StemCell Therapy

Objectives:Predicting serious infections (SI) in patients with rheumatoid arthritis (RA) is crucial for the implementation of appropriate preventive measures. Here we aimed to identify risk factors for SI and to validate the RA Observation of Biologic Therapy (RABBIT) risk score in real-life settings.

Methods:A multi-centre, prospective, RA cohort study in Greece. Demographics, disease characteristics, treatments and comorbidities were documented at first evaluation and one year later. The incidence of SI was recorded and compared with the expected SI rate using the RABBIT risk score.

Results:A total of 1557 RA patients were included. During follow-up, 38 SI were recorded [incidence rate ratio (IRR): 2.3/100 patient-years]. Patients who developed SI had longer disease duration, higher HAQ at first evaluation and were more likely to have a history of previous SI, chronic lung disease, cardiovascular disease and chronic kidney disease. By multivariate analysis, longer disease duration (IRR: 1.05; 95% CI: 1.005, 1.1), history of previous SI (IRR: 4.15; 95% CI: 1.7, 10.1), diabetes (IRR: 2.55; 95% CI: 1.06, 6.14), chronic lung disease (IRR: 3.14; 95% CI: 1.35, 7.27) and daily prednisolone dose 10 mg (IRR: 4.77; 95% CI: 1.47, 15.5) were independent risk factors for SI. Using the RABBIT risk score in 1359 patients, the expected SI incidence rate was 1.71/100 patient-years, not different from the observed (1.91/100 patient-years; P = 0.97).

Conclusion:In this large real-life, prospective study of RA patients, the incidence of SI was 2.3/100 patient-years. Longer disease duration, history of previous SI, comorbidities and high glucocorticoid dose were independently associated with SI. The RABBIT score accurately predicted SI in our cohort.

Keywords:comorbidities; glucocorticoids; infections; rheumatoid arthritis; risk score.

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Incidence, risk factors and validation of the RABBIT score for serious infections in a cohort of 1557 patients with rheumatoid arthritis - DocWire...

Cold weather can have a significant impact on your health, particularly for those who are suffering from arthritis. As the temperature drops, bones usually become stiff, inflexible and creaking, which can heighten discomfort in the joints, making life of people with arthritis troublesome. In fact, anyone who suffers from arthritis pain can sense and predict the change in weather. Also Read - Arthritis: Smoking and other bad habits that can be deadly for your joints

Not only the cold weather increase stiffness and joint pain, it can also lead to increased anxiety, depression and isolation for patients with arthritis. Also Read - Dont delay your arthritis pain, seek timely intervention

So, here are some tips to ease joint pain, maintain your bone health and stay happy during the winters. Also Read - 5 home remedies and tips to combat winter-induced pain and joint stiffness

Keep your aching hands, knees and legs warm with gloves, tights or leggings, and boots. Add extra layers of clothing, if needed and especially when you go out in winter. But make sure it doesnt restrict your movement. More layers of clothes work better at trapping the body heat than wearing thicker clothes.

Dehydration can make you more sensitive to pain, as revealed by a 2015 study published in Experimental Physiology. Water flushes toxins out of your body, which can help fight inflammation. Also, water helps keep your joints well lubricated. Whats more, drinking water before a meal can promote weight loss. Studies have found significant improvement in people with knee arthritis when they lost weight loss.

Many people tend to hibernate and laze around during the winters. But staying active is crucial for people living with arthritis. It can help ease pain, increase strength and flexibility, and boost energy. Doctors recommend adults with arthritis to do at least 150 minutes of moderate-intensity aerobic activity a week and two weekly sessions of strength training. Note: This advice is for those who have normal physical function and no other severe health conditions. If you want to avoid the winter chill, workout indoors.

A warm shower or soak in a tub, swimming in a heated pool, using heating pads, hot water bag, electric blankets these are some ways to reap the benefits of heat therapy. Heat can improve blood flow and help flush out pain-producing chemicals. It can also stimulate receptors in your skin that improve your pain tolerance. In addition, heat relaxes muscles, which in turn helps decrease spasms and reduce stiffness.

Less exposure to the sun makes it difficult to get enough vitamin D or sunshine vitamin in the winter. Studies have linked lower vitamin D levels with more severe clinical manifestations of rheumatic arthritis. Low vitamin D levels may also increase sensitivity to pain. Therefore, Vitamin D supplement is often recommended for arthritis patients. Talk to your doctor about your need for supplements. Meanwhile, you can add foods that contains vitamin D such as fatty fish like swordfish, mackerel, salmon, and tuna, and fortified products like orange juice, milk, and breakfast cereals to your diet.

Omega-3 fatty acids have anti-inflammatory properties, which can be beneficial for people who have an inflammatory type of arthritis.

A study published in the Annals of Rheumatic Disease in 2013 found that people with rheumatoid arthritis who took omega-3s supplements had a reduction in joint pain. Other studies suggest that omega-3s may help rheumatoid arthritis patients lower their dose of nonsteroidal anti-inflammatory drugs (NSAIDs). People with rheumatoid arthritis are at higher risk of heart disease, and omega-3s are known for their role in promoting heart health.

Fish oil is a rich source of omega-3 fatty acids. Plant-based sources of omega-3 fatty acids include avocado, flaxseeds, and walnuts.

Published : December 8, 2020 7:50 pm | Updated:December 8, 2020 8:04 pm

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Winter can exacerbate arthritis pain: Heres how to deal with it - TheHealthSite

Eat This, Not That!

One year ago, the holiday movie season was about to kick off, shopping centers were filled to the brink with people, and little kids were sitting on Santa's lap telling him what they wanted for Christmas. However, since COVID-19 became a threat to the health of Americans in early 2020, life as we know it has changed drastically. With a seemingly safe and effective vaccine just days to weeks away, many people are hoping there will be a return to normalcy within the next few months. On Tuesday, Dr. Anthony Fauci, the nation's leading infectious disease expert, spoke with The Wall Street Journal's Jonathan D. Rockoff, revealing when he expects life to be "normal" again. In short, it depends on the actions of you: the American people.. Read on, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.We Could "Start Approaching Normality" by Q2/Q3, Says Dr. FauciWhile a vaccine will help us return to normalcy, it will only be effective if people actually get it. "I think that if we implement the vaccine program that I've just been describing with you, John, that we can do it in the back half of 2021," Fauci revealed."I believe if we get people vaccinated at a good rate, as we get into the open component where anybody can get vaccinated in April, May, June, July, I believe as we get to the end of the second quarter into the third quarter of the 2021, we can have a degree of protection community that we could start approaching normality in many of that over activities."So what will normal look like? It will involve "getting the CEOs"he mentioned CEOs because many were tuning into the Wall Street Journal livestream"to feel comfortable in getting people back in their establishments, having restaurants get in full capacity indoor, having some indoor functions that we can feel safe," such as theaters and places of entertainment and sports events.RELATED: 7 Tips You Must Follow to Avoid COVID, Say DoctorsNormality Depends on Enough People Taking the VaccineHowever, he reiterated that in order to get back to normal "towards the second half of 2021," we would need to "implement the vaccine program properly and aggressively." He sounds confident about the distribution. But there are hurdles, like convincing those who are anti-vaccine to take it. He's been promoting the safety of the vaccine to help spread the good word. "The data to prove it's safe and effective is seen first and only, and exclusively, by an independent data and safety monitoring board, not by the company, not by the federal government, but by an independent group of clinicians, vaccinologist immunologists, virologists, statisticians. They look at the data when the data shows, which it has, that the vaccine is safe and efficaciousIf you can get people to understand that, with an open mind, you will have essentially dissolved any reason that they might have for not getting vaccinated," he said. "And if they still don't want to get vaccinated, then I think there's something that we really can't overcomethat just inherently anti-vax."RELATED: Simple Ways to Avoid a Heart Attack, According to DoctorsHow to Stay Healthy During the PandemicUnfortunately, it is unlikely that COVID-19 will ever fully go away, and will forever linger. "I don't think we're going to eradicate it the way we did with smallpox, but I think we can do what we've done with polio and what we've done with measles and other vaccine-preventable diseases," he admitted.Until the vaccine takes into effect and there is herd immunity, public health measures will be crucial. Do everything you can to prevent gettingand spreadingCOVID-19 in the first place: Wear a face mask, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.

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6 Things That Can Make Rheumatoid Arthritis Symptoms Worse - Yahoo Canada Shine On

A study examined factors that may be associated with poorer intensive care unit (ICU) outcomes among patients with rheumatoid arthritis (RA).

Immunosuppressive treatment for RA using glucocorticoids, conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biologic disease-modifying antirheumatic drugs (bDMARDs), and targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs; e.g., JAK inhibitors) significantly improves disease activity and joint destruction; however, numerous comorbidities and complications, including infection, malignancy, and organ failure (cardiovascular disease [CVD], respiratory distress, and renal failure) remain associated with the increased mortality of RA patients compared with the general population, the researchers noted.

The retrospective study, published in BMC Rheumatology, consisted of 67 patients (47 were female) with RA admitted to the ICU for at least 48 hours between January 2008 and December 2017, who were assessed for 30-day mortality. Six patients were admitted to the ICU more than once during the study period, in which case only the first ICU admission was analyzed.

The median age at the time of admission was 70 years, and RA duration was 10 years. The five-year survival rate after ICU admission was 47%. The 30-day mortality rate was 22%, 90-day rate was 27%, and one-year rate was 37%. Most patients were admitted to the ICU due to infection (40%) and cardiovascular complications (24%). When in the ICU, the most common treatments were vasopressor (78%), mechanical ventilation (69%), and renal replacement (25%).

Two-thirds of the 30-day mortality patients died as a result of infection; factors associated with mortality were a significantly higher glucocorticoid dose, updated Charlsons comorbidity index (CCI), and acute physiology and chronic health evaluation (APACHE) II score.

According to laboratory data collected at admission, factors predictive of a significantly poorer prognosis were lower platelet number and total protein and higher creatinine and prothrombin time international normalized ratio (PT-INR). Upon multivariate analysis, factors that increased mortality risk following ICU admission were nonuse of csDMARDs, high updated CCI, increased APACHE II score, and prolonged PT-INR.

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When Admitted to the ICU, These Factors in Patients with Rheumatoid Arthritis May Increase Mortality Risk - DocWire News

New findings from a clinical utility study in Rheumatology International

A new study published in Rheumatology International demonstrates clinical utility of PrismRA test in guiding therapy selection for rheumatoid arthritis patients.

Dr. James Mossell

Dr. James Mossell, DO is a Rheumatology Specialist in Tifton, GA and has over 31 years of experience in the medical field. He graduated from New York Osteopathic Medicine - New York medical school in 1989 and completed his fellowship in rheumatology at the University of Florida. He is affiliated with medical facilities such as the Tift Regional Medical Center, Coffee Regional Medical Center, and Crisp Regional Hospital. He is also a fellow with the American College of Rheumatology.

WALTHAM, Mass., Dec. 07, 2020 (GLOBE NEWSWIRE) -- Scipher Medicine, a precision immunology company matching patients with the most effective therapy, today announced findings from a clinical utility study published in Rheumatology International that the PrismRA test can lead to major changes in prescribing behaviors. When test results indicated a likelihood of non-response, up to 89% of providers shifted their proposed therapy from tumor necrosis factor inhibitor (TNFi) to an alternative drug class based on the PrismRA score.

The majority of rheumatoid arthritis (RA) patients prescribed the worlds largest selling drug class, TNFi, do not adequately respond to treatment. PrismRA is a first-of-its-kind blood test that accurately predicts patients who will not have an adequate response to TNFi therapy so alternative effective therapy can be prescribed from day one, without first cycling through multiple TNFi drugs.

The results of this study clearly show that rheumatologists would change their medical management of RA patients if they had access to a predictive biomarker test like PrismRA, said James Mossell, Doctor of Osteopathic Medicine, Fellow of the American College of Rheumatology and an author of the study. Rheumatologists are eager to use precision medicine in complex autoimmune diseases such as RA and find high value in eliminating therapies that will likely fail in certain patients before selecting a more optimal targeted therapy.

The study surveyed 248 rheumatologists as to the clinical utility of a TNFi non-responder biomarker. A vast majority found the test easy to interpret and clinically useful, selection of TNFi therapy declined by 81% (from 79.8% to 15.3%) and 86% (from 79.8% to 11.3%) respectively when presented with a test result indicating a high or very high signal of non-response.

The clinical breakthrough enabled by PrismRA means more patients will be prescribed effective therapy sooner resulting in significantly improved health outcomes, said Alif Saleh, CEO of Scipher Medicine. We are pleased this study demonstrates the support of PrismRA by the rheumatology community.

About Scipher Medicine

Scipher Medicine, a precision immunology company, holds the fundamental belief that patients deserve simple answers to treatment options based on scientifically backed data. Leveraging our proprietary Network Medicine platform and artificial intelligence, we commercialize blood tests revealing a persons unique molecular disease signature and match such signature to the most effective therapy, ensuring optimal treatment from day one. The unprecedented amount of patient molecular data generated from our tests further drives the discovery and development of novel and more effective therapeutics. We partner with payers, providers, and pharma along the health care value chain to bring precision medicine to autoimmune diseases. Visit http://www.sciphermedicine.com and follow Scipher on Twitter, Facebook, and LinkedIn.

About PrismRA

PrismRA, a molecular signature test, is a revolutionary advancement bringing precision medicine to the treatment of rheumatoid arthritis, which affects 20 million patients globally. From a routine blood draw, the PrismRA test analyzes an individual's molecular signature, helping identify who is unlikely to adequately respond to TNFi therapy, the worlds largest selling drug class, so non-responders can be prescribed alternative effective therapy. Providers now have objective data to guide therapeutic decision-making and give patients the best chance of achieving treatment targets and improving clinical outcomes. For more information, please visit http://www.PrismRA.com

Media Contact:Alexander PettiAlexander@TakeOnCommunications.com201-978-4882

Scipher Medicine company contact:Andrea Mooreandrea.moore@scipher.com801.209.1175

Photos accompanying this release are available athttps://www.globenewswire.com/NewsRoom/AttachmentNg/63fce27f-c5e3-421b-a9c6-e57d9e2ffa99https://www.globenewswire.com/NewsRoom/AttachmentNg/3a651586-0fb6-433c-af6a-bb41baeb2b0c

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New Study Demonstrates Clinical Utility of PrismRA Test in Guiding Therapy Selection for Rheumatoid Arthritis Patients - GlobeNewswire

Among patients with rheumatoid arthritis (RA), there is a correlation between the cortical thickness relative to the transverse diameter of third metacarpal bone and bone mineral density (BMD), suggesting this can be a promising screening tool for osteoporosis in this population, according to study results published in Bone.

Patients with RA are at increased risk for osteoporosis and fragility fractures. While dual-energy X-ray absorptiometry (DXA) is the gold standard for the diagnosis of osteoporosis, it is not widely available in many countries worldwide. Here the researchers sought to determine whether a screening index for BMD loss can be used as a substitute to the DXA method.

The Sharp/van der Heijde Scores were calculated using X-ray pictures of both sides of the hand. All patients with RA treated at Yoshii Hospital, Kochi, Japan, between April 2014 and September 2019, were subjected to the routine administration of X-ray pictures of the bilateral hands and feet at the first consultation and thereafter in order to calculate Sharp/van der Heijde Scores. Cortical thickness and the transverse diameter of the mid-portion of the metacarpal bone of the right middle finger were calculated and researchers determined the Cortical Thickness Ratio (CTR) as the cortical diameter relative to the transverse diameter. At the same time, BMD of the lumbar spine and femoral neck was measured.

Using the receiver operation characteristics (ROC) technique, the cut-off index of the CTR to the BMD was calculated. In addition, sensitivity, specificity, area under the curve, and the odds ratio for T-score < -2.5 were evaluated.

The cross-sectional study included 300 patients with RA (87.4% women, mean age 73.9 years). The mean transverse width of the third metacarpal bone was 7.3 mm and the thickness of the cortex was 2.0 mm, thus the average SD CTR was 0.2790.124.

There was a significant correlation between CTR and BMD in both the lumbar spine and femoral neck according to DXA testing.

In ROC analysis, the cut-off index of the CTR was 0.25 for the lumbar spine and femoral neck. For the lumbar spine, the sensitivity was 67.9% and the specificity was 83.0%, with an area under the curve of 0.78, and an odds ratio of 4.17 (95% CI, 2.51-6.92). For the femoral neck, sensitivity was 76.1%, specificity was 81.6%, the area under the curve was 0.81 with an odds ratio of 4.90 (95% CI, 2.75-8.73).

The index was examined in treatment nave patients in order to eliminate confounding of drug interventions, and the data suggested the CTR is a potential useful tool for the initial screening of osteoporosis for patients who are nave for osteoporosis and RA treatment.

[T]he CTR may be a strong candidate marker for screening for osteoporosis in patients with RA with the index less than 0.25. These findings may provide physicians with the diagnosis of osteoporosis in patients with RA, concluded the researchers.

Yoshii I, Akita K. Cortical thickness relative to the transverse diameter of third metacarpal bone reflects bone mineral density in patients with rheumatoid arthritis. Bone. 2020;137:115405. doi:10.1016/j.bone.2020.115405

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New Screening Tool for Osteoporosis in Patients With Rheumatoid Arthritis - Rheumatology Advisor

In mid-November, an arthritis drug with a tricky name hit a pandemic milestone then slipped back into relative obscurity.

The drug, baricitinib, was granted an emergency authorization by the Food and Drug Administration to treat a subset of hospitalized Covid-19 patients in combination with another medication, the antiviral remdesivir. It is one of only a handful of treatments to have earned the agencys green light.

But baricitinibs reception by the medical community has been lukewarm. It doesnt work all that well, for one thing, and comes with side effects, such as blood clots. And at a cost of roughly $1,500 per patient, many doctors dont know when it would make sense to use the drug, which might have overlapping roles with cheap and widely available steroids like dexamethasone.

In a clinical trial sponsored by the National Institutes of Health, hospitalized Covid-19 patients treated with baricitinib and remdesivir recovered one day faster than patients who had received remdesivir alone.

I think its really a nothing burger, said Dr. Ilan Schwartz, an infectious disease physician at the University of Alberta. Were talking about adding a drug that reduces the time to clinical improvement by one day, in a disease that takes weeks to recover.

These results, which were announced through a series of news releases by drugmaker Eli Lilly, have yet to be published in a peer-reviewed scientific journal. Kristen Porter Basu, a spokeswoman for the company, wrote in an email that a more detailed analysis would be published very soon.

When an emergency authorization has been released but the data have not, doctors are caught in a difficult place, said Dr. Manuela Cernadas, a critical care physician at Brigham and Womens Hospital in Boston. Its not entirely clear where this drug fits in our armamentarium of drugs were comfortable using.

Baricitinib is a repurposed arthritis treatment that, like a steroid, dampens inflammation, which, in severe cases of Covid-19, can spiral out of control and destroy healthy tissues. The drug acts like a molecular muffler, preventing the cells from responding to alarm signals that could make the bodys immune response spiral out of control.

The N.I.H. trial was designed to test whether baricitinib could boost the benefits of remdesivir, now the standard of care for Covid-19 patients. Remdesivir by itself speeds recovery by several days. The researchers found that the addition of baricitinib clipped an additional day off a patients recovery time and kept a few extra people off ventilators. But these and other results largely failed to impress experts, many of whom said the drug would need to have far bigger benefits to outweigh its price tag and potential harms.

It seems more incremental than blockbuster, said Dr. Taison Bell, a critical care physician at the University of Virginia, who was involved in the clinical trial. Although Dr. Bell described baricitinib as a reasonable addition to the Covid treatment toolbox, and even deserving of an emergency approval, I dont think its a game changer, he said.

Still, the findings were enough to convince the F.D.A., which issued an emergency authorization on Nov. 19. The drug is now allowed to be paired with remdesivir, but only to hospitalized patients who need supplemental oxygen, mechanical ventilation or other breathing support.

The agencys limited clearance aligns with the subset of patients in the N.I.H. trial who benefited the most from the dual drug combo, said Dr. Andre Kalil, an infectious disease physician at the University of Nebraska Medical Center and one of the lead researchers on the trial.

But this same population of patients people sick enough to need some form of breathing support would also be great candidates for steroids like dexamethasone, said Dr. Phyllis Tien, an infectious disease physician at the University of California, San Francisco.

Dexamethasone, unlike baricitinib, has been shown in studies to curb mortality in severely sick Covid-19 patients. A generic drug, its also cheap, costing cents or dollars per day of treatment, and has for months been a part of the coronavirus treatment playbook.

Im asking myself, Who would I think about using baricitinib in, over dexamethasone? Dr. Tien said.

But Dr. Boghuma Kabisen Titanji, an infectious disease physician at Emory University who pioneered early studies of baricitinib against the coronavirus, offered a more sobering perspective on dexamethasone. Steroids are blunt knives, she said, quashing inflammation on a broader scale than drugs like baricitinib do. Thats why steroids come with a host of unwanted side effects, including exacerbating conditions like diabetes or osteoporosis, she said.

The family of drugs that includes baricitinib, on the other hand, may offer more therapeutic precision, Dr. Titanji said. Theres also been some evidence that baricitinib might be able to block the coronavirus from entering cells.

Confused by the terms used about how to treat Covid-19?Let us help:

Still, baricitinib comes with its own problems, such as raising the risk of blood clots already an issue in many cases of Covid-19. That does give you pause, Dr. Cernadas said.

Both baricitinib and dexamethasone also blunt immune function, increasing the likelihood that other viruses or bacteria might infiltrate the bodies of the people theyre used in. But of the two, dexamethasone is the devil you know, said Dr. Lauren Henderson, a pediatric rheumatologist at Boston Childrens Hospital. I would probably not turn to baricitinib as a first line.

Dr. Tien and other experts echoed this sentiment, saying they would be likely to choose dexamethasone over baricitinib when treating someone with a serious case of Covid-19, unless there was an obvious reason their patient might respond poorly to steroids.

A head-to-head comparison between baricitinib and dexamethasone might clarify which patients would be better off taking one drug over another. At the end of November, the N.I.H. announced a trial that will compare outcomes between hospitalized Covid-19 patients who receive either a combination of remdesivir and dexamethasone, or a combination of remdesivir and baricitinib. But Dr. Schwartz and others raised ethical concerns about this trial, which he said would by definition deprive some patients of a lifesaving steroid therapy.

Eli Lilly is also running a trial to study the effects of baricitinib on its own in hospitalized patients. In this study, which isnt likely to finish until next summer, all participants will receive dexamethasone.

Link:
Baricitinib: Doctors Are Skeptical of This Covid-19 Drug From Eli Lilly - The New York Times

The Scandinavian countries may look rather similar when watching from a distance. However, if you zoom in on details, the differences become manifest.

This has been a returning truth in the more than ten years that the NORD-STAR collaboration has been running.

Initially, we saw the similarities: All countries (including the Netherlands, which joined the collaboration half-way through) had a history of high quality research in the field of rheumatoid arthritis and an idea of how to treat this debilitating and destructive inflammatory disease best. Investigator-initiated trials such as Fin-RACo and Neo-RACo (Finland), Swe-fot (Sweden), ARCTIC (Norway), CIMESTRA and OPERA (Denmark) and BeSt (The Netherlands) have contributed important knowledge to the field. Despite the modest sizes of our countries, our national quality registries (ARTIS, DANBIO, ICEBIO, NORDMARD, ROB-FIN) have informed clinicians around the world about treatment outcomes for real world patients with inflammatory arthritis. Moreover, in all countries biological drugs with different modes of action were widely available due to a tax-paid system for reimbursement.

Despite our previous research at the national level, we were stuck with an important, unanswered clinical question: What are the benefits and harms of the different biological therapies compared with active conventional treatment in patients with early rheumatoid arthritis?

The question had multiple aspects: The shorter term ability of the different therapies to induce remission was key. However, longer term results regarding the prevention of joint damage and safety profile were also important. Would there be differences in the flare rates between the drugs if treatment was de-escalated? Would spin-off projects based on the study biobank pave the way for more tailored treatments?

A cross-national collaboration was needed to answer these questions with sufficient statistical power. For our investigator-initiated trial, we needed more than 800 treatment-naive patients randomized to four different treatments, turning our study into one of the largest ever in rheumatoid arthritis.

This was when the differences between our countries became evident. Defining the active conventional therapy was a hard nut to crack in the planning of the design. Despite very similar EU-based legislation across the countries, bureaucratic obstacles challenged the approval from ethics, medical and data authorities. Securing public funding for the study infrastructure was an important milestone in the early phases, as was the willingness of two of three companies to provide us with free study drug.

We are proud to present the first results in The BMJ. Our 24-week results highlight the efficacy and safety of active conventional treatment based on methotrexate combined with corticosteroids, with nominally better results for the biologic abatacept.

The NORD-STAR research network has solved challenges, coped with frustrations, shared the joy and excitement during the various phase of the project. Ten years so far, and probably ten more years before we have the last results.

We believe the currentand futureresults from the NORD-STAR trial and spin-off projects will provide the medical community with important insights on how to best care for patients with early rheumatoid arthritis.

Merete Lund Hetland, Professor in Rheumatology, Consultant, and Head of the DANBIO steering committee, Copenhagen Center for Arthritis Research (COPECARE) and DANBIO, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.

Competing interests: Please see research paper for more details.

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Merete Lund Hetland: A cross country collaboration to assess the benefits and harms biological therapies for early rheumatoid arthritis - The BMJ -...

UPPER NYACK, N.Y.--(BUSINESS WIRE)--CreakyJoints, the digital arthritis community for patients and caregivers worldwide and part of the Global Healthy Living Foundation (GHLF), today announced the launch of eRheum.org, a new digital destination to help patients get the most from their telehealth appointment. Data presented at the 2020 ACR Convergence by CreakyJoints from our ArthritisPower supported Autoimmune COVID-19 Project showed that as the pandemic ramped up (post-March 15, 2020) return patient appointments dropped and telehealth visits increased, but not enough to overcome the frequency of missed/cancelled in-person appointments. This is a problem because disruptions in rheumatology care slow the rate at which patients can be diagnosed and treated, adversely affecting health outcomes and chronic disease management. Optimizing the availability and effectiveness of telehealth appointments will help with continuity of care.

After consulting with rheumatologists and speaking with our patient members, we recognized the urgent need to help patients understand how to access telehealth and make the most of their virtual appointment, said Louis Tharp, executive director and co-founder of CreakyJoints and the Global Healthy Living Foundation. Written in patient-friendly language, eRheum defines telehealth and how rheumatologists utilize it, provides patients with access to difference video conferencing portals to try with their physician, and explains how to make the most of your limited face-to-face time with your physician during the appointment itself.

Taking Advantage of Telehealth

In May of 2020, GHLF asked its chronic disease patient community to rate their experience with telehealth over the previous two months on a scale of 1-10 (where 10 = excellent experience). Seventy-three percent of respondents said they have used telehealth in the past two months and of those who have used it, they rated with experience as eight. Given the positive response, CreakyJoints built eRheum.org with arthritis patient input and then shared it with provider groups to encourage them to share it with patients in their care. In addition to the main portal, eRheum has been adopted and co-branded by the Association of Women in Rheumatology (AWIR) and the Rheumatology Nurses Society (RNS).

"Weve taught our patients who are on immunosuppressants for so long to avoid communicable diseases, particularly during flu season. This pandemic has really affected their willingness to venture out of their homes, even to medical appointments. Understandably, those with chronic diseases like inflammatory arthritis, who also already belong to a group with some of the highest risks for COVID-19 serious complications, such as blacks, Hispanics, the elderly, or those who are overweight, are most reluctant to venture out, said RNS President Cathy Patty-Resk, MSN, RN-BC, CPNP-PC. We introduced eRheum to our nurses and advanced practice providers in our organization because we want to continue to be the resource they need for their patients. The tools available on eRheum promote confidence in patients to ask their questions to get the care they need to continue effectively managing their condition.

AWIR is dedicated to improving the health of all patients with rheumatic diseases and bridging the gaps experienced by patients from diverse backgrounds. Virtual care allows us to bring our caring to our patients wherever they are, and wherever we are. We embrace this initiative to optimize care for our patients, said Grace C Wright M.D. PhD., President of AWIR.

Understanding Telehealth Best Practices

Recently, the University of Alabama at Birmingham announced that the university and collaborators such as Cedars-Sinai Medical Center and CreakyJoints and its ArthritisPower Research Registry received a two-year, $400,000 grant from the American College of Rheumatologys Rheumatology Research Foundation to support telehealth-delivered healthcare. The Telehealth-delivered Healthcare to Improve Care (THRIVE) projects primary investigator, Swamy Venuturupalli, M.D., is the recipient of this years ACRs Norman B. Gaylis, M.D., Clinical Research Award, and the study is slated to begin in January of 2021.

THRIVE seeks to evaluate the quality of telehealth services when provided to a rheumatology patient in their home and deliver recommendations for physicians about best practices regarding what telehealth-related care delivery should include, how to deliver it, and how to standardize high quality care. It will produce a peer-reviewed white paper that describes those best practices. Overall, the goal is to expand the impact of rheumatology by increasing patient access to care, especially among those marginalized or most at risk by the COVID-19 pandemic. CreakyJoints will produce a patient-facing training video that will show rheumatoid arthritis (RA) patients how to perform joint self-assessment and compare its accuracy with an in-person clinician joint exam (the gold standard).

Telehealth offers patients the flexibility they need to stay in contact with their doctors, but this works only when both parties understand how to get the most out of the appointment, said W. Benjamin Nowell, PhD., Director, Patient-Centered Research at CreakyJoints, principal investigator of the ArthritisPower Research Registry, and a co-investigator of the THRIVE study. Telehealth in rheumatology has some unique features and this study is an important complement to eRheum as it enables us to further enhance the telehealth tools and education we offer to rheumatologists and people living with arthritis. Ultimately, we want to do all we can to ensure productive and satisfying telehealth appointments for arthritis patients and their doctors.

About CreakyJoints

CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. We represent patients in English and Spanish through our popular social media channels, our websites http://www.CreakyJoints.org, http://www.creakyjoints.org.es/, http://www.creakyjoints.org.au, and the 50-State Network, which includes more than 1,500 trained volunteer patient, caregiver and healthcare activists.

As part of the Global Healthy Living Foundation, CreakyJoints also has a patient-reported outcomes registry called ArthritisPower (ArthritisPower.org) with more than 29,000 consented arthritis patients who track their disease while volunteering to participate in longitudinal and observational research. CreakyJoints also publishes the popular Raising the Voice of Patients series, which are downloadable patient-centered educational and navigational tools for managing chronic illness. It also hosts PainSpot (PainSpot.org), a digital risk assessment tool for musculoskeletal conditions and injuries. For more information and to become a member (for free), visit http://www.CreakyJoints.org.

Find us on social media:Facebook: https://www.facebook.com/creakyjoints and https://www.facebook.com/GlobalHealthyLivingFoundation/ Twitter: @GHLForg, @CreakyJoints, #CreakyChatsInstagram: @creaky_joints, @creakyjoints_aus, @creakyjoints_espTikTok: globalhealthylivingfndLinkedIn: https://www.linkedin.com/company/ghlf/

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CreakyJoints Launches eRheum.org to Educate Patients on Getting the Most From Their Telehealth Appointment - Business Wire

Thursday evening's Our Health event gives local residents a chance to get answers to their questions regarding the disease

Getting answers about a debilitating medical condition can sometimes be a challenge.

Thats why Thursday's Our Health session will explore the toll arthritis exerts on area residents, who might be having trouble these days getting out of a chair or walking up the stairs at home.

It's serious, said Dr. Olivia Cheng, an orthopaedic surgeon at Georgian Bay General Hospital and Collingwood General and Marine Hospital.

One in five Canadians live every day with arthritis and there is no cure. Arthritis is a collection of conditions affecting joints and other tissues. It causes pain, restricts mobility and diminishes quality of life.

Entitled Living your Best Life with Arthritis, the live, virtual event goes Thursday at 7:30 p.m.Moderated by retired physician Keith Rose, Cheng and other panelists will discuss how residents can manage their symptoms and improve their quality of life through therapeutic exercise, physical activity and joint-replacement surgery.

According to the Canadian Arthritis Society, arthritis affects about 6 million Canadians. There are many types of arthritis, including non-inflammatory osteoarthritis or inflammatory such as rheumatoid arthritis.

Osteoarthritis affects one in six Canadians. It is a chronic disease which causes pain, stiffness, swelling and decreased movement in the hips, knees, fingers, toes or spine resulting from the bodys failed attempt to repair damaged joint tissue.

When we look at the impact of arthritis, we need to take into consideration other musculoskeletal disorders affecting the joints, ligaments, tendons, bones, etc., Cheng said. All of these can cause pain and functional limitations.

Arthritis is often written off as just arthritis, and a natural part of aging, however, the mortality, morbidity burden of arthritis and the economic cost of arthritis has been underestimated. As a result, people often live with arthritis for years before receiving appropriate help.

Cheng said its important to learn about the symptoms of arthritis and to seek appropriate help.

Early diagnosis and treatment of the illness can prevent or delay progression of the disease, she said. Also, managing the symptoms of arthritis can help you live a better life. The natural history of arthritis is that this disease will flare up intermittently with an overall progression over time.

According to Cheng, risk factors for arthritis that you can control include being overweight, previous injury to the joint and smoking with factors beyond ones control ranging from age, gender since its more common in women and genetics since inflammatory arthritis often runs in the family.

Once you are diagnosed with arthritis, then you can address the factors that are within your control, she said. These include strengthening exercises to help protect and unload your joint.

Keeping your weight healthy will help decrease the mechanical load on your joint and decrease the inflammatory factors in your body. Environmental factors such as eating food that minimizes inflammationand stopsmoking are also important.

For inflammatory arthritis such as rheumatoid arthritis, there are many advances in medications that can help control the disease progression.

Cheng said shes often asked about the wait list for total joint-replacement surgeries.

There is an increase in the prevalence of arthritis in Canada, the static trend in rates of joint-replacement procedures suggests that the system may be operating at capacity, she said. In our region, patients with arthritis are referred by their family doctors to a central intake clinic where they are assessed by an advanced-practice physiotherapist.

Patients who are candidates for surgery are then referred to either their preferred or next available surgeon. The limiting factors on the ability for us to perform joint-replacement surgery include the number of joints we are allocated by the health ministry, operating room availabilityand hospital capacity.

Thursdays event will be broadcast on Rogers TV channel 53 (Midland, Tay and Penetanguishene only). For those with smart phones, tablets or computers with a Wi-Fi connection, you can view online. Questions can be submitted to mccjared@mcc.com.

Originally posted here:
Help to alleviate the nagging, debilitating pain of arthritis - OrilliaMatters

In early November 2020, at the age of only 33, former British national champion and Omloop Het Nieuwslad winner Ian Stannard announced he would retire from professional cycling, having developed rheumatoid arthritis...but it doesn't have to mean the end of your time in the saddle.

> Health Q&A: Ischial bursitis more than just a saddle sore

So, what is rheumatoid arthritis, and how can it affect cyclists?In this Q+A, consultant rheumatologist at University Hospitals of Morecambe Bay NHS Trust and honorary senior lecturer at Manchester University Dr Marwan Bukhari explains why a diagnosis of rheumatoid arthritis doesnt have to stop you riding, and why cycling might actually help to preventdeveloping it in the first place...

road.cc: First of all, what is rheumatoid arthritis?

Marwan Bukhari: Rheumatoid arthritis is an auto-immune condition where your immune system decides to activate itself and starts attacking different parts of your body. It usually starts in the joints but it can affect most of the organs in your body, including the eyes, the lungs and the skin. So while it often begins in the joints, it can become far more widespread.

What causes it?

We dont actually know what causes it but its believed that there is a genetic component to it. We think that if you are exposed to an unspecified infection and you have the corresponding genetics, your immune system will activate itself and start by attacking the joints.

Ian Stannard'srheumatoid arthritisinitially presentedin his wrists, but can it present itself elsewhere?

Rheumatoid arthritis most commonly starts off in the hands and feet, then it can affect the knees, elbows and shoulders. Those are the normal joints where it starts, although it can present at any joint in your body - and there are quite a lot of joints in your body!

How would cyclists first spot that they might have an issue?

One of the things that will happen first is that you will start to feel very stiff first thing in the morning, and that will last for more than half an hour after getting up. You will then start to get specific pain and stiffness. For example, a cyclist might have problems grabbing the handlebar, or problems pedalling, with the area underneath the pad of their feet feeling particularly tender. The knees can also get a lot of fluid in them and feel quite tight.

Cyclists are always suffering from a bit of pain or stiffness is there a specific sign that it might be more than just normal activity strain or general fatigue?

Yes, if the pain is very specifically in the joints and if you discover that your motion is significantly restricted. For example, if it is in the hand, just grabbing the brake lever will be painful. You will get fatigue as well and you can get flu-like symptoms - because your immune system is active, its almost as if youre fighting an infection.

What should somebody do if they do think they have a potential problem with rheumatoid arthritis?

The most important thing is to understand that the time between symptom onset and starting treatment is crucial for the prognosis. In the old days, people used to think that anybody with rheumatoid arthritis would end up in a wheelchair or have deformities but that is not the case. If you can have treatment within four months of symptom onset that requires recognising whats happening, seeing your GP, having tests and being referred to a specialist then you can get the disease into remission. But that can only be done if we get the disease under control early enough. Then, to get rheumatoid arthritis into remission requires taking fairly high doses of immune-suppressing treatments. If youre on a fair amount of them, that could make you more susceptible to other problems such as infections, which is obviously a particular consideration in the current climate with so much focus on Covid-19.

How is a diagnosis of rheumatoid arthritis made?

There is a combination of things that are needed to provide a diagnosis. The first is clinical symptoms. Then we use two blood tests: one measures levels of rheumatoid factors, which are proteins that the immune system produces when it attacks healthy tissue; the other is known as anti-cyclic citrullinated peptide (anti-CCP), which are antibodies also produced by the immune system. Then that might be combined with some imaging - either x-rays or ultrasound imaging of the joints.

We tend to think of arthritis as an old persons condition, but Ian Stannard is only 33 so at what age can it develop?

Even children can develop inflammatory arthritis that looks exactly like rheumatoid, so it can happen from birth really. The most common ages are people in their 30s or 40s. It affects women more than men, but were now also seeing a form that appears in peoples 70s and that equally affects men and women. So all ages can be affected, and it affects around 1% of the population in the UK - there are more than 600,000 patients with rheumatoid arthritis in the UK.

Is there anything that makes cyclists more likely to develop rheumatoid arthritis? Or is there anything about cycling that aggravates it?

No, actually the evidence is that if you build the muscles around your joints and you use then a lot more, you can actually get better circulation and that helps to take away some of the accumulated toxins that your joints are producing. Your body is producing proteins that are telling your joints to get inflamed. But when you exercise youre actually taking the toxins away. So exercise is always very good.

What other steps can be taken to treat it?

There are lots of trials looking at diet modification using herbal remedies including turmeric and things such as that. There is some weak evidence that they will help your system because some foodstuffs do have naturally occurring anti-inflammatory properties. But usually the treatment is fairly heavy immune suppression with a possible amount of steroids as well. For professional athletes, these arent anabolic steroids but they might cross-react, so it could be quite tricky for high-level athletes to use them.

Finally then, although its not a diagnosis anybody would want, the outlook for people with rheumatoid arthritis doesnt have to be bleak?

Absolutely. As long as we catch it early enough and begin treatment, it is possible to get it under control.

For more information about rheumatoid arthritis, visit Versus Arthritis,or the National Rheumatoid Arthritis Society website,or call the NRAS helpline onHelpline number 0800 298 7650

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Rheumatoid arthritis and cycling: how to keep the inflammation at bay - road.cc

Woman's Doctor: Knowing the symptoms of psoriatic arthritis

Updated: 9:21 AM EST Nov 28, 2020

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LACEE: IN THIS MORNING'S WOMAN'S DOCTOR, KNOWING THE SYMPTOMS OF PSORIATIC ARTHRITIS, IT'S A DOUBLE WHAMMY OF AUTOIMMUNE DISORDERS. NOT ONLY DO PSORIATIC ARTHRITIS SYMPTOMS MIMIC THOSE OF PSORIASIS, LIKE PATCHES OF RED, SCALY SKIN, BUT THEY CAN ALSO CAUSE THE PAINFUL, SWOLLEN JOINTS THAT ARE COMMON WITH RHEUMATOID ARTHRITIS. THE SYMPTOMS CAN CHANGE FROM DAY TO DAY AND PERSON TO PERSON, MAKING PSORIATIC ARTHRITIS A PARTICULARLY TRICKY DISEASE TO DIAGNOSE AND MANAGE. MERCY MEDICAL CENTER DR. SADE YA KHAN SAYS THAT SYMPTOMS LEFT UNTREATED CAN LEAD TO PERMANENT JOINT DAMAGE. >> SYMPTOMS OF IT CAN BE INVOLVEMENT OF DIFFERENT AREAS OF THE SKELETON. IT COULD BE IN JOINT INVOLVEMENT, INCLUDING FINGERS AND FEET, WHICH WILL BE CONSIDERED SMALL JOINTS. IT COULD INVOLVE LARGER JOINTS, INCLUDING HIPS AND SHOULDERS. AND SOMETIMES, IT CAN ALSO AFFECT SPINE. LACEE: JOINING US THIS MORNING FROM MERCY MEDICAL CENTER, DR. JOSEPH CIO TOLA. THANK YOU FOR JOINING US. >> GOOD MORNING. LACEE: THIS SEEMS LIKE A PAINFUL CONDITION. TELL ME ABOUT THE BEGINNING SYMPTOMS OF PSORIATIC ARTHRITIS. >> IT'S SIMILAR TO REGULAR ARTHRITIS. JUST INFLAMED AND SWOLLEN, VERY SORE JOINTS. THEY GET A LOT OF FLUID BUILT UP ON THEM SOMETIMES. WE MANAGE THEM WITH CORTISONE INJECTIONS AND RELIEVING THE INFLAMMATION. LACEE: IS THIS SOMETHING THAT AFFECTS A CERTAIN GROUP MORE THAN OTHER? YOUNG OR OLD, MEN OR WOMEN? >> NO. NOT PARTICULARLY. IT CAN BE YOUNGER BECAUSE PSORIASIS CAN AFFECT YOUNGER PEOPLE. IT CAN AFFECT JOINTS AS WELL. LACEE: AT WHAT POINT IS IT TIME TO TALK TO A DOCTOR. IT CAN BE CONFUSED WITH PSORIASIS AT FIRST OR ARTHRITIS. >> WHEN SOMEBODY HAS PSORIASIS AND THEIR JOINTS BEGIN TO HURT, I THINK THAT'S THE TIME WHERE THEY NEED TO REALLY GET AGGRESSIVE WITH TREATING IT. LACEE: IN TERMS OF TREATMENT, WHERE DOES TREATMENT START FOR IT? >> IT STARTS WITH MANAGING THE INFLAMMATION. SO THEY WOULD SEE EITHER THEIR DERMATOLOGIST OR THEIR REGULAR PHYSICIAN TO GET ON ANTIINFLAMMATORY REGIMEN. AND THEN WHEN IT COMES TO THE POINT WHERE THEY'RE READY FOR AN ORTHOPEDIC SURGEON, WE BEGIN MANAGING IT BY CONTROLLING THE INFLAMMATION AT THE JOINT LEVEL WITH INJECTIONS. LACEE: WHAT KIND OF POSSIBLE SURGERY COULD THIS LEAD TO? >> IT LEADS TO JOINT REPLACEMENT. IT'S VERY SIMILAR TO RHEUMATOID ARTHRITIS. WHEN THE CARTILAGE IS ERODED ENOUGH AND THE JOINT CAN'T RECOVER, WE REPLACE IT. LACEE: IS IT SOMETHING THAT YOU CAN CURE? >> NO, IT'S JUST MANAGEMENT. IT'S MANAGEMENT OF THE INFLAMMATION. LACEE: WHAT CAN YOU DO TO PREVENT IT IN THE FIRST PLACE? >> I MEAN, I THINK YOU WANT TO BE AS HEALTHY AS POSSIBLE. ANTIINFLAMMATORY DIET AND DOING THE BEST YOU CAN TO CONTROL SUGAR AND INFLAMMATORY PRODUCTS IN YOUR LIFE STYLE. BUT THAT'S REALLY ABOUT IT. LACEE: GOT TO STAY HEALTHY. >> IT'S NOT SOMETHING WE CAN CURE. LACEE: THIS TIME OF YEAR IS HARD BECAUSE THERE'S A LOT OF SUGAR AND THAT STUFF IN FRONT OF US. THANKS FOR TAKING TIME OUT OF YOUR MORNING TO JOIN US. APPRECIATE

Woman's Doctor: Knowing the symptoms of psoriatic arthritis

Updated: 9:21 AM EST Nov 28, 2020

Psoriatic arthritis is a double-whammy of autoimmune disorders. Not only do psoriatic arthritis symptoms mimic those of psoriasis -- like patches of red, scaly skin -- but they can also cause the painful, swollen joints that are common with rheumatoid arthritis. Mercy Medical Center's Dr. Joseph Ciotola explains.

Psoriatic arthritis is a double-whammy of autoimmune disorders. Not only do psoriatic arthritis symptoms mimic those of psoriasis -- like patches of red, scaly skin -- but they can also cause the painful, swollen joints that are common with rheumatoid arthritis. Mercy Medical Center's Dr. Joseph Ciotola explains.

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Woman's Doctor: Knowing the symptoms of psoriatic arthritis - WBAL TV Baltimore

A novel outpatient procedure offers lasting pain relief for patients suffering from moderate to severe arthritis in their hip and shoulder joints.

According to a study presented at the annual meeting of the Radiological Society of North America, researchers said the procedure could help reduce reliance on addictive opiates.

People with moderate to severe pain related to osteoarthritis face limited treatment options. Common approaches like injections of anesthetic and corticosteroids into the affected joints grow less effective as the arthritis progresses and worsens.

Usually, over time patients become less responsive to these injections, said Felix M. Gonzalez, M.D., from the Radiology Department at Emory University School of Medicine in Atlanta, Georgia. The first anesthetic-corticosteroid injection may provide six months of pain relief, the second may last three months, and the third may last only a month. Gradually, the degree of pain relief becomes nonsignificant.

Without pain relief, patients face the possibility of joint replacement surgery. Many patients are ineligible for surgery because of health reasons, whereas many others choose not to go through such a major operation.

CHECK OUT: First Ever Study Shows Chair Yoga is Effective Arthritic Treatment

For those patients, the only other viable option may be opiate painkillers, which carry the risk of addiction.

Dr. Gonzalez and colleagues have been studying the application of a novel interventional radiology treatment known as cooled radiofrequency ablation (c-RFA) to achieve pain relief in the setting of advanced degenerative arthritis. The procedure involves the placement of needles where the main sensory nerves exist around the shoulder and hip joints. The nerves are then treated with a low-grade current known as radiofrequency that stuns them, slowing the transmission of pain to the brain.

For the new study, 23 people with osteoarthritis underwent treatment, including 12 with shoulder pain and 11 with hip pain that had become unresponsive to anti-inflammatory pain control and intra-articular lidocaine-steroid injections.

Treatment was performed two to three weeks after the patients received diagnostic anesthetic nerve blocks. The patients then completed surveys to measure their function, range of motion and degree of pain before and at three months after the ablation procedures.

There were no procedure-related complications, and both the hip and shoulder pain groups reported statistically significant decrease in the degree of pain with corresponding increase in dynamic function after the treatment.

In our study, the results were very impressive and promising, Dr. Gonzalez said. The patients with shoulder pain had a decrease in pain of 85%, and an increase in function of approximately 74%. In patients with hip pain, there was a 70% reduction in pain, and a gain in function of approximately 66%.

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The procedure offers a new alternative for patients who are facing the prospect of surgery. In addition, it can decrease the risk of opiate addiction.

This procedure is a last resort for patients who are unable to be physically active and may develop a narcotic addiction, Dr. Gonzalez said. Until recently, there was no other alternative for the treatment of patients at the end of the arthritis pathway who do not qualify for surgery or are unwilling to undergo a surgical procedure.

At last years RSNA annual meeting, Dr. Gonzalez presented similarly encouraging results from a study of a similar procedure for the treatment of knee arthritis. Together, the knee, shoulder and hip articulations account for approximately 95% of all arthritis cases.

The procedure could have numerous applications outside of treating arthritic pain, Dr. Gonzalez explained. Potential uses include treating pain related to diseases like cancer and sickle cell anemia-related pain syndrome, for example.

MORE:Hydrolyzed Collagen Supplements Are Good for Health: Benefitting Hair, Skin, Joints, and Muscles

Were just scratching the surface here, Dr. Gonzalez said. We would like to explore efficacy of the treatment on patients in other settings like trauma, amputations, and especially in cancer patients with metastatic disease.

Source:Radiological Society of North America

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Sufferers Living With Severe Arthritis Could be Given Lasting Pain Relief Thanks to a New Technique - Good News Network

Contributors: MLH, EAH, DN, BG, KHP, TU, GG, M, RvV designed the study and wrote the protocol. RvV, DN, MSH, EAH, Niels Steen Krogh, DG, SK, MLH developed the CRFs. MLH, EAH, AR, DN, MN, BG, JL, KHP, TU, GG, M, MSH, SK, JL, AKHE, KLG, MK, FF, RT, TL, GC, EBa, OH, DV, TSI, TH, MKAL, EBr, TE, AS, MR, RO, PL, LU, SAJ, DJS, TBL, GB, RvV contributed to the data collection and data cleaning. SK and Niels Steen Krogh did data management. JT and ICO conducted the statistical analyses. ICO and SK made the figures. MLH wrote the manuscript with input from all authors. All authors had access to the raw dataset and vouch for the veracity of the results. All authors read and approved the final version of the manuscript including the decision to submit the paper. MLH and RvV are guarantors of the overall content, accept full responsibility for the work and the conduct of the study, had access to the data, and controlled the decision to publish. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Funding: Funding was obtained through public sources: Academy of Finland (grant No 258536), Finska Lkaresllskapet, grant from the South-Eastern Health Region, Norway, HUCH Institutional grant, Finland (grant No 1159005), Icelandic Society for Rheumatology, interregional grant from all health regions in Norway, NordForsk (grant No 70945), Regionernes Medicinpulje, Denmark (grant No 14/217), Stockholm County Council, Sweden (grant No 20100490), Swedish Medical Research Council (grant No C0634901, D0342301, 2015-00891_5), Swedish Rheumatism Association, The Research Fund of University Hospital, Reykjavik, Iceland (A2015017). UCB supported the work in the context of an investigator initiated study where UCB provided certolizumab pegol at no cost. UCB had no role in study design, collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit for publication. Bristol-Myers Squibb (BMS) provided abatacept at no cost. In addition, the Karolinska Institute received several unrestricted grants from BMS; these were subsequently transferred to the principal investigators of Denmark, Finland, and the Netherlands to help defray various trial related costs at the local level. BMS had no role in study design, collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit for publication. The final manuscript was provided for courtesy review to UCB and BMS in line with Good Publication Practice (GPP3). We confirm the independence of researchers from funders and that all authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility of the integrity of the data and the accuracy of the data analysis.

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: support from Academy of Finland, Finska Lkaresllskapet, South-Eastern Health Region (Norway), HUCH (Finland), Icelandic Society for Rheumatology, all health regions in Norway, NordForsk, Regionernes Medicinpulje (Denmark), Stockholm County Council (Sweden), Swedish Medical Research Council, Swedish Rheumatism Association, The Research Fund of University Hospital (Reykjavik, Iceland) for the submitted work; MLH reports grants from Nordforsk, from Danske Regioner during the conduct of the study; grants from Bristol-Myers Squibb, grants from AbbVie, grants from Roche, grants from Novartis, grants and personal fees from Merck, grants and personal fees from Biogen, grants and personal fees from Pfizer, personal fees from Eli Lilly, personal fees from Orion Pharma, personal fees from CellTrion, personal fees from Samsung Bioepsi, personal fees from Janssen Biologics BV, personal fees from MSD, outside the submitted work; she chairs the steering committee of the Danish Rheumatology Quality Registry (DANBIO), which receives public funding from the hospital owners and funding from pharamaceutical companies; EAH reports grants from NORDFORSK, grants from the Norwegian Regional Health Authorities, grants from the South-Eastern Norway Regional Health Authority, during the conduct of the study; personal fees from Pfizer, personal fees from AbbVie, personal fees from Celgene, personal fees from Novartis, personal fees from Janssen, personal fees from Gilead, personal fees from Eli-Lilly, personal fees from UCB, outside the submitted work; AR reports grants from the Swedish Research Council, financial support from AstraZeneca, outside the submitted work; DN reports grants from UCB, grants from BMS, during the conduct of the study; grants from AbbVie, grants from Celgene, grants from MSD, grants from Novartis, grants from Pfizer outside the submitted work; MN reports grants from BMS, during the conduct of the study; grants from Abbvie, grants from BMS, personal fees from Celltrion, grants from MSD, grants from Pfizer, personal fees from Eli Lilly, grants from Amgen, outside the submitted work; BG reports personal fees from Novartis, outside the submitted work; TU reports a grant from NORDFORSK during the conduct of the study; personal fees from Grnenthal, personal fees from Lilly, personal fees from Novartis, personal fees from Pfizer, outside the submitted work; M reports grants, personal fees and non-financial support from AbbVie, grants, personal fees and non-financial support from BMS, personal fees from Boehringer-Ingelheim, personal fees from Eli Lilly, personal fees and non-financial support from Janssen, grants, personal fees and non-financial support from Merck, personal fees and non-financial support from Pfizer, personal fees and non-financial support from Roche, grants, personal fees and non-financial support from UCB, grants and personal fees from Celgene, personal fees from Sanofi, personal fees from Regeneron, grants, personal fees and non-financial support from Novartis, personal fees from Orion, personal fees from Hospira, outside the submitted work; MSH reports grants from the South-Eastern Norway Regional Health Authority, during the conduct of the study; personal fees from Lilly, outside the submitted work; SK reports receiving grants from AbbVie, MSD and Novartis outside the submitted work; AKHE reports receiving personal fees from AbbVie, personal fees from Pfizer, outside the submitted work; KLG reports grants from BMS, outside the submitted work; RT reports grants from Finnish Rheumatology Research Fund, during the conduct of the study; OH reports non-financial support from Pfizer, personal fees from Abbvie, personal fees from Novartis, during the conduct of the study; TSI reports non-financial support from DiaGraphIT, personal fees from Abbvie, personal fees from BMS, personal fees from Celgene, personal fees from Medac, personal fees from Merck, personal fees from Novartis, personal fees from Orion Pharma, personal fees from Pfizer, personal fees from Roche, personal fees from Sandoz, personal fees from UCB, personal fees from Bohringer Ingelheim, outside the submitted work; LU reports personal fees from Abbvie, Eli Lilly and Novartis (speaker fees), outside the submitted work; DJS reports grants from KLINBEFORSK, during the conduct of the study; TBL reports personal fees from UCB, outside the submitted work; GB reports personal fees from BMS, outside the submitted work; ABA reports personal fees from Abbvie, personal fees from Eli Lilly, personal fees from Novartis, personal fees from Pfizer, outside the submitted work; AB reports grants from BMS, during the conduct of the study; CT reports grants and personal fees from Bristol Myers-Squibb, personal fees from Roche, personal fees from Abbvie, personal fees from Pfizer, outside the submitted work; HR reports personal fees from MSD, personal fees from Roche, personal fees from Abbvie, personal fees from Celgene, outside the submitted work; JR reports grants from BMS, during the conduct of the study; JW reports fees from Celgene, fees from Eli Lilly, fees from Novartis, outside the submitted work; KM reports personal fees from Abbvie, personal fees from Celgene, personal fees from Medac, personal fees from BMS, outside the submitted work; OKS reports grants from the Research Committee of the Kuopio University Hospital Catchment Area for the State Research Funding, during the conduct of the study; non-financial support from Pfizer, non-financial support from Novartis, non-financial support from MSD, personal fees from Boeringer Ingelheim, outside the submitted work; PP reports personal fees from Novartis Finland Oy, outside the submitted work; R reports personal fees from Bristol-Meyer Squibb, personal fees and non-financial support from AbbVie, personal fees from Gilead, personal fees from Janssen, personal fees from Eli-Lilly, personal fees from Novartis, outside the submitted work; SNC reports personal fees from Bristol Myers Squibb, personal fees from General Electric, outside the submitted work; SE reports personal fees from Novartis, outside the submitted work; TO reports personal fees from Eli Lilly, consultancy fee from Merck Sharp and Dohme, outside the submitted work; reports grants from BMS, during the conduct of the study; grants from Roche, grants from Mylan, other from Abbvie, outside the submitted work; VR reports grants from BMS, during the conduct of the study; grants from Roche, grants from Mylan, other from Abbvie, outside the submitted work; RvV reports grants from BMS, during the conduct of the study; grants from BMS, GSK, Lilly, UCB, grants from Pfizer, Roche, personal fees from AbbVie, AstraZeneca, Biogen, Biotest, Celgene, Galapagos, Gilead, Janssen, Pfizer, Servier, UCB, outside the submitted work; no other relationships or activities that could appear to have influenced the submitted work.

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Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised,...

Known for his rock 'n' roll antics and attitude, Liam Gallagher may need to take better care of his health as he enters middle age. It was only last year when the star revealed he has arthritis in his hip.

Named as William John Paul Gallagher at birth, the 48-year-old has matured in the spotlight.

Twice divorced, and the father of four children, Liam did a candid interview with Q Magazine in June 2019.

It was there he stated he suffers from arthritis in his hip - a painful inflammatory condition.

Dad to Molly (22), Lennon (21), Gene (19) and Gemma (seven), Liam is still keen to maintain his rock 'n' roll image.

Due to his arthritis, he has developed calf pain he's been seeking treatment for.

Speaking about his acupuncture treatment, he said: "This geezer is mega, he doesnt f**k about.

"He gets the needles and whacks them in. He sorts it but it keeps coming back. Acupuncture is alright, at least its needles."

READ MORE:Coronavirus vaccine roll out priority: List outlines who in britain will get jab first

Another charity, Versus Arthritis, said: "Its common to have aches and pains in your muscles and joints from time to time.

"This may especially be true if you take part in unusual or strenuous physical activities."

This can make it difficult to identify the warning signs of arthritis, but the charity makes it crystal clear on how you can spot the disease early.

"If you have swelling or stiffness that you cant explain and that doesn't go away in a few days, or if it becomes painful to touch your joints, you should see a doctor," it advised.

If you're diagnosed with arthritis, you may be offered medical treatments.

In addition to medication, Versus Arthritis encourage sufferers to exercise.

"Exercise can make symptoms such as pain and swelling better," it certified.

Low-impact exercises are typically recommended, such as cycling, brisk walking, yoga, T'ai Chi and pilates.

Be aware that "some discomfort and pain" is expected when you exercise, but it "should calm down a few minutes after you finish".

However, "it's important to not overdo it" added the charity. "The key is to start off gently and to gradually increase the amount you do."

Physical activity also helps you to maintain a healthy weight (or achieve one), which can put less pressure on the joints.

This in turn can help relieve the painful effects of arthritis.

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Liam Gallagher health: Rockstar has arthritis in his hip- what is this condition? - Express

A recent grant to UAB researchers from a national organization will yield insight into telehealth and potentially increase patient access to rheumatic care.

Jeffrey Curtis, M.D.The need for virtual health care options has significantly increased because of the COVID-19 pandemic. UAB researchers and collaborators have received a two-year, $400,000 grant from the American College of Rheumatologys Rheumatology Research Foundation to support telehealth-delivered health care.

Jeffrey Curtis, M.D., professor of medicine in the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham, will use this grant to support the project Telehealth-delivered Healthcare to Improve Care THRIVE in community-practice rheumatology. The projects collaborators include Cedars-Sinai Medical Center, CreakyJoints, a digital arthritis community for patients and caregivers worldwide, and its ArthritisPower research registry. The THRIVE projects primary investigator, Swamy Venuturupalli, M.D., is the recipient of this years ACRs Norman B. Gaylis, M.D., Clinical Research Award, and is slated to begin in January of 2021.

This grant is an exciting opportunity to identify and build best-in-class approaches to telehealth and to test specific strategies to assess patients with inflammatory arthritis, particularly rheumatoid arthritis, Curtis said. Clinical trials and routine patient care have been severely hampered by COVID-19-related perturbations in care delivery. We will scope and validate methods for disease activity assessment using telehealth-related technology, coupled with remote patient monitoring capabilities, including digitally captured, patient-reported outcome data.

The THRIVE project seeks to define, solidify and incorporate the best practices in telehealth rheumatology, disseminating these tools to community rheumatologists everywhere through a variety of channels.

The ultimate goal of this project is to increase patient access to care, expand the impact of rheumatology especially for those marginalized or most at risk by the COVID-19 pandemic and enable and improve the value of care provided by rheumatology providers in community settings through telehealth.

We are excited about the partnership between academia, community practitioners and arthritis patient communities, in what we expect to be a model paradigm for collaborative, practice-based research now and into the future, Curtis said.

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Rheumatology Research Foundation grant allows for advancement in telehealth - The Mix

This report on Psoriatic Arthritis Treatment market, published by DataIntelo, is an in-depth analysis that studies crucial aspects of the market, which will assist clients to make right decision about their business investment plans and strategies. The market report entails a detailed information regarding the key segments and sub-segmentations including the product types, applications, and regions by examining the emerging market size, performance, and scope of each segment of the Psoriatic Arthritis Treatment.

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Eli LillyRocheMerckNovartisAbbvieAmgenBristol Myers SquibbCelgene CorporationJanssenValeant Pharmaceuticals

*Note: Additional companies can be included on request

The report covers a detailed performance of some of the key players and analysis of major players in the industry, segments, application, and regions. Moreover, the report also considers the governments policies in different regions which illustrates the key opportunities as well as challenges of the market in each region.

By Application:

HospitalsClinicsAmbulatory Surgery CentersDiagnostic Laboratories

By Type:

KitsReagentsInstruments

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Psoriatic Arthritis Treatment Market To 2026: Growth Analysis By Manufacturers, Regions, Types And Applications - The Market Feed

BOULDER, Colo. The CBDMEDIC brand, now part of the Charlottes Web, Inc. family of hemp CBD wellness products, and an official Impact Sponsor for the Arthritis Foundation, announces its matching funds campaign for Giving Tuesday. On Dec. 2nd CBDMEDIC will match individual donations made to the Arthritis Foundation up to a total sum of $50,000.

To those on Giving Tuesday who donate $50 or more to the Arthritis Foundation, CBDMEDIC will ship a free thank you gift of its Arthritis Aches and Pain Relief Cream, a retail value of $39.99 The Arthritis Foundation continues to pursue a cure for Americas number one cause of disability, and provides advocacy, community connections, and educational resources to those battling arthritis. The Giving Tuesday donations and CBDMEDIC matching funds donation will support scientific research, legislation and life-improvement programs led by the Arthritis Foundation. CBDMEDIC is the only hemp CBD brand to be approved and serve as an Arthritis Foundation Impact Sponsor.

According to GivingTuesday.org, last year more than 13% of the U.S. population participated in Giving Tuesday raising $511M online to support thousands of nonprofits. To participate in the CBDMEDICs Giving Tuesday Matching Funds Campaign donors may link here beginning at midnight Dec. 1 through midnight Dec. 2, 2020.

The Arthritis Foundation is leading the charge to find solutions that make a life-changing impact for people with arthritis. Partnering with CBDMEDIC helps bring greater awareness around the challenges of living with arthritis, which includes managing chronic pain, said Rick Willis, Senior Vice President, Community Engagement. We appreciate their commitment to providing the arthritis community with topical alternatives for temporary pain relief.

Especially in these uncertain times, due to the pandemic, it is vitally important that businesses and their brands step up and support nonprofits like the Arthritis Foundation this Giving Tuesday, said Deanie Elsner, CEO of Charlottes Web, Inc. Our CBDMEDIC brand is offering $50,000 in matching funds so that the Arthritis Foundations work in scientific research and advocacy can continue to benefit the millions of Americans suffering from arthritis. This is also a part of our Charlottes Web mission to help people heal through compassion and science. We encourage everyone who is able to do so to give this Giving Tuesday to the Arthritis Foundation.

According to the Center for Disease Control, 22.7% of adults in US have doctor-diagnosed arthritis (or one in four adults). And, About 43.5% (or 23.7 million) of people with arthritis (54.4 million) have limitations in their daily activities due to their arthritis.

CBDMEDIC is now part of the Charlottes Web family of hemp-derived CBD brands sold online <https://www.charlottesweb.com/cbd-medic>, as well as in more than 4,500 retail stores, according to Nielsen data (9/5/2020). CBDMEDIC top-selling products for those suffering from the symptoms of arthritis, as well as pain and inflammation, include its Back & Neck Pain Relief Ointment, Arthritis Aches & Pain Relief Ointment, Arthritis Aches & Pains Hand Cream, Active Sport Pain Relief Stick, Muscle & Joint Pain Relief Spray and Muscle & Joint Pain Relief Ointment.

Find out more about CBDMEDIC topical pain relief products.

About the Arthritis Foundation:The Arthritis Foundation is the Champion of Yes. Leading the fight for the arthritis community, the Foundation helps conquer everyday battles through life-changing information and resources, access to optimal care, advancements in science and community connections. The Arthritis Foundations goal is to chart a winning course, guiding families in developing personalized plans for living a full life and making each day another stride toward a cure. Visit arthritis.org to learn more.

About CBDMEDICLaunched in 2019 and now sold in more than 4,500 retail stores, the CBDMEDIC brand offers a line of 15 THC-free and hemp-derived CBD topical pain relief products that provide revolutionary pain relief. CBDMEDIC products combine naturally derived pain-relieving pharmaceutical ingredients along with natural emollients (skin softening ingredients) and essential oils, and THC-free hemp extract to create unique formulations for fast and effective relief. CBDMEDIC formulations combine advanced science with organic and natural ingredients to provide safe relief. CBDMEDIC products are offered across the United States and are produced by a contract manufacturer in a cGMP compliant and audited manufacturing facility.

About Charlottes Web Holdings, Inc.Charlottes Web Holdings, Inc., a Certified B Corporation headquartered in Boulder, Colo., is the market leader in the production and distribution of innovative hemp-derived cannabidiol (CBD) wellness products under a family of brands which includes Charlottes Web, CBD Medic, CBD Clinic, and Harmony Hemp. The Companys premium quality products start with proprietary hemp genetics that are 100-percent American farm grown and manufactured into whole-plant hemp extracts containing a full spectrum of naturally occurring phytocannabinoids including CBD, CBC, CBG, terpenes, flavonoids and other beneficial hemp compounds. Charlottes Web product categories include CBD oil tinctures (liquid products), CBD gummies (sleep, stress, inflammation recovery), CBD capsules, CBD topical creams and lotions, as well as CBD pet products for dogs. Charlottes Web is the number one CBD brand in the USA and distributed through more than 22,000 retail locations, select distributors and online through the Companys website at http://www.CharlottesWeb.com.

Charlottes Web was founded by the Stanley Brothers with a mission to unleash the healing powers of botanicals through compassion and science, benefiting the planet and all who live upon it. Charlottes Web is a socially and environmentally conscious company and is committed to using business as a force for good and a catalyst for innovation. The Company weighs sound business decisions with consideration for how its efforts affect employees, customers, the environment, and diverse communities. The rate the Company pays for agricultural products reflects a fair and sustainable rate driving higher quality yield, encouraging regenerative farming practices, and supporting U.S. farming communities. Management believes that its socially oriented and environmentally responsible actions have a positive impact on its customers, suppliers, employees and stakeholders. Charlottes Web donates a portion of its pre-tax earnings to charitable organizations.

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CBDMEDIC to Match $50000 in Funds for Arthritis Foundation on Giving - CBD Today

You have one sacroiliac (SI) joint on either side of your body where your ilium and sacrum bones join together. Your sacrum is the wide, flat bone between your tailbone and lumbar spine. Your ilium is often referred to as your hip bone.

Unlike many other joints like your knee or elbow, your SI joint moves very little and is held together with thick ligaments. Sudden injuries or repetitive stress can cause the SI joint to become inflamed and painful. You may feel this pain in your buttocks or lower back.

Sitting for extended periods of time can lead to pain in your SI joint or aggravate existing pain. However, certain positions are less likely to cause pain than others.

Keep reading to learn the best sitting, standing, and lying positions if youre dealing with SI joint pain.

The ligaments in your SI joint help transfer force between your trunk and your leg when performing activities like walking or running. If youre dealing with SI joint pain, sitting in positions that put these ligaments under tension may lead to further pain and irritation.

When sitting in a chair, you should aim to keep your hips neutral to avoid excess stress on the ligaments in your SI joint. Think about keeping your hips level with each other and avoid rotating more to one side.

Avoid positions that hike one hip higher or put create an asymmetry in your hips, such as when you cross your legs.

Heres how you can sit with good posture to help manage SI joint pain:

The tailors position is another option for keeping your pelvis neutral and reducing stress on the ligaments on your SI joint. You should focus on keeping your hips symmetrical.

If sitting is giving you pain, you may want to alternate between sitting and standing. If youre using a standing desk, heres how you can set it up:

Chair exercises and stretches may help you reduce pain and stiffness around your SI joint and help strengthen muscles around the joint.

This simple seated backbend stretch may help you reduce lower back stiffness.

The seated cat-cow stretches and strengthens the muscles in your back and core.

A seated torso stretch is an easy way to mobilize your spine.

The seated hamstring stretch helps you loosen your hamstrings and may help alleviate pain from muscle imbalances.

If you spend a lot of time sitting at a desk, finding a comfortable office chair may help you reduce SI joint pain. You should look for:

No matter what chair youre sitting in, its a good idea to take frequent breaks from sitting about every 30 minutes.

Many people with SI joint pain find that it gets worse when they stand for extended periods of time.

Standing with good posture can help keep your spine in alignment and may help you manage your SI joint pain. When standing:

Its generally best to avoid sleeping on your stomach if youre dealing with neck or back pain. Sleeping on your stomach puts more stress on your spine. If you do sleep on your stomach, try putting a pillow beneath your abdomen.

If youre having SI joint pain on one side, you may want to sleep on your opposite side to take your weight off the joint. Putting a pillow between your knees and ankles can help put your hips in alignment.

Another sleeping posture to take the stress off your SI joint is to sleep on your back with one or two pillows under your knees to put your hips in a neutral posture.

If youre dealing with SI joint pain, you should aim to sit with your hips neutral and with your lower back relaxed and supported. If your chair doesnt provide support, you can put a pillow or cushion behind your lower back.

Even if you sit with perfect posture, taking frequent breaks about every 30 minutes is important.

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How to Sit with SI Joint Pain: Posture and Seated Exercises - Healthline

High disease activity in early rheumatoid arthritis (RA) is correlated with depression and anxiety, according to study results published in RMD Open. Depression and anxiety were also found to be more prevalent among patients with poor self-reported functional status.

The Scottish Early Rheumatoid Arthritis (SERA) inception cohort included patients with new-onset RA who received care at rheumatology centers in Scotland between 2011 and 2015. Baseline demographic and clinical data of patients were collected within 6 months of RA diagnosis, with follow-up visits conducted after 6 and 12 months.

The primary study outcome was depression and anxiety symptoms, measured using the Hospital Anxiety and Depression Scale. Exposures of interest included disease activity, functional status, and laboratory parameters. Disease activity was measured using the Disease Activity Score-28 (DAS28) and the patient global assessment visual analog scale (PGA-VAS); functional status was measured using the Health Assessment Questionnaire (HAQ). Erythrocyte sedimentation rate, C-reactive protein (CRP) levels, rheumatoid factor positivity, and anticyclic citrullinated peptides status were also recorded. Multivariable linear regression was performed to assess the relationship between anxiety and depression scores and various demographic and clinical variables.

The study cohort included 848 patients with RA (mean age, 58.2713.71 years; mean DAS28 score, 4.951.41), among whom 70.0% were women. At 6 and 12 months, follow-up data of 691 and 618 participants with RA, respectively, were available for evaluation.

No significant differences in depression or anxiety symptoms were observed between patients who continued follow-up and those who dropped out of the study. The baseline prevalence of anxiety and depression was higher among patients with early RA vs healthy individuals (19.0% vs 1.7% and 12.2% vs 1.75; P =.0002 and P =.009, respectively). However, prevalence of anxiety and depression in early RA decreased to 13.4% and 8.1%, respectively, at 12 months. Depression and anxiety scores were significantly positively associated with DAS28 at baseline, 6 months, and 12 months (all P <.001).

Multivariable linear regression models showed that baseline anxiety was associated with younger age (P =.001) and higher HAQ score (P <.0001). Anxiety at the 6-month follow-up was negatively correlated with body mass index (P =.015) and positively associated with baseline anxiety (P <.0001), current HAQ score (P =.006), and higher current PGA-VAS score (P =.008). Similar associations were observed at 12 months.

Baseline depression was associated with younger age (P =.029), being single at the time of measurement (P =.022), and a higher current HAQ score (P <.001). Depression at 6 months was associated with higher baseline depression (P <.0001) and anxiety (P =.002) scores, higher current HAQ score (P <.0001), and greater current CRP levels (P =.009). The same associations persisted at 12 months. At 6 months only, men were more likely than women to have depression.

These results suggested that anxiety and depression were prevalent in early RA, particularly among those with greater disease activity and poorer self-reported functioning. Although anxiety and depression rates appeared to decrease during follow-up, they were still reported at rates higher than those observed in the general population.

The primary study limitation included the fact that more than 200 participants had been lost to follow-up by 12 months. In addition, data were only available at 6-month intervals, which prevented a more precise assessment of mood during all timepoints.

Our study indicates that clinicians should be alert to neuro-psychiatric comorbidity in RA from the earliest stages of the disease, the researchers wrote. [I]t remains to be determined whether more intense screening and treatment for psychiatric comorbiditiescan improve outcomes.

Disclosure: The SERA cohort was supported by Pfizer Inc. Please see the original reference for a full list of authors disclosures.

Reference

Fragoulis GE, Cavanagh J, Tindell A, et al. Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features. RMD Open. 2020 Oct;6(3):e001376.

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Depression and Anxiety Associated With Disease Activity, Functional Status in Early RA - Rheumatology Advisor