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When you have an inflammatory disease like rheumatoid arthritis (RA), what you do every day can majorly impact your joints and your level of pain.

While treatment and medications will vary from patient to patient, doctors typically tell people living with RA to get regular activity since its been shown to reduce arthritis-related joint pain and delay disability. The Centers for Disease Control and Prevention (CDC) specifically recommends that RA patients strength train twice a week and do at least 150 minutes of moderate-intensity cardio (think: fast walking, swimming, and running) weekly.

But lets be real: Its one thing to hear that exercise can help, and another to actually do it when youre not feeling your best. To help you stick to a routine, we asked three women living with RA how they stay active on the regular.

Rheumatoid arthritis advocate Eileen Davidson, who blogs at ChronicEileen.com, says she makes working out at home a priority to help combat her RA symptoms. She tends to use an elliptical, but also likes going for brisk, long walks and doing pilates and yoga videos on YouTube. I just do the moves I can do. Davidson says.

Davidson loves doing yoga videos at home and going on long walks.

Davidson said she started small with working out and saw benefits from exercising and her medication, like less pain in her joints. The important thing was that I started and stayed consistent, she says. Now, when I am feeling crummy, I know that moving my body a little will help me feel better.

Linda Luckmann, who identifies herself on Instagram as a rheumatoid arthritis warrior, discovered after her diagnosis that she loves Zumba and taking long walks. It hurts sometimesmy joints don't feel greatbut being active definitely helps keep me feeling good, she says.

Luckman says being active helps her symptoms under control. But at the same time, she listens to her body when she needs to take a day off.

Still, Luckmann says there are some days when she needs to rest. I have to know how much energy I can spend doing things each day because you dont want to completely drain yourself, she says, pointing out that shes still not pain-free. Every day there is discomfort, but you kind of get used to it and learn to appreciate the days you feel less crappy, she says.

Davidson says she does all her strength training at home because she feels more comfortable and motivated when she has privacy. My balance is off, and I need to break things up, she says.

Chronic illness advocate Mariah Zebrowski Leach, who runs a blog about her life with RA called From This Point. Forward., was playing college water polo when she was initially diagnosed with RA. She eventually had to quit the team after her symptomswhich included pain, severely swollen joints, and low energygot to be too much. Now, shes found different ways to stay active.

Living with RA has actually encouraged me to try things I might not have done otherwise, she says. Leachs husband did a fundraising 525-mile bike ride, which inspired her to take up cycling. I had never been on a road bike before, but I bought one and started riding it, she said. She eventually ended up doing the same 525-mile bike ride as her husband. Its funny to me that one of the greatest athletic achievements of my life happened because of my RA diagnosis, she says.

Leach now has three kids, and says she largely stays active by doing walks and bike rides with them. I wore my third baby [in a baby carrier] a lot while trying to keep up with her very active brothers, she says, noting that it helped take the strain off of her hands and wrists, and made her core stronger.

Leach takes a moment to enjoy the scenery while on a family hike.

Leach was a snowboarder before she had RA, and says she stopped doing the sport for five years after she was diagnosed. Even when we found a treatment plan that was effective, for a long while I was still afraid to get back on my snowboard because I was worried about injuring myself, she says. It took a few more years for me to understand my new body well enough to try snowboarding again.

Now, Leach says she snowboards at a very different pace than I used to, adding, its more about getting out on the beautiful mountain and enjoying a few runs and fresh air than shredding all day long or doing double black diamonds.

Regular activity can help combat symptoms of rheumatoid arthritis, but everyone is different. If youre struggling with symptoms of RA, check in with your doctor. They should be able to provide personalized guidance to help.

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How 3 Women Stay Active with Rheumatoid Arthritis - Women's Health

For the first time, nationally endorsed performance measures in British Columbia, Canada, were operationalized using administrative data, allowing for population-level quality of care reports on patients with rheumatoid arthritis (RA). The reports showed improvements in access to rheumatologist care and early treatment over time, although suboptimal rates of specialist follow-up and accompanying low levels of disease modifying antirheumatic drug (DMARD) use persisted, according to study findings published in Arthritis Care & Research.

This longitudinal population-based RA cohort study used administrative health data to operationalize and report on 4 of 6 nationally endorsed RA performance measures developed by the Arthritis Alliance of Canada. The 4 tested performance measures were: percentage of incident patients with 1 rheumatologist visits within 365 days of diagnosis; proportion of prevalent RA patients with 1 rheumatologist visits per year; percentage of prevalent RA patients who received DMARD therapy; and time from RA diagnosis to DMARD prescription. All adult patients who received care for RA in British Columbia from January 1, 1997, to December 31, 2009, were identified and followed until December 2014.

A total of 38,673 incident cases and 57,922 prevalent cases of RA were included in the cohort. Although the percentage of patients seeing a rheumatologist in the first year of diagnosis was suboptimal, rates improved from 35% in 2000 to 65% in 2009. Improved performance was noticed in patients who ever saw a rheumatologist in follow-up, which increased from 74% in 2000 to 96% in 2009; however, the lower performance in earlier years could have been due to longer follow-up times. When the measure was reported as patients seeing a rheumatologist within the first 5 years, the performance became 88% in 2000 and 97% in 2009.

The percentage of patients with RA under the care of a rheumatologist declined from 79% in 2001 to 39% in 2014 using the fixed interval method, or from 82% in 2001 to 42% in 2014 using the gaps method. Among patients not under the care of a rheumatologist, DMARD use was suboptimal, with little improvement over time. Overall, regardless of physician type, only 37% of patents were prescribed a DMARD in 2014, with the highest rates of DMARD use (87% in 2014) seen among patients under active rheumatology care. The median time from RA diagnosis to DMARD therapy initiation in patients seen by a rheumatologist improved from 49 days in 2000 to 23 days in 2009, with 21% and 34% receiving DMARD treatment within the 14-day benchmark in 2000 and 2009, respectively.

The investigators concluded that the results of this study will inform further reporting on the measures nationally and help serve in benchmarking when planning quality improvement and advocacy work.

Timely communication of performance at the practice level could be used to influence clinical care, they added.

Reference

Barber CEH, Marshall DA, Szefer E, et al. A population-based approach to reporting system-level performance measures for rheumatoid arthritis care [published online March 7, 2020]. Arthritis Care Res (Hoboken). doi:10.1002/acr.24178

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PopulationBased Reports of National Rheumatoid Arthritis Care Performance Measures - Rheumatology Advisor

The following article is part of coverage from the American Academy of Dermatologys Annual Meeting (AAD 2020). Because of concerns regarding the coronavirus disease 2019 (COVID-19) pandemic, all AAD 2020 sessions and presentations were transitioned to a virtual format. While live events will not proceed as planned, readers can click here to view more news related to research presented during the AAD VMX 2020 virtual experience.

Patients with a newly recorded diagnosis of hidradenitis suppurativa (HS) have increased risks for developing inflammatory arthritis, including ankylosing spondylitis (AS), psoriatic arthritis (PsA), and rheumatoid arthritis (RA), according to study results presented at the American Academy of Dermatologys Virtual Meeting Experience (AAD VMX) 2020, held online from June 12 to 14, 2020.

To evaluate and compare the risk for inflammatory arthritis in patients with vs without HS, researchers collected data from patients having commercial insurance in the United States, from January 1, 2003 to January 1, 2017. The study cohort included patients with newly diagnosed HS who were propensity score-matched 1:1 with control participants without HS with similar risk profiles. All participants were followed until 1 of the events, including primary outcome, death, disenrollment, or end of datastream, occurred. The main outcome of the study was a new diagnosis of inflammatory arthritis, including AS, PsA, other spondyloarthritis (SpA), or RA. Researchers conducted all statistical analyses using a validated version of the Aetion Evidence Platform.

Researchers identified 70,697 patients with HS (mean age, 36.5414.65 years; 78.0% women) and 141,411 without HS (mean age, 38.2921.12 years; 52.0% women) after 2:1 risk set sampling and before propensity score matching. Researchers also noted that patients did not have a range of chronic inflammatory and autoimmune conditions before cohort entry. Median follow-up for patients with and without HS was 527 and 539 days, respectively.

After propensity score matching, results showed that age, sex, healthcare utilization, and comorbidities were similar between both groups. Patients with vs without HS (n=60,872 for both) had a 65%, 44%, and 16% increased risk for AS, PsA, and RA, respectively (incidence rates, 0.6 vs 0.4, 0.8 vs 0.6, and 4.5 vs 3.9 per 1000 person-years; hazard ratios [HRs; 95% CI], 1.65 [1.15-2.35], 1.44 [1.08-1.93], and 1.16 [1.03-1.31], respectively). Researchers did not observe any association of HS with other SpA (HR, 1.02; 95% CI, 0.89-1.93), including reactive arthropathy, spinal enthesopathy, sacroiliitis, or unspecific inflammatory spondylopathies.

Researchers concluded, Given the high burden of disease associated with both HS and arthritis, physicians treating patients with HS should be aware of symptoms suggestive of inflammatory arthritis (ie, morning stiffness, joint pain or swelling).

Reference

Schneeweiss MC, Kim SC, Schneeweiss S, Rosmarin D, Merola JF. Hidradenitis suppurativa and the risk of inflammatory arthritis: a population-based follow-up study. Presented at: AAD VMX 2020; June 12-14, 2020. Poster 14344.

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Increased Risk for Inflammatory Arthritis in Patients With Newly Diagnosed Hidradenitis Suppurativa - Dermatology Advisor

Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue.

Osteoarthritis, on the other hand, is attributed to lifestyle factors such as injury and obesity, and genetic factors such as family history.

Both are also united in their lack of cure but there are a number of treatments to help relieve the symptoms.

Several research studies suggest the anti-inflammatory properties found in ginger can have an alleviating effect, for example.

READ MORE:Arthritis symptoms: The tell-tale signs you could have the condition in your knees

Taking ginger extract helped to reduce knee pain upon standing and after walking.

What's more, researchers in study published in The Journal of Pain found that ginger was an effective pain reliever for human muscle pain resulting from an exercise-induced injury.

Participants who ingested two grams of either raw ginger or heated ginger experienced reduced pain and inflammation.

Heat-treated ginger was thought to have a stronger effect, but both types of ginger were found to be equally helpful.

Too much weight places excess pressure on the joints in your hips, knees, ankles and feet, leading to increased pain and mobility problems, says the NHS.

In fact, exercise can bring both direct and indirect benefits for managing arthritis, notes the health body.

In addition to aiding weight loss, exercise can:

"Your GP can recommend the type and level of exercise that's right for you," adds the NHS.

Original post:
Arthritis treatment: The natural extract shown to be as effective as a pain relief drug - Express

If you or someone you love has rheumatoid arthritis, youve probably thought about remission from rheumatoid arthritis more than once. As you likely know, rheumatoid arthritis is a very serious illness, and it can often be debilitating. So the concept of achieving remission can feel like a beacon of hope.

Today more than 1.3 million Americans are living with rheumatoid arthritis, and about 75 percent of them are women, according to the American College of Rheumatology. Rheumatoid arthritis is the most common form of autoimmune arthritis and causes pain, stiffness, and swelling in the joints of the hands, feet, and wrists.

As a quick refresher: Autoimmune diseases like rheumatoid arthritis arise when the bodys immune systemwhich typically keeps you healthy and defends against diseasestops working properly and mistakenly attacks healthy cells in your body, according to the U.S. National Library of Medicine. But with new advances in treatment options, it is possible to stop or slow the progression of rheumatoid arthritis with the right treatment. In some cases, people are even able to achieve a state of remission where the joints arent seeing further damage and the disease doesnt interfere with day-to-day living. Heres what you need to know about achieving rheumatoid arthritis remission.

Rheumatoid arthritis remission is defined as very, very low disease activity, or no disease activity for a particular individual, Dana DiRenzo, M.D., rheumatologist and instructor of medicine at Johns Hopkins Medicine, tells SELF.

You dont need to be completely free of symptoms to be in a state of remission, Dr. DiRenzo explains, but you would rate how your joints are feeling somewhere around a 0 or 1 out of 10, where 10 indicates the most pain or discomfort and 0 is the least.

There is no definitive answer to how many people achieve remission from rheumatoid arthritis, but it may fall somewhere between 5% and 45%, according to a 2017 analysis of studies. Diagnosis and aggressive treatment early on in the course of the illness seems to be an important factor in achieving remission, according to the Arthritis Foundation.

Remission can be achieved at any point, Dr. DiRenzo says, but its more likely with earlier treatment, especially within the first six to 12 months or so after diagnosis.

While there isnt one specific test that can show when someone is in remission, a rheumatologist can determine if youre in remission by evaluating your reported symptoms along with a number of clinical signs and symptoms. In the process, theyll often use a scoring guide such as the Clinical Disease Activity Index (CDAI) or the Disease Activity Score (DAS / DAS28). These scoring guides bring together different criteria and test results to measure disease activity for each patient in order to indicate how active the disease is at a specific point in time.

So this way we have an idea of whos doing really well and whos having a lot of disease activity, Fotios Koumpouras, M.D., rheumatologist, assistant professor of medicine at Yale School of Medicine, and director of the Yale Lupus Program, tells SELF.

Being in remission doesnt look exactly the same for everyone, but if youre in remission youll experience very minimal joint symptoms or none at all, and your joint symptoms wont interfere with your day-to-day life in any way.

Typically, a combination of medication and lifestyle changes are needed in order to achieve remission, but the exact requirements for achieving remission wont be the same from person to person.

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What Does It Mean to Be in Remission from Rheumatoid Arthritis? - Self

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Early, intensive treatment that combines methotrexate with prednisone can reduce the debilitating fatigue tied to rheumatoid arthritis even in patients at low risk of severe disease, finds a two-year study.

Rheumatoid arthritis causes chronic inflammation that can lead to weakness, exhaustion, and abnormal tiredness in up to 90% of patients, explained researchers from Belgium. Their study examined whether intensive treatment directly after diagnosis could change the disease course and reduce fatigue.

The investigators followed 80 patients with a low risk profile who were randomized into two groups. Immediately following diagnosis, participants received either 15 mg of methotrexate weekly or a combination therapy of 15 mg of methotrexate weekly plus cortisone (prednisone), starting at 30 mg and tapered weekly to 5mg. Both methotrexate and prednisone suppress inflammation, but prednisone is a quicker-acting anti-inflammatory and researchers used it as a bridge between initial treatment and the time the methotrexate took to be effective.

While disease activity in both groups was comparable over time, patients who received the intensive combination therapy for two years were less tired than patients in the monotherapy control group. Differing fatigue levels between the groups became more pronounced over time, the researchers reported.

In response, the European League Against Rheumatism has recommended that clinicians consider initiating early, intensive treatment, even in low-risk patients.

The study was published in Annals of Rheumatic Diseases.

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Early drug therapy eases exhaustion in rheumatoid arthritis patients: study - Clinical Daily News - McKnight's Long Term Care News

Objective:To investigate the association between allergic rhinitis (AR) and the risk of rheumatoid arthritis (RA).

Methods:Potentially eligible studies were identified from MEDLINE and EMBASE databases from inception to November 2019. Eligible cohort study must report relative risk with 95% confidence intervals (95% CIs) of incident RA between AR patients and comparators. Eligible case-control studies must include cases with RA and controls without RA, and must explore their history of AR. Odds ratio with 95% CIs of the association between AR and RA must be reported. Point estimates with standard errors from each study were combined using the generic inverse variance method.

Results:A total of 21,824 articles were identified. After two rounds of the independent review by three investigators, two cohort studies and 10 case-control studies met the eligibility criteria. The pooled analysis showed no association between AR and risk of RA (RR = 0.94; 95% CI, 0.73 to 1.20; I2= 84%). However, when we conducted a sensitivity analysis including only studies with acceptable quality, defined as Newcastle-Ottawa score of seven or higher, we found that patients with AR had a significantly higher risk of RA (RR = 1.36; 95% CI, 1.12 to 1.65; I2= 45%).

Conclusions:The current systematic review and meta-analysis could not reveal a significant association between AR and RA. However, when only studies with acceptable quality were included, a significantly higher risk of RA among patients with AR than individuals without AR was observed.

Keywords:allergic rhinitis; hay fever; meta-analysis; rheumatoid arthritis; systematic review.

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The Association Between Allergic Rhinitis and Risk of Rheumatoid Arthritis: A Systematic Review and Meta-Analysis - DocWire News

Plasma omega-3 levels, body mass index (BMI), and smoking history are predictors of treatment response in patients with early rheumatoid arthritis (RA), according to study data published in ACR Open Rheumatology. As such, modification of these lifestyle factors may be beneficial in improving treatment response in this population.

This study enrolled patients with recent-onset RA (disease duration <12 months) who were attending the Early Arthritis Clinic at the Royal Adelaide Hospital in Australia. The researchers aimed to examine lifestyle factors as predictors for treatment response in early RA. Patients with prior exposure to disease-modifying antirheumatic drugs (DMARDs) were excluded.

Enrollees received triple therapy with conventional synthetic DMARDs sulfasalazine, hydroxychloroquine, and methotrexate. Every 3 to 6 weeks, patients returned to the study clinic for evaluation of treatment response. If disease response was subpar at any visit, therapeutic doses were adjusted. A subset of patients received fish oil supplementation in addition to study treatment. Disease activity was evaluated using the 28-joint Disease Activity Score (DAS28) with erythrocyte sedimentation rate (ESR). The primary end points were achievement of remission (DAS28 2.6) or low disease activity (DAS28 3.2) at 1 year.

The study cohort comprised 300 patients, of whom 211 (70.3%) were women. Mean age at RA onset was 55.514.9 years, and median disease duration at enrollment was 16.0 weeks. Mean baseline DAS28 score was 5.41.3, suggesting high disease activity. Of 300 participants, 179 (57.6%) and 136 (43.7%) achieved DAS28 low disease activity and remission at 1 year, respectively.

In the total cohort, higher mean plasma EPA level was associated with a significantly increased likelihood of achieving DAS28 low disease activity (odds ratio [OR], 1.27; 95% CI, 1.12-1.45; P <.0001) and DAS28 remission (OR, 1.21; 95% CI, 1.08-1.36; P <.001) at 1 year. Separate logistic regression models were used to examine 2-way interactions involving BMI, sex, and plasma EPA, but no significant associations were found.

An interaction between smoking status and BMI was observed for the low disease activity outcome. Specifically, increased BMI was associated with lower odds of achieving DAS28 low disease activity among participants who reported current (OR, 0.803; 95% CI, 0.670-0.962; P =.017) and prior smoking (OR, 0.913; 95% CI, 0.842-0.991; P =.029). This association was not apparent among those who had never smoked. BMI alone was also modestly associated with RA remission (OR, 0.94; 95% CI, 0.89-0.99; P =.034).

According to these results, increased omega-3 uptake and smoking cessation may benefit patients with early RA, and weight-loss treatment may also be beneficial, particularly for patients with a history of smoking. As study limitations, the investigators noted the lack of data on potential confounders, including socioeconomic status, physical activity, and medication adherence.

Reference

Brown Z, Metcalf R, Bednarz J, et al. Modifiable lifestyle factors associated with response to treatment in early rheumatoid arthritis [published online May 26, 2020]. ACR Open Rheumatol. doi:10.1002/acr2.11132

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Omega-3 Levels, Smoking, and BMI Associated With Treatment Response in Early RA - Rheumatology Advisor

A new paper provides timely evidence to explain the therapeutic benefits of vagal nerve stimulation(VNS), a nervous system-modifying treatment that proponents say could offer relief to patients with lupus, arthritis and even heart failure.

Its a prospect that sounds too good to be true. One 20-minute outpatient surgery could lead to relief from epilepsy, depression, arthritis, heart failure and lupus. Thats the ultimate promise of VNSn, a technique that has accrued interest from enthusiastic startups and major biopharma firms alike.

Importantly, it has also accrued some convincing evidence to back up at least some of its claims VNS has been approved by the FDA as a therapy for treatment-resistant depression and epilepsy. As of 2015, 100,000 people worldwide had received a VNS implant.

But large gaps remain in our understanding of how VNS works. One of those gaps has now been plugged with the publication of a paper investigating how a technique called anodal block works to allow targeted stimulation during VNS. The research team behind the paper, led by Dr Stavros Zanos, have published their work in Scientific Reports.

VNS involves implanting electrodes on the vagal nerve near the carotid artery in the neck. The vagal nerve is in charge of routing signals between the brain and the peripheral organs. As Zanos, an assistant professor in the Institute of Bioelectronic Medicine at the Feinstein Institutes for Medical Research, explains, this means it is a uniquely attractive target for neurotechnology. This is primarily the nerve that the brain uses to convey information to the organs and change the way they function. And also, it's the main nerve through which information about the function of the organs is conveyed back into the brain. Because it's such an important nerve for ongoing physiology, it's a very attractive target for neuromodulation, says Zanos.

During VNS implantation, a pair of electrodes is attached to the vagus nerve. Depending on the electrode polarity, signals to or from the brain are stimulated or blocked when the VNS device is activated.

But the nervous system is a little more complicated than a two-lane highway. Nerve fibers sending signals in different directions exist within these larger bundles. Getting the level of stimulation right to ensure therapeutic benefit is of central importance, but is currently done quite crudely, Zanos tells me: The way VNS is done clinically is by increasing intensity. The healthcare provider changes some parameters, most notably the intensity, until the patient starts getting some side effects. Typically, those side effects have to do with contraction of the laryngeal muscles, so it causes coughing, and voice hoarseness.

This is far from optimal, and Zanos says that fine-tuning the approach is a priority. If we wanted to deliver an individualized therapy, we would have to know exactly how we're affecting the physiology of a specific individual, he says.

Anodal block is a central tenet of the current surgical procedure. The precise placement of the VNS electrodes can limit nerve conduction in the fibers under the positively charged anode back in the simplified highway example, this is the equivalent of setting up a tollbooth for traffic going in one direction the flow is slowed, if not stopped. But evidence that anodal block works this way in practice was sorely lacking from the wider literature. Would it be possible to find a biomarker, Zanos wondered, that could show that anodal block works as intended?Zanos and his team investigated this possibility by carrying out experiments with rats. Firstly, they needed to see what would happen when electrical impulses up and down the vagus highway were stopped entirely. The rodents had VNS devices implanted, and then had their vagus nerve cut either above or below the implant completely ending any vagus electrical stimulation towards the brain or the peripheral organs, respectively.

Zanos team noticed a consistent marker. Rats with intact vagus nerves showed a heavy reduction in their breathing and heart rates. When the same rats had their vagus nerve severed near the brain, the rats breathing rates returned to normal whilst the heart rate remained low. Severing the nerve nearer to the body had the opposite effect.

This told Zanos team that:

With these easy-to-measure markers identified, the next step was to work out whether breathing and heart rate were consistently affected by anodal block.The theories behind anodal block suggested that if the anode polarity was towards the brain, then the VNS devices effects on breathing rate would be reduced. Anode polarity facing the body would impair the effects on heart rate.

Whilst the same drastic changes seen in the first experiment were not present the rats in this group had intact vagus nerves, so signals still traveled both ways Zanos noted that their results supported the theories around anode block in a large number of the rats studied.

Importantly, these results werent consistent across all the rats studied. Three rats actually showed reversed effects. This paradox, says Zanos, is likely to be explained by the stimulation of the nearby aortic depressor nerve by the VNS. This unintended stimulation hasnt proved an issue in human VNS studies, so is likely to be a quirk only seen in certain rodents.

Even if the inconsistent data has an explanation, the study still highlights that the mechanisms behind VNS would be much easier to understand if those individual types of nerve fiber could be better identified. Zanos says this will be the target of an upcoming paper that should advance understanding in the area further. In the upcoming paper, says Stavros, We look at even finer relationships between some of these biomarkers; heart rate, breathing rate, but also additional biomarkers with the activation of specific fiber types.

Zanos suggests his teams data supports the idea that anodal block can make VNS more directional and targeted. But there is obviously more research to be done to support our understanding of why VNS works. This, says Zanos, could lead to the technique meeting its potential sooner than we might think. He highlights two US-based companies, LivaNova and Set Point Medical, who are investigating VNS for heart failure and rheumatoid arthritis respectively. My guess is that in the next two or three years at least one of these [companies], based on what I what I see in preliminary reports, will be successful, and VNS will be part of the therapeutic options for physicians for these two diseases.

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Vagus Nerve Stimulation Breakthrough Suggests Route To Therapies for Arthritis, Heart Failure - Technology Networks

The modified Disease Activity Score in 28 joints with C-reactive protein (DAS28-CRP) is a strong predictor of rapid radiographic progression in patients with early rheumatoid arthritis (RA), according to research results published in ACR Open Rheumatology.

Using data from PREMIER, a 2-year, multicenter, double-blind, active comparator-controlled, phase 3 clinical trial, researchers aimed to determine which measures of disease activity best predicted rapid radiographic progression in a population of patients with early RA. They examined the DAS28-CRP; modified DAS28-CRP, using weighted coefficients of CRP, physician global assessment, and swollen joint count in 28 joints; Clinical Disease Activity Index; and patient-reported outcomes, including the patient global assessment and the Health Assessment Questionnaire Disability Index.

Disease activity measures were taken at baseline and at 3-month follow-up. Investigators defined rapid radiographic progression as a change in the modified total Sharp score of >3.5 between baseline and 12 months. A decrease in DAS28-CRP >1.2 from baseline to 3 months was considered an improvement in disease.

In total, 149 patients were included in the analysis (mean age, 52.913.3 years; 75.8% women; mean RA duration, 0.80.9 years; 85.2% rheumatoid factor positive). Mean DAS28-CRP was 6.30.9, mean Clinical Disease Activity Index was 44.712.2, and mean modified DAS28-CRP was 5.11.3. With regard to therapies, 30.9% of patients were previously treated with conventional synthetic disease-modifying antirheumatic drugs, whereas 41.6% of patients were treated with steroids.

At baseline, modified DAS28-CRP was the strongest predictor of rapid radiographic progression at 12 months (adjusted odds ratio [aOR], 3.29; 95% CI, 1.70-6.36); other measures of RA showed no significant effect on progression at 12 months. The area under the curve (AUC) for modified DAS28-CRP at baseline was also higher compared with other measures (AUC, 0.66; 95% CI, 0.57-0.74), with a significant difference noted for AUC between the modified DAS28-CRP and DAS28-CRP (AUC difference, 0.10; P =.02).

At 3 months, investigators found that all disease activity measures and patient-reported outcomes were significant predictors for rapid radiographic progression. Despite this, only modified DAS28-CRP was a significant predictor at 12 months after applying the multivariate analysis and adjusting for potential confounders (aOR, 2.56; 95% CI, 1.43-4.56). Investigators also noted that the effect of modified DAS28-CRP at 3 months was less than its effect at baseline.

Results of a multivariable logistic regression analysis demonstrated that CRP at baseline and 3 months (aORs, 2.82 and 4.03, respectively) had the strongest effect on radiographic progression predictions at 12 months.

Per the Youden index, investigators found that the optimal cutoff point for the modified DAS28-CRP at baseline was 4.5 (positive and negative predictive values 50% and 76%, respectively) in predicting rapid radiographic progression at 1 year. The 3-month corresponding optimal cutoff point for the modified DAS28-CRP was 2.6 (positive and negative predictive values 59% and 81%, respectively).

The study was limited by its relatively small sample size in the original study and an inability to access data from all treatment groups in the PREMIER study.

[A] modified version of disease activity scores, such as the [modified DAS28], might be beneficial as an alternative measure of disease activity for rheumatologists in the routine care setting for their treat-to-target approach, the researchers concluded.

Disclosure: This clinical trial was supported by Horizon Therapeutics. Please see the original reference for a full list of authors disclosures.

Reference

Movahedi M, Weber D, Akhavan P, Keystone EC. Modified disease activity score at 3 months is a significant predictor for rapid radiographic profession at 12 months compared with other measures in patients with rheumatoid arthritis. ACR Open Rheumatol. 2020;2(3):188-194.

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Modified DAS28-CRP an Effective Predictor of Rapid Radiographic Progression in Early RA - Rheumatology Advisor

The incidence and severity of coronavirus disease 2019 (COVID-19) in patients with rheumatic disease receiving disease-modifying antirheumatic drugs (DMARDs) vs the general population is not significantly different, according to study results published in Arthritis and Rheumatology.

Patients at 2 rheumatology centers in Lombardy, Italy were invited to participate in a survey for the study between February 25t and April 10, 2020. All patients with rheumatic disease were being treated with targeted synthetic or biologic DMARDs (ts/bDMARDs). The survey included data on contact with individuals infected with COVID-19, viral symptoms, and changes in behavior, or disease management; COVID-19 was confirmed by a nasopharyngeal swab.

A total of 955 patients (67.4% women; mean age, 53.714 years) with rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis, spondyloarthritis, and other autoinflammatory diseases, were included in the study, with a survey responder rate of 98.05%. A majority of patients were receiving anti-tumor necrosis factor (TNF) therapy (55.8%), with nearly half the patient cohort (47.3%) receiving a bDMARD as monotherapy. A total of 47.3% of patients had 1 comorbidity, mostly high blood pressure.

The survey indicated that 90.6% of patients took precautionary measures to prevent infection with COVID-19; 93.2% of patients maintained their ts/bDMARD treatment regimen, and rheumatic disease activity remained stable in 89.5%. In total, 6 patients with rheumatic diseases tested positive for COVID-19, 5 of whom were treated with anti-TNF agents; 2 patients were receiving bDMARDs as monotherapy.

Researchers observed that the COVID-19 infection rate of patients with rheumatic disease did not differ from the general population (0.62% vs 0.66%; P =.92). While half the number of infected patients (n=3) were admitted to the hospital for oxygen supplementation, none were admitted to the intensive care unit. All patients who tested positive for COVID-19 temporarily discontinued receiving ts/bDMARD therapy during viral infection. An additional 144 patients developed respiratory symptoms; however, they had no access to nasopharyngeal swabs. Of these patients who suspected to have COVID-19, 33 temporarily suspended receiving biologic therapy for an average of 16.9 days, with 9 patients reporting a disease relapse.

A limitation of this study was the cross-sectional survey design. Patients were interviewed by telephone, and it was possible that some symptoms were missed or that nonresponsive patients (n=24) were infected. Furthermore, tests for COVID-19 were unavailable for many patients who were experiencing respiratory symptoms.

Researchers concluded [The] results highlight the attitude [of patients with] rheumatic [disease] to prevent the contagion while maintaining their chronic treatments. The incidence and severity of COVID-19 in patients treated with ts/bDMARDs was not significantly different from that of the general population in the same region.

Reference

Favalli EG, Monti S, Ingegnoli F, Balduzzi S, Caporali R, Montecucco C. Incidence of COVID-19 in patients with rheumatic diseases treated with targeted immunosuppressive drugs: what can we learn from observational data? [published online June 7, 2020] Arthritis Rheum. doi:10.1002/ART.41388

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Similar Rates of COVID-19 Incidence, Severity in Patients With and Without Rheumatic Disease - Rheumatology Advisor

With having published myriads of reports, Rheumatoid Arthritis Treatment Market Research imparts its stalwartness to clients existing all over the globe. Our dedicated team of experts delivers reports with accurate data extracted from trusted sources. We ride the wave of digitalization facilitate clients with the changing trends in various industries, regions and consumers. As customer satisfaction is our top priority, our analysts are available to provide custom-made business solutions to the clients.

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Segment by Regions

North America

Europe

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Market Segmentation based on Type:

Non-Steroidal Anti-inflammatory Drugs (NSAIDs)CorticosteroidsDisease-modifying anti-rheumatic drugs (DMARDs)

Market Segmentation based on Application:

HospitalRetail PharmaciesDrugstores

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Global Rheumatoid Arthritis Treatment Market Latest Trends, Development, Growth Analysis And Forecast by 2027 - Cole of Duty

With 75 percent of current S&P 500 companies expected to disappear until 2027, according to research by McKinsey. The only constant in our world is changing, the pace of change has been expediting significantly over the past years, fueled by huge investments in technology and science, easier access to truly global markets, and a general cultural shift towards innovation among other key drivers are helping to rise of Rheumatoid Arthritis and Lupus Treatments market.

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Know Future Opportunities of the Rheumatoid Arthritis and Lupus Treatments Market latest Technology, New Innovation, Growing factors with Top Key...

Osteoarthritis pain can be debilitating. Strategies can help get you moving again.

Pain from osteoarthritis is more than just a nuisance. Knee pain, in particular, can not only keep people from exercising, but also have a chilling effect on their ability to participate in social activities, especially those that involve walking or traveling, says Elena Losina, the Robert W. Lovett Professor of Orthopedic Surgery at Harvard Medical School and co-director of the Orthopaedic and Arthritis Center for Outcomes Research at Brigham and Women's Hospital.

"In fact, the quality of life of a person with persistent pain due to knee osteoarthritis is similar to quality of life in women with metastatic breast cancer controlled by therapy," she says.

Arthritis can produce a range of symptoms from pain to stiffness. "The patterns of pain differ from person to person, but it often comes in waves or flares," says Losina. "Also, evolving data show that while pain may fluctuate between flares, a relative minority 10% to 15% of knee osteoarthritis patients experience a steady worsening."

Osteoarthritis is the most common type of arthritis, affecting nearly half of all Americans over 65. It results from the deterioration of the cartilage that acts as a cushion between the bones in a joint. A number of factors can cause cartilage to break down, including general wear and tear from friction and pressure on the joint over time, injuries, and even your genes, as osteoarthritis tends to run in families. Obesity is also a risk factor for osteoarthritis.

As the cartilage padding wears thin, the bones begin to rub together, causing pain and in some cases spurring, an overgrowth of bone as it attempts to heal. All this can lead to inflammation and tissue damage in the surrounding area.

Symptoms of arthritis typically develop over time and may include

Living with arthritis pain can be a challenge, but there are numerous strategies you can use to manage it. There is not yet a treatment that can reverse the underlying joint damage caused by osteoarthritis, Losina says, although several pharmaceutical companies are pursuing disease-modifying agents.

Current treatments for osteoarthritis instead focus on relieving symptoms. They fall into three categories:

Nondrug therapies. These include exercise (one of the most effective treatments currently available) and physical therapy, says Losina. Regular exercise can reduce stiffness, pain, and fatigue. But it can be a challenge to get moving if you aren't exercising regularly already. Try starting off slow, with simple activities such as regular walks.

Drug therapies. Doctors often treat osteoarthritis with nonsteroidal anti-inflammatory drugs, which relieve swelling and pain. Examples include ibuprofen (Advil) and naproxen (Aleve). "There is also evolving research on the role of the antidepressant duloxetine [Cymbalta] and muscle relaxants," says Dr. Losina.

A strategy that has come under scrutiny in recent years is the use of corticosteroid injections to treat pain. This treatment, in which a doctor injects a strong anti-inflammatory medication into the joint, is often used to temporarily relieve pain in people who aren't responding well to other medications or nondrug strategies.

"Recent data suggest that pain control from corticosteroid injections is limited to the short term," says Losina.

These injections may actually lead to more damage to the joint. This means that while you may alleviate pain in the short term, you're making the joint worse in the long term, which could make it harder to control symptoms over time.

Surgery. Joint replacement is sometimes an option for people who aren't seeing success with other strategies. A total knee replacement, for example, can be used to alleviate pain for people with severe knee osteoarthritis.

"It is shown to be effective, leading to substantial pain relief in about four out of five recipients," says Losina. Having this procedure can help many people with severe osteoarthritis regain function in their joint. The replacement can last for 15 to 20 years.

To find the best treatment for your condition, you should discuss your options with a primary care physician or a specialist, such as a rheumatologist, physiatrist, or orthopedic surgeon.

Image: Victor_69/Getty Images

Disclaimer:As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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Easing the ache - Harvard Health

Recommended treatments include emollients and intermittent use of topical corticosteroids. For those with moderate-to-severe disease and where topical therapy fails, oral immunosuppressive treatments, for example, prednisolone, ciclosporin, azathioprine and methotrexate are used and while effective, apart from methotrexate, long-term use of oral treatments is not recommended.2 The introduction of the first monoclonal antibody dupilumab, in August 2019, for patients with moderate-to-severe AE was a major treatment advance although a proportion of patients do not achieve a satisfactory response from the drug,3 hence the need for alternative and effective therapeutic options.

In recent years much interest has centred on a new-class of drugs, the Janus kinase inhibitors (JAKis) of which there are three (tofacitinib, baricitinib and upadacitinib) currently licensed for rheumatoid arthritis and psoriatic arthritis (tofacitinib only). The Janus kinase (JAK) pathway facilitates transmission of chemical signals from outside of the cell (that is, once a ligand binds to its receptor) to the nucleus and the subsequent activation of genes involved in a variety of processes such as immune cell division, activation, recruitment and in the context of AE, inflammation. The Janus family consists of four receptor-associated kinases (JAK1, JAK2, JAK3 and TYK2) and a signal transducer and activator of transcription (STAT) pathway. While the precise aetiology of AE remains to be determined, it is characterised by barrier impairment which is thought, in part due to an exaggerated T-helper 2 (Th2) cell response. Keratinocytes activate dendritic and Langerhans cells which subsequently stimulate Th2 cells to produce a range of pro-inflammatory cytokines including interleukin (IL)-4, IL-5, IL-13, IL-31 and IL-33.4 Furthermore, both IL-4 and IL-13 activate the JAK-STAT pathway, leading to the production of pro-inflammatory cytokines5 and through their action on gene expression, downregulate the production of many of the proteins essential for skin-barrier function.6 As a result, JAKis have a potentially important role in attenuating the downstream activation of many different inflammatory cytokines, hence their role in rheumatoid arthritis. However, the recent publication of the results from two Phase III trials, suggest that oral JAKis represent a potentially important new development in the management of moderate-to-severe atopic eczema.

Clinical studiesThe first trial involved baricitinib, which inhibits JAK1 and JAK2. In two identical, double-blind, 16-week, Phase III trials, 1239 adults with moderate-to-severe AE who had failed to adequately respond to topical therapies, received either placebo, or 1, 2 or 4mg oral baricitinib daily.7 Emollients were allowed throughout the trial but any other oral or topical therapies were stopped but permitted as rescue treatment if required. The primary outcomes were an investigator global assessment (IGA) score of 0 (clear) or 1 (almost clear) and a > 2-point improvement from baseline in IGA score. After 16 weeks, 16.8% of patients taking baricitinib 4mg achieved the primary outcome, 11.4% (baricitinib 2mg) and 11.8% (baricitinib 1mg) compared with 4.8% in the placebo group. Baricitinib 4mg was most effective and improvements in itch, sleep disturbance and skin pain were evident after one week of treatment.

The second trial involved abrocitinib (a JAK1 inhibitor) with 391 patients, aged 12 years and over, given the drug at a daily dose of 200mg or 100mg compared with placebo for 12 weeks.8 As in the baricitinib trials, all patients had a documented inadequate response to topical corticosteroids and topical calcineurin inhibitors. The study employed the same primary outcome measures as the baricitinib trials. At the study end, 38.1% of those given abrocitinib 200mg achieved the primary outcome, 28.4% (abrocitinib 100mg) vs 9.1% in the placebo group. As with baricitinib, patients receiving abrocitinib, improvements in signs and symptoms of AE, were apparent within two weeks. Trials of a third agent, upadacitinib, which is also a JAKi, are underway.

In terms of adverse effects, these occurred in up to 58% of patients receiving baricitinib 4mg although no more than 2.5% of these, which included nasopharyngitis and upper respiratory tract infections, were considered as severe. In the abrocitinib trial, 65.8% of those given the 200mg dose experienced an adverse effect, compared to 62.7% in the lower dose group and 53.8% in those taking placebo. The most common adverse effect was nausea in the high dose groups (14.2%), followed by nasopharyngitis (7.7%).

Place in therapyTo date, the information on the efficacy of JAKis in the management of atopic eczema is promising but limited. There are several Phase II studies of other oral and topical JAKis and the results from Phase III studies of these agents are eagerly awaited. Nevertheless, there is a need for studies to assess the longer-term effectiveness of this class of drugs and if there are any important trade-offs between efficacy and safety. None of these agents are currently licensed for the use of atopic eczema and there is an FDA black box warning for the risk of severe infection with baricitinib 2mg (brand name Olumiant) when used for rheumatoid arthritis.9 It is also important to ascertain where this class might sit in the treatment hierarchy. Despite these reservations, it is likely that JAKis represent a potentially useful addition to the treatment armamentarium of doctors managing patients with atopic eczema and their introduction, once it occurs, should be welcomed.

References

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JAK inhibitors: a major advance in the treatment of atopic eczema - Hospital Healthcare Europe

For Immediate Release: June 16, 2020

The U.S. Food and Drug Administration today approved Ilaris (canakinumab) injection for the treatment of Active Stills disease, including Adult-Onset Stills Disease (AOSD). Ilaris was previously approved for Systemic Juvenile Idiopathic Arthritis (SJIA) in patients aged 2 years and older.

Prior to todays approval, patients had no FDA-approved treatments for their disease, which can include symptoms such as painful arthritis, fevers and rash, said Nikolay Nikolov, M.D., acting director of the Division of Rheumatology and Transplant Medicine in the FDAs Center for Drug Evaluation and Research. Todays approval provides patients with a treatment option.

AOSD is a rare and serious autoinflammatory disease of unknown origin. Autoinflammatory diseases are caused by abnormalities of the immune system, which trigger an inflammatory response that can damage the body's own tissues. Characteristics of AOSD have considerable overlap with Systemic Juvenile Idiopathic Arthritis (SJIA), which includes fever, arthritis, rash and elevated markers for inflammation. The overlapping features of AOSD and SJIA suggest this is a disease continuum rather than two separate diseases.

The role of interleukin-1 (IL-1), a type of cytokine important in regulating the bodys immune system, is well-established in AOSD and SJIA. Ilaris works by blocking the effects of IL-1 and suppressing inflammation in patients with this autoinflammatory disorder. The safety and efficacy of Ilaris for the treatment of patients with AOSD was established using comparable pharmacokinetic exposure and extrapolation of established efficacy of canakinumab in patients with SJIA, as well as the safety of canakinumab in patients with AOSD and other diseases.

Common side effects reported by patients treated with Ilaris are infections (colds and upper respiratory tract infections), abdominal pain and injection-site reactions. The prescribing information for Ilaris includes a warning for potential increased risk of serious infections due to IL-1 blockade. Macrophage activation syndrome (MAS) is a known, life-threatening disorder that may develop in patients with rheumatic conditions, in particular Stills disease, and should be aggressively treated. Treatment with immunosuppressants may increase the risk of malignancies. Patients are advised not to receive live vaccinations during treatment.

Ilaris was granted Priority Review designation, under which the FDAs goal is to take action on an application within six months where the agency determines that the drug, if approved, would significantly improve the safety or effectiveness of treating, diagnosing or preventing a serious condition.

The approval of Ilaris was granted to Novartis Pharmaceuticals Corp.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nations food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

###

06/16/2020

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FDA Approves First Treatment for Adult Onset Still's Disease, a Severe and Rare Disease - FDA.gov

The introduction of JAKs inhibitors for the treatment of rheumatoid arthritis represents a promising new era in the management of the disease. New compounds under investigation, like upadacitinib, with greater selectivity for JAK1 inhibition have recently been approved for the treatment of adults with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to conventional synthetic disease-modifying antirheumatic drugs.Herein, the authors review the pharmacological data, the therapeutic efficacy, and safety data of upadacitinib before providing the reader with their critical evaluation and future perspectives.Upadacitinib was able to accomplish all the primary and secondary end points in most of the trials, with a safety profile that is similar to the other JAK inhibitors. It has also demonstrated superiority over a tumor necrosis factor inhibitor and data on new indications is also favorable. Upadacitinib is a promising new drug for the treatment of rheumatoid arthritis.Adalimumab: ADA; American College of Rheumatology: ACR; Assessment of Spondylarthritis International Society 40: ASAS40; Ankylosis Spondylitis: AS; Area under the Curve: AUC; Biological Disease-modifying arthritis drugs: bDMARDs; Clinical disease activity index: CDAI; C Reactive Protein: CRP; Conventional Synthetic Disease-modifying arthritis drugs: csDMARDs; Deep Venous Thrombosis: DVT; Disease arthritis score: DAS.

PubMed

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Evaluating upadacitinib for the treatment of rheumatoid arthritis. - Physician's Weekly

AbbVie (NYSE:ABBV) has a solution for the loss of patent protection on its blockbuster drug Humira: ABBV-3373, a souped-up version of the monoclonal antibody that's quite literally Humira on steroids; it's Humira, an antibody that targets tumor necrosis factor (TNF), connected to a glucocorticoid receptor modulator (GRM) steroid.

In a phase 2a clinical trial, ABBV-3373 reduced the Disease Activity Score 28 C-Reactive Protein (DAS28-CRP) -- a measurement of the severity of rheumatoid arthritis disease -- by 2.65 points, compared to a decline of 2.13 points for patients who were given Humira in other clinical trials. The phase 2a study also had some patients on Humira, and when data from those patients was combined with the historical Humira data, Abbvie calculated that there was a 90% chance that ABBV-3373 was associated with a greater improvement in DAS28-CRP than Humira.

Image source: Getty Images.

Antibody-drug conjugates have been used for decades to treat cancer by using an antibody to target a toxic payload to tumor cells. But AbbVie is using the technology to target a molecule -- the GRM steroid that is anti-inflammatory -- to activated immune cells while still blocking the pro-inflammatory TNF protein. By specifically targeting activated immune cells, the drugmaker hopes to dampen the systemic side effects seen with glucocorticoid steroids.

A few other companies are developing antibody-drug conjugates where the additions aren't the traditional toxic payload. Privately held Bolt Biotherapeutics and Silverback Therapeutics, for instance, are using antibodies to target tumor cells and attaching molecules that can stimulate immune cells to attack the cancerous ones. And Avidity Biosciences, which has filed to go public under the ticker RNA, is attaching oligonucleotides to antibodies in order to target them to specific cells in the body.

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AbbVie's Humira on Steroids (Literally) Treats Rheumatoid Arthritis Better Than the Original - The Motley Fool

Trusted Business Insights answers what are the scenarios for growth and recovery and whether there will be any lasting structural impact from the unfolding crisis for the Psoriatic Arthritis Therapeutics market.

Trusted Business Insights presents an updated and Latest Study on Psoriatic Arthritis Therapeutics Market 2019-2026. The report contains market predictions related to market size, revenue, production, CAGR, Consumption, gross margin, price, and other substantial factors. While emphasizing the key driving and restraining forces for this market, the report also offers a complete study of the future trends and developments of the market.The report further elaborates on the micro and macroeconomic aspects including the socio-political landscape that is anticipated to shape the demand of the Psoriatic Arthritis Therapeutics market during the forecast period (2019-2029).It also examines the role of the leading market players involved in the industry including their corporate overview, financial summary, and SWOT analysis.

Get Sample Copy of this Report @ Global Psoriatic Arthritis Therapeutics Market 2020 (Includes Business Impact of COVID-19)

Global Psoriatic Arthritis Therapeutics Market Analysis Trends, Applications, Analysis, Growth, and Forecast to 2028 is a recent report generated by Trusted Business Insights. The global Psoriatic Arthritis Therapeutics market report has been segmented on the basis of drug, diseases type, and region.

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Global Psoriatic Arthritis Therapeutics Market: Overview

Psoriatic arthritis (PsA) is a type of chronic disease, characterized by inflammation in the joints and skin. This disease is progressive category of diseases that may worsening over time. If left untreated, this psoriatic arthritis may lead to joint damage permanently. It is characterized by potential involvement of diverse tissues, including, enthesitis, peripheral and axial joints, skin & nail disease, and dactylitis. The treatment of PsA includes the use of a variety of interventions that act as an agent for the treatment of patients with other forms of inflammatory arthritis, such as rheumatoid arthritis (RA), spondyloarthritis and others.

Global Psoriatic Arthritis Therapeutics Market: Dynamics

Increasing number of cases of psoriatic arthritis especially in elderly population is a key factor expected to drive the growth of the global market over the forecast period. In addition, rising awareness about psoriatic arthritis treatment among the healthcare professionals and increasing elderly population. The above mentioned are some of the other factors expected to drive growth revenue of the global market. However, high cost of the drugs and treatment, entry of biosimilar drug in the market, and lack of standardization tools for diagnosis and treatment. These are some of the major factors expected to hamper growth of the target market to a certain extent.

Global Psoriatic Arthritis Therapeutics Market: Segment Analysis

Among the drug type segments, Nonsteroidal anti-inflammatory drug is estimated to account for majority of revenue share in the global market. This is due to, rising prescribing of NSAID drugs for patients, in order to pain and morning stiffness, controlling swelling, and to improve range of motion to joints.

Among the diseases type segments, symmetric psoriatic arthritis is estimated to hold highest revenue and register highest CAGR over the forecast period, due to increasing number of cases of affecting several joints in pairs on both sides of your body. It may damage joints over time, that can lead to limited movement and function of body.

Global Psoriatic Arthritis Therapeutics Market: Trends

The established players are adopting various growth strategies such as partnership, collaboration, mergers, new product launch etc., in order to cater the growing demand for Psoriatic Arthritis Therapeutics globally. In addition, the prominent players are collaborating with local player in order to form string value and supply chain. The aforementioned are some of the current key trend witnessed in the target market.

Global Psoriatic Arthritis Therapeutics Market: Regional Analysis

In 2019, the markets in North America estimated to account for highest market revenue share in the target market over the forecast period. This is primarily attributed to, increasing incidences of psoriatic arthritis. According to RheumatoidArthritis.org, which is a non-profit team of healthcare professionals around 85% of individuals living with psoriatic arthritis in US. The markets in Asia Pacific accounted for highest CAGR over the forecast period, owing to increasing prevalence and incidences in the temperate zones in the region, and growing healthcare expenditure. In addition, higher demand and increased rate of adoption of biologic drugs in countries such as Australia & New Zealand, are projected to drive the psoriatic arthritis therapeutics market in Asia Pacific region.

Global Psoriatic Arthritis Therapeutics Market Segmentation:

Segmentation by drug:

Nonsteroidal anti-inflammatory drug (NSAID)Disease-modifying antirheumatic drug (DMARD)Biologic drugEnzyme inhibitor

Segmentation by diseases type:

Asymmetric Psoriatic ArthritisSymmetric Psoriatic ArthritisDistal Interphalangeal Predominant (Dip) Psoriatic ArthritisSpondylitisArthritis Mutilans

Quick Read Table of Contents of this Report @ Global Psoriatic Arthritis Therapeutics Market 2020 (Includes Business Impact of COVID-19)

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Psoriatic Arthritis Therapeutics Market Analysis Of Global Trends, Demand And Competition 2020-2028 - 3rd Watch News

Jess Glass, Press Association

10 June, 2020 16:06

Drugs used to treat conditions including rheumatoid arthritis will be tested as potential treatments in a Covid-19 trial.

Researchers at the University of Birmingham announced on Wednesday that four drugs will be used as part of their Catalyst trial into therapeutics for patients with the virus.

The trial will use drugs that are on the market or are in late stages of clinical trials to treat hospitalised patients with Covid-19, in the hope they can prevent them from needing intensive care.

The first drug in the research is Namilumab, produced by the Oxford-based Izana Bioscience, which is in late-stage trials for use for rheumatoid arthritis and the inflammatory disease ankylosing spondylitis.

READ MORE:Coronavirus: Tougher border controls 'more effective if introduced earlier', MPs told

The drug targets substances called cytokines which are naturally released by immune cells but can cause damage during an over-reaction of the immune system known as a cytokine storm.

These substances are believed to be a key factor in the excessive and potentially dangerous lung inflammation seen in some Covid-19 patients.

The second drug is Infliximab, developed by Slough-based Celltrion Healthcare UK, and is an anti-tumour necrosis therapy.

It is currently used to treat inflammatory and autoimmune conditions including rheumatoid arthritis and irritable bowel syndrome.

The other two drugs to be used in the trial will be announced at a later date.

Researchers hope that by targeting some of the most serious symptoms of Covid-19, the severity of the disease could be reduced leading to a fall in deaths.

Researchers at the University of Birmingham are testing four different drugs which could be used to treat coronavirus

Dr Ben Fisher, co-clinical investigator of the Catalyst trial, said: "Emerging evidence is demonstrating a critical role for anti-inflammatory drugs in the cytokine storm associated with severe Covid-19 infection.

"In the Catalyst study, we hope to show with a single dose of these kinds of drugs in hospitalised patients that we are able to delay or prevent the rapid deterioration into intensive care and requirement for invasive ventilation in this critical patient group."

Up to 40 Covid-19 patients will be recruited to each part of the trial and will be randomly selected to either receive standard treatment alone or treatment with the addition of one of the four drugs.

The trial has been designed by the inflammation - advanced and cell therapy trials Team at the University of Birmingham's Cancer Research UK clinical trials unit.

In addition to the team at the university, the trial is being conducted with University Hospitals Birmingham NHS Foundation Trust, as well as teams from Oxford University and University College London.

Recruitment for patients has started in Oxford and Birmingham.

If a drug is found to be successful, the trial will be expanded for further testing on a national level.

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Arthritis drugs used in new coronavirus treatment trial - The Irish News