoarthritis who failed to respond to conservative non-drug treatment and nonsteroidal anti-inflammatory drugs. Sodium hyaluronate is injected into the affected joint. Approved by the FDA on Feb. 25, 2014, sodium hyaluronate is the first single-injection viscosupplement product with hyaluron from a non-animal source.

Treat-to-Target Protocol Effective in Early RA
Disease activity can be lowered in early rheumatoid arthritis (RA) with a treat-to-target strategy combining methotrexate plus intra-articular steroid injections, with rates equivalent to those achieved with the addition of adalimumab (Humira®) in early RA, according to a study published in the Annals of the Rheumatic Diseases (April 2014). A total of 76 percent of patients randomized to methotrexate plus steroid injection had low disease activity as shown by Disease Activity Scores in 28 joints (DAS28) below 3.2 at one year. Eighty percent of those who received the tumor necrosis factor (TNF) also showed the same low disease activity of 3.2. Yet, the absolute DAS28 score, or disease activity, was lower in patients when given adalimumab compared to methotrexate plus injections, reaching a rate of 2 at one year compared with 2.6 for those not receiving the biologic drug. “The impact of adding adalimumab was reflected in [a number to treat] between 4 and 5.4 to achieve one additional case of remission after 12 months by adding the drug,” the researchers noted.