In The News: December 2010
Statins May Prevent Rheumatoid Arthritis
Statins, known for their ability to lower cholesterol and prevent strokes and heart attacks, may also reduce the risk of developing rheumatoid arthritis (RA). Researchers at Maccabi Healthcare Services in Tel Aviv, Israel, found—after collecting data on 1.8 million of its patients—that those who took statins less than 20 percent of the time had a 23 percent higher risk of developing RA than those who took statins 40 to 50 percent of the time. The study also found that those not taking statins had a 51 percent higher risk of developing RA over approximately 80 percent of the follow-up period. After looking at other possibilities, researchers noted that those who took statins regularly had a 41 percent lower risk of developing RA compared to those who did not take statins regularly. The study also found that the effect of statin use was strongest in younger patients and in patients using more effective statins.
New Target Improves Pain Management After Chronic Morphine Use
Researchers have discovered a major mechanism underlying the development of tolerance to chronic morphine treatment. Overcoming tolerance to morphine after chronic use has been a persistent problem in treating patients with severe pain; after a week of morphine use, its effectiveness decreases as patients build tolerance. Investigators at Mount Sinai School of Medicine in New York identified changes in the brain that occur during the continuing administration of morphine, providing a treatment target for preventing tolerance to the pain killer. After studying changes in the abundance of a protein complex containing different types of opioid receptors in the brains of mice, researchers concluded that it is the accumulation of this protein complex in pain-processing brain regions that may be the cause of morphine tolerance. The discovery may help investigators find new therapies to treat chronic pain and reduce the tolerance and side effects associated with morphine use.
Older Patients May Benefit from Rotator Cuff Repair
A new study has determined that arthroscopic surgery to repair a torn rotator cuff can reduce shoulder pain and improve shoulder mobility in people 70 and older. Rotator cuff surgery has often been discouraged in older people because the risk of complications, and the inability of an older person to recover quickly, has been thought to outweigh the potential benefits. Researchers at Chicago’s Rush University Medical Center found, on the contrary, that surgery does have real benefits for older people. Researchers looked at 39 people age 70 or older who had arthroscopic surgery to repair a fully torn rotator cuff. After two years, the subjects’ shoulders were found to function better and have greater mobility and strength than before surgery. Additionally, 96 percent of the former patients experienced complete pain relief. Researchers cautioned that the subjects all had full-thickness tears, in which the tendon or muscle is torn all the way through. Partial tears of the rotator cuff are more common than full-thickness tears. Researchers recommended that people with rotator cuff tears should in almost all cases try nonsurgical treatments first, including ice, rest, the use of a sling, corticosteroid injections, and nonsteroidal anti-inflammatory drugs.
Biomarker Could Help Doctors Tailor Arthritis Pain Treatment
Investigators have identified a biomarker—a biological molecule that is used to measure the presence or progression of a disease—that could help doctors select patients with rheumatoid arthritis (RA) who would benefit from the new biologics, TNF- blockers, that work by interrupting the chemical chain of events the immune system uses in its attacks. A study of 35 RA patients conducted at New York City’s Hospital for Special Surgery found that people who had the highest levels of an immune system protein called type I interferon also had the best response to TNF-blockers. Given the high cost of biologic drugs, and the fact that they are not highly effective in 30 to 50 percent of patients, the findings should help doctors decide whether to prescribe the drugs or try another therapy to relieve RA pain.