StemCell Therapy

Background:Spontaneous rupture of extensor pollicis longus (EPL) tendon is a rare condition often found in patients actively having regular extensive use of hands and fingers especially the thumb. In this article, we report 7 cases of spontaneous rupture of EPL tendon and investigate the associated factors and treatment outcome.

Methods:Retrospectively, the databases for the 7 cases were retrieved and studied. These cases represent all cases of spontaneous rupture of EPL in our institution. Demographic data, clinical presentation, any history of trauma or steroid injection, laboratory and clinical findings suggestive for rheumatoid arthritis, co-morbidities and imaging findings were obtained. In addition, the operative technique and findings were retrieved. Moreover, histopathological studies and follow-up assessment were included.

Results:Six males and one female were included. The mean age was 45.2 years. No prior history of trauma, rheumatological disease or steroid use was detected in any patient. All patients experienced prodromal pain in the radial side. Clinical examination was the most effective diagnostic measure. Magnetic resonance imaging (MRI) was used to confirm the diagnosis and to look for other abnormalities that may predispose to rupture. Five patients underwent extensor indicis proprius to EPL tendon transfer employing Pulvertaft weave technique and one patient underwent primary repair as there was a little gap in the tendon ends. In this study, one patient refused any treatment. All patients achieved a favorable outcome at the last follow-up.

Conclusion:Diagnosis of spontaneous ruptures of EPL tendon can be confirmed through clinical examination and MRI for patients with restricted thumb movement even with the absence of any identifiable predisposing risk factor. During surgery, detailed attention must be drawn towards the tendon ends which can have unusual gaps and bone abnormalities.

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Spontaneous Rupture of Extensor Pollicis Longus Tendon: Clinical and Occupational Implications, Treatment Approaches and Prognostic Outcome in...

For World Inflammatory Bowel Disease day we spoke to Pfizers Matt Shaulis, president of international developed markets for inflammation and immunology, to hear how the company hopes to harness innovation to address the many unmet needs in these disease areas.

What would you say are the biggest challenges in the area at the moment?

One of the biggest challenges in the area of immune-mediated and inflammatory diseases is the lack of understanding of the true burden of these diseases, which has meant that these patients have historically been underserved.

While significant advances have been made in the treatment of rheumatic diseases, such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS), many patients still experience the daily burdens of living with these diseases.

Whether a patient is unable to reach remission with his or her current treatment or is settling for good enough, uncontrolled disease can lead to irreversible joint damage and may also impact overall wellbeing and daily functioning.

For this reason, different treatment options in addition to timely diagnosis and access to advanced therapies are needed.

As for gastroenterology, chronic inflammatory diseases of the digestive tract can be painful, inconvenient and embarrassing, dramatically affecting how patients live their lives. Many patients have not been able to achieve optimal symptom control with current therapies and lead a life profoundly impacted by ongoing symptoms.

Wearable technologies commonly seen in the fitness field can be employed to measure itching and sleep disturbance in atopic dermatitis

There is also a critical unmet need for diseases such as nonalcoholic steatohepatitis (NASH), a leading cause of liver transplant, for which there are no approved drug therapies.

In dermatology, despite significant recent advances in inflammatory skin diseases, there are still many such as atopic dermatitis (AD), alopecia areata (AA) and vitiligo where new treatments are needed to make a meaningful impact in patients lives.

Are there any particular issues in diagnosis and detection youre hoping to address?

The treatment landscape for immune-mediated diseases has evolved significantly, from broad immunosuppression with steroids to targeted immune modulation through selective agents. However, improved treatment options will only really make a difference to patients lives if they go hand in hand with an increase in awareness among physicians and other healthcare providers.

We need to work with the medical community to enable a deeper understanding of immunological disease management, triggers, and the importance of treatment adherence. The resulting improvement in patient wellbeing can soften the impact on healthcare systems.

What does innovation mean to you when it comes to inflammation and immunology?

Innovation comes in many forms for the inflammation and immunology (I&I) team. Innovation in research and development is crucial and we are relentlessly pursuing new breakthroughs such as next generation kinase inhibitors, novel biologics, biosimilars and topicals.

But we also strive to innovate in how we run clinical trials both in terms of the technology we use for example employing wearable technologies commonly seen in the fitness field to measure itching and sleep disturbance through to the means to undertake testing in patients homes to obtain true real world evidence.

Finally, we partner with a variety of organisations who are driving innovation in helping patients make informed lifestyle choices, manage treatment adherence and facilitate doctor/patient relationships.

What kind of beyond-the-pill measures are important for patients in these disease areas?

There are improvements that could be proposed at all levels of the healthcare ecosystem to help address immunological and inflammatory diseases, but a critical step is for stakeholders to collaborate and drive meaningful change at the policy level.

This begins with establishing guidelines to ensure standardised treatment paradigms. Further assistance can be provided to patients through holistic patient and family support programmes that integrate disease management with good overall health and wellness practices.

One organisation we are partnering with in this regard is Sidekick Health, which offers technology-based solutions for patients suffering from the two main IBD conditions ulcerative colitis (UC) and Crohns disease (CD), and also for patients with rheumatoid arthritis (RA), atopic dermatitis (AD) and psoriatic arthritis (PsA).

The platform provides these patients with a rich user experience, where they earn rewards for managing their nutrition, exercise, sleep, stress and medication adherence. They also receive condition-specific education, and a connection to a community of health professionals and patients on a similar health journey.

Finally, expanded general awareness of AD can break the stigma associated with its flare-ups. When patients concerns are met with understanding and support, it can lessen their embarrassment and anxiety. This in turn may make them more likely to seek the help they need to manage their condition successfully.

Whats your overall view on how digital technology fits into I&I research, treatment and care?

There is a lot of interesting work being done in I&I research utilising technologies from the broader health arena. For example, our own Pfizer Innovation Research (PfIRe) lab is looking at solutions such as using wearable devices to help scientists monitor treatment for atopic dermatitis.

The lab equips patients with a device that can monitor sleep disruption caused by scratching. The team assesses that sleep disruption both with treatment and without treatment to determine how effective a particular therapy is for that particular endpoint. This is particularly critical in assessing scratching and sleep disruption in younger patients who would have trouble recalling or indeed articulating these symptoms themselves.

Do you think eczema and other inflammatory skin diseases are overlooked compared to other conditions?

Chronic inflammatory skin diseases can have a devastating impact on a persons mental and emotional wellbeing, although they are often overlooked as being simply cosmetic. This leads to a vast discrepancy in how patients are managed around the globe. Furthermore, the physical and social pressure that this disease creates goes hand in hand with a financial burden as patients pay for various products and treatments in search of symptom relief.

One recent study found that the average AD patient spends an additional 927 per year on health care expenses. Add to this the potential cost of doctors visits and treatments for co-morbidities, and the economic impact of absenteeism and time off work, and we start to get a true picture of the cost this condition imposes on health care systems at large.

We are now seeing an increased focus on developing treatments for chronic inflammatory skin diseases, but there is still a long way to go.

How do you see I&I evolving in the future?

The JAK pathways are believed to play an important role in inflammatory processes as they are involved in signalling for over 50 cytokines and growth factors, many of which drive immune-mediated diseases. JAK inhibition may offer patients with these conditions a potential new advanced treatment option.

Were taking a different R&D approach to that of other companies involved in JAK research instead of studying a single molecule for all its potential uses, where it may not be optimal for some, we purposefully match Pfizers candidates with unique selectivity profiles to the conditions where, if approved, we believe they have the greatest potential to address unmet need.

Ultimately, we are working toward supporting fast, accurate diagnoses, providing effective treatment options and enabling appropriate patient choices which lead to freedom from the burden of immune-mediated and inflammatory diseases.

About the interviewee

Matt Shaulis currently serves as the president of Pfizer inflammation and immunology for international developed markets. He has approximately 20 years of experience in the pharmaceutical industry across several functions including: in-line and global strategic marketing, sales management, strategic customers group, licensing and acquisitions, finance, and compound and indication launches across multiple disease states. He joined Pfizer from Teva Pharmaceuticals, where he was vice president, global CNS, multiple sclerosis.

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Innovating in inflammation and immunology - - pharmaphorum

Dr.Brian McKay of Core Health Darien discusses arthritis pain and how it relates to low back pain. Core Health Darien is located at 551 Post Road.

(Newswire.net -- May 14, 2020) Darien, CT --Osteoarthritis is a common condition involving articular surfaces that can develop gradually over time into a debilitating condition, which causes pain and restriction of motion. Specifically, spine osteoarthritis is the presence of disc degeneration and osteophyte formation as well as pain. Facet joint arthritis is present in 19% of individuals between the ages of 45 and 65 years of age and 57% of patients over the age of 65 in the United States. The facet joint is where the bones meet to form a biomechanical arch, this is where weight is supported. With undue stress, the surface of the bone starts to wear out causing pain. Arthritis can affect any articular surface; it is more likely to affect weight-bearing joints, which includes the spinal column.

Osteoarthritis is a chronic, degenerative disease. Low back pain and spine arthritis are among the leading health-related causes of disability and reduction in patients' quality of life. Pathologically osteoarthritis can cause spinal stenosis, herniated nucleus pulposus, myelopathy, radiculopathy, spondyloarthritis, and spondylolisthesis. Also complicating the diagnosis is how radiographic imaging of spine osteoarthritis does not necessarily correlate with patients' pain and thus leads to treatment options that may not improve symptoms.

Osteoarthritis is responsible for the breakdown of the cartilage (the tissue that cushions the ends of the bones between joints), bony changes of the joints, deterioration of tendons and ligaments, and various degrees of inflammation of the joint lining (called the synovium). Spinal arthritis is a degenerative process that develops over time in response to the stresses placed on the spinal joints.

Arthritis is a general term that describes conditions that affect your joints. There are many types of arthritis besides osteoarthritis, here are a few of the more common ones. Ankylosing spondylitis (AS) is a type of inflammatory arthritis that targets the joints of the spine. Reactive arthritis is a form of arthritis that occurs as a result of some bacterial infections. Rheumatoid arthritis is a long-term condition that causes pain, swelling, and stiffness in the joints. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease. Psoriatic arthritis is a chronic, inflammatory disease of the joints and the places where tendons and ligaments connect to bone. Psoriatic arthritis can also cause inflammation of the eyes, such as Conjunctivitis and Iritis.

Osteoarthritis is the most common type of arthritis. The treatment for these common types of arthritis is usually rest, ice, and NSAIDs. Lumbar osteoarthritis is a form of degenerative arthritis in the lower back that causes pain, stiffness, and inflammation in the joints between vertebrae. Arthritis is the most common cause of lower back pain, especially in people over age 50, and affecting approximately 27 million Americans. While osteoarthritis can damage any joint, the disease most often affects joints in your spine, hands, knees, and hips.

Chiropractic care can help take the stress off the arthritic joints by restoring biomechanical efficiency. When the joints are properly aligned the muscles, ligaments, tendons, and discs all work together to support the body's weight effortlessly. You should consider chiropractic care if you have arthritis. Chiropractic treatment is natural and unlike NSAIDS has no dangerous side effects.

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Back Pain and Types of Arthritis - Newswire

New treatment guidelines for gout strongly support a treat-to-target strategy for urate lowing therapy with a serum urate target of less than 6 mg/dl.

The 2020 iteration of the guidelines by the American College of Rheumatology (ACR) are based on a review of data from recently published research clinical trials. There are 42 recommendations of which 16 are considered strong due to the high quality of the evidence. The strong recommendations address indications, initiation of treatment, titration and treat-to-target, treatment approaches post urate lowering therapy (ULT) failure, and treatment protocols for managing flares.

With this update, we sought to look at new and emerging clinical evidence that would be beneficial for treating patients with gout , said John FitzGerald, M.D., Ph.D., a rheumatologist and one of the guidelines co-principal investigators. The guideline now includes expanded indications for starting ULT, a greater emphasis to use allopurinol as the first line agent for all patients with gout that require urate lowering therapy including those patients with chronic kidney disease, and broadened recommendations about who needs HLA-B*5801 testing prior to starting allopurinol.

The 2020 and 2012 versions both support the use of treat-to-target strategies for urate-lowering therapy (ULT). In 2012, the recommendation was made conditionally due to poor quality evidence, but in 2020, it was bumped up to a strong recommendation due to higher quality evidence.

"Data from more recent research clinical trials comparing treat-to-target protocols versus usual care provide the basis for the strong recommendation to use a treat-to-target strategy with urate lowering therapy that includes a plan to achieve and maintain an serum urate target of less than 6 mg/dl to optimize patient outcomes," wrote the authors of the guidelines published this month in the journal Arthritis Care and Research. "These guidelines reinforce the strategy of starting with low-dose ULT and titrating up to achieve the serum urate (SU) target."

RELATED: "The 2020 Treatment Guidelines for Gout"

Adherence to urate lowering therapies is poor in the U.S. and over the last 20 years, there has been no increase in the use of urate lowering therapies among gout patients. The authors speculated this may be due to conditional recommendations made in 2012, but adherence to ULT in gout is lowest among seven common chronic medical conditions so there may be factors at play.

Among the most noteworthy recommendation, allopurinol is recommended as the first-line treatment for all patients, including patients with chronic kidney disease. This recommendation was made, in part, due to the cost of medications and concerns over cardiovascular-related issues with febuxostat.

For patients with severe disease, the guideline does not support achieving serum urate levels of below 6 mg/dl. "There is ample evidence that lower serum urate levels hasten the resolution of tophi and are associated with less frequent gout flares, suggesting that lower serum urate thresholds may be preferable for patients with more burdensome gout."

The authors note that while there have been extensive clinical trials on treatment strategies for achieving a serum urate target of less than 6 mg/dl, to date, there are no data to support targeting lower serum urate levels for patients with severe disease.

While it wasn't included in the 2012 guidelines, the indications for receiving urate lowering therapies have been expanded to include individuals with evidence of radiographic damage due to gout. This is important because gout presents in a number ways, including joint damage.

REFERFENCE: "2020 American College of Rheumatology Guideline for the Management of Gout," Arthritis Care and Research, May 6, 2020. DOI:10.1002/art.41247

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Treat-to-target With Urate Lowering Therapy Recommended for All Gout Patients - Rheumatology Network

Global Rheumatoid Arthritis Therapeutics Market Size, Status and Forecast 2020-2026 initially represents the historical overview of the current market situation and forecast 2026. The report gives a comprehensive study of various factors of the global Rheumatoid Arthritis Therapeutics market. The report analyzes the market by carrying out the valuation in the constrained period. After an in-depth market study and analysis of the market, the analysts have testified the constant growth in the market, considering the current unsteady market scenario in terms of revenue. The major players dominating the market are focused upon throughout the by analyzing their revenue, their business summary, product segmentation along with the latest developments.

Then the report gives analysis on market size, trends, share, growth, and cost structure and drivers. The global Rheumatoid Arthritis Therapeutics market report has studied key opportunities in the market and influencing factor which is useful and helpful to the business. The report assists users to analyze the future demand and predict exact implementation. The report explains current business and industrial developments, future policy changes, and opportunities available in the market. It gives a detailed summary of the market trends, shares, and patterns of revenue growth and the market value.

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Competitive Analysis:

The report gives you a detailed list of competitive analysis and it would give you a detailed report on the various market strategies, models and growth patterns in terms of revenue of the competitors. The players examination will help the reader identify the footprints of the manufacturers by knowing about the global revenue of manufacturers, the global price of manufacturers, and production by manufacturers during the forecast period of 2015 to 2026. Major market players of the global Rheumatoid Arthritis Therapeutics market are analyzed on various aspects such as company profile, product portfolio, sales analysis, revenue generation through the forecast period from 2020 to 2026.

Leading companies reviewed in the report are: AbbVie, Boehringer Ingelheim, Novartis, Regeneron Pharmaceuticals, Pfizer, Bristol-Myers Squibb, F. Hoffmann-La Roche, UCB S.A., Johnson & Johnson Services, Amgen,

Market product type segmentation as provided below:

Market applications can be fragmented as: Prescription, Over-the-Counter (OTC),

The global Rheumatoid Arthritis Therapeutics market is analyzed across key geographies namely: North America (United States, Canada, Mexico), Asia-Pacific (China, Japan, South Korea, India, Australia, Indonesia, Thailand, Malaysia, Philippines, Vietnam), Europe (Germany, France, UK, Italy, Russia, Rest of Europe), Central & South America (Brazil, Rest of South America), Middle East & Africa (GCC Countries, Turkey, Egypt, South Africa, Rest of Middle East & Africa)

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President Donald Trumps unprompted admission that hes been taking hydroxychloroquine for a week and a half is aligned to some degree with medical research that aims to understand if the controversial drug can prevent infections with the coronavirus in high-risk frontline workers.

Hydroxychloroquine, which is approved by the Food and Drug Administration to treat malaria, lupus and rheumatoid arthritis, is not a proven treatment or prophylaxis for COVID-19. It received emergency-use authorization from the FDA in mid-March to be used in certain clinical settings as a treatment for COVID-19 patients. But, in the two months since then, medical experts have raised questions about the heart risks associated with the drug and its efficacy against the virus and how those concerns play out against a backdrop of political maneuvering.

Youd be surprised at how many people are taking it, especially the frontline workers before you catch it, Trump told reporters on Monday. I happen to be taking it.

Several White House staffers have recently tested positive for the coronavirus, including Katie Miller, Vice President Mike Pences press secretary, as well as one of Trumps personal valets. It is unclear whether Trump was exposed to any of those individuals; however, a letter from Dr. Sean Conley, the White House physician, that was shared on social media mentions that a member of Trumps support staff tested positive for COVID-19.

Read:The next stage of the COVID-19 recovery is here. This is how investors prepare, says UBS

Since the earliest days of the pandemic in the U.S., Trump has been promoting hydroxychloroquine and chloroquine, an older formulation of the same drug. His remarks in favor of the decades-old medicine likely helped spur a run on the drug that created a supply shortage for the patients who already take the treatment for lupus and rheumatoid arthritis.

But a series of medical studies, many of which haven't been peer reviewed, have concluded that the drug isnt efficacious against COVID-19 infections, including one conducted at Veterans Health Administration hospitals that found patients taking the drug had higher mortality rates. Then the FDA on April 24 issued a warning to health-care providers about the serious heart-rhythm problems that can occur in patients taking the drug. And Dr. Rick Bright, former director of Biomedical Advanced Research and Development Authority, has accused the administration in a whistleblower complaint of demoting him when he resisted promoting chloroquine without transparent information on the potential health risks.

Even the Federal Aviation Administration has warned pilots that they cant fly while taking the drugs or for 48 hours after the last dose, citing the known risks of these medications, such as cardiac rhythm disturbances and hypoglycemia against unproven benefits.

Among clinicians, however, it has been one of the few tools available to treat patients hospitalized with COVID-19, at least until Gilead Sciences Inc.s GILD, -3.23% remdesivir received an emergency-use authorization earlier this month. Many frontline clinicians are using a range of therapies, including zinc, azithromycin, hydroxychloroquine, and some HIV and anti-inflammatory arthritis drugs. Plus, hydroxychloroquine and chloroquine have proven safety profiles, are cheap to make and are readily available.

The choice to use these drugs has already been made, probably in hundreds of thousands of patients, but with scant evidence about the risks and benefits, researchers wrote in a New England Journal of Medicine editorial about hydroxychloroquine and chloroquine.

Raymond James analyst Steven Seedhouse, who said he still sees the potential in hydroxychloroquine, wrote in a May 7 note to investors that the study preprints, including the VA research, collectively paint a jumbled picture of hydroxychloroquine, and he believes the drug may reduce mortality by targeting antiviral activity that cant be picked up by a traditional diagnostic test.

See also:Darkest winter in modern history coming without stronger coronavirus response, Rick Bright to testify

This may be why clinical trials testing hydroxychloroquine as a possible COVID-19 treatment or prophylactic are moving forward.

The World Health Organization plans to study hydroxychloroquine and chloroquine in 20,000 frontline health-care workers, as will a trial funded by the COVID-19 Therapeutics Accelerator, which is backed by the Bill and Melinda Gates Foundation, among others.

The National Institute of Allergy and Infectious Diseases said last week it is testing hydroxychloroquine and the antibiotic azithromycin in 2,000 patients with mild and moderate cases of COVID-19 to see if the drug can reduce the need for hospitalizations and prevent death. The University of Minnesota began trialing hydroxychloroquine in health-care workers reporting pre- and post-exposure to the novel coronavirus in early April. A University of Chicago study aims to see if the drug can slow the progression of the disease and keep patients out of the hospital, and the Baylor Research Institute wants to see if hydroxychloroquine can prevent infections among health-care workers in high-risk settings.

From the existing data, which need validation in a trial, it looks like hydroxychloroquine could be a good agent for prophylaxis, Trevor Mundel, president of the Gates Foundations global health program, wrote on the accelerators website. It actually blocks the entry of the virus into the cell, so the hypothesis makes a lot of sense: if you have the drug in your system and you get exposed, you wont let the virus get into your cells and you wont get onset of disease.

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Can hydroxychloroquine prevent a COVID-19 infection? Thats Trumps hope, it appears and it is being looked into by researchers - MarketWatch

Systemic Idiopathic Juvenile Arthritis Treatment Market has recently been added to its extensive repository by Market Research Intellect. This intelligence report includes research based on current scenarios, historical records and future forecasts. In this research report, specific data on various aspects such as type, size, application and end user were checked. It offers a 360-degree overview of the competitive landscape of industries. The SWOT analysis was used to understand the strengths, weaknesses, opportunities and threats faced by companies. This helps companies understand the threats and challenges ahead. The Systemic Idiopathic Juvenile Arthritis Treatment market is growing steadily and the CAGR is expected to improve over the forecast period.

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Chapter 1: Introduction, market driving force product scope, market risk, market overview, and market opportunities of the global Systemic Idiopathic Juvenile Arthritis Treatment market

Chapter 2: Evaluating the leading manufacturers of the global Systemic Idiopathic Juvenile Arthritis Treatment market which consists of its revenue, sales, and price of the products

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Approach may lead to new treatment approach for osteoarthritis, obesity

Researchers at Washington University School of Medicine in St. Louis found that gene therapy in mice helped build strength and significant muscle mass quickly, while reducing the severity of osteoarthritis. The gene therapy also prevented obesity, even when the mice were fed a high-fat diet.

Exercise and physical therapy often are recommended to help people who have arthritis. Both can strengthen muscle a benefit that also can reduce joint pain. But building muscle mass and strength can take many months and be difficult in the face of joint pain from osteoarthritis, particularly for older people who are overweight. A new study in mice at Washington University School of Medicine in St. Louis, however, suggests gene therapy one day may help those patients.

The research shows that gene therapy helped build significant muscle mass quickly and reduced the severity of osteoarthritis in the mice, even though they didnt exercise more. The therapy also staved off obesity, even when the mice ate an extremely high-fat diet.

The study is published online May 8 in the journal Science Advances.

Obesity is the most common risk factor for osteoarthritis, said senior investigator Farshid Guilak, PhD, the Mildred B. Simon Research Professor of Orthopaedic Surgery and director of research at Shriners Hospitals for Children St. Louis. Being overweight can hinder a persons ability to exercise and benefit fully from physical therapy. Weve identified here a way to use gene therapy to build muscle quickly. It had a profound effect in the mice and kept their weight in check, suggesting a similar approach may be effective against arthritis, particularly in cases of morbid obesity.

With the papers first author, Ruhang Tang, PhD, a senior scientist in Guilaks laboratory, Guilak and his research team gave 8-week-old mice a single injection each of a virus carrying a gene called follistatin. The gene works to block the activity of a protein in muscle that keeps muscle growth in check. This enabled the mice to gain significant muscle mass without exercising more than usual.

Even without additional exercise, and while continuing to eat a high-fat diet, the muscle mass of these super mice more than doubled, and their strength nearly doubled, too. The mice also had less cartilage damage related to osteoarthritis, lower numbers of inflammatory cells and proteins in their joints, fewer metabolic problems, and healthier hearts and blood vessels than littermates that did not receive the gene therapy. The mice also were significantly less sensitive to pain.

One worry was that some of the muscle growth prompted by the gene therapy might turn out to be harmful. The heart, for example, is a muscle, and a condition called cardiac hypertrophy, in which the hearts walls thicken, is not a good thing. But in these mice, heart function actually improved, as did cardiovascular health in general.

Longer-term studies will be needed to determine the safety of this type of gene therapy. But, if safe, the strategy could be particularly beneficial for patients with conditions such as muscular dystrophy that make it difficult to build new muscle.

In the meantime, Guilak, who also co-directs the Washington University Center for Regenerative Medicine and is a professor of biomedical engineering and of developmental biology, said more traditional methods of muscle strengthening, such as lifting weights or physical therapy, remain the first line of treatment for patients with osteoarthritis.

Something like this could take years to develop, but were excited about its prospects for reducing joint damage related to osteoarthritis, as well as possibly being useful in extreme cases of obesity, he said.

Tang R, Harasymowicz NS, Wu CL, Collins KH, Choi YR, Oswald SJ, Guilak F. Gene therapy for follistatin mitigates systemic metabolic inflammation and post-traumatic arthritis in high-fat diet-induced obesity. Science Advances, published online May 8, 2020.

This work was supported by the Shriners Hospitals for Children, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute on Aging and the Office of the Director of the National Institutes of Health (NIH). Grant numbers AR50245, AR48852, AG15768, AR48182, AG 46927, AR073752, OD10707, AR060719, AR057235. Additional funding was provided by the Arthritis Foundation and the Nancy Taylor Foundation for Chronic Diseases.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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Gene therapy in mice builds muscle, reduces fat Washington University School of Medicine in St. Louis - Washington University School of Medicine in...

Rheumatoid Arthritis Drug Market has recently been added to its extensive repository by Market Research Intellect. This intelligence report includes research based on current scenarios, historical records and future forecasts. In this research report, specific data on various aspects such as type, size, application and end user were checked. It offers a 360-degree overview of the competitive landscape of industries. The SWOT analysis was used to understand the strengths, weaknesses, opportunities and threats faced by companies. This helps companies understand the threats and challenges ahead. The Rheumatoid Arthritis Drug market is growing steadily and the CAGR is expected to improve over the forecast period.

The report includes the latest coverage of the impact of COVID-19 on the Rheumatoid Arthritis Drug industry. The incidence has affected nearly every aspect of the business domain. This study evaluates the current scenario and predicts future outcomes of the pandemic on the global economy.

**Our FREE SAMPLE COPY of the report gives a brief introduction of the Rheumatoid Arthritis Drug market, Detailed TOC, key players of the market, list of tables and figures and comprising key countries regions.**

We provide a detailed analysis of key players operating in the Rheumatoid Arthritis Drug Market:

The scope of the Report:

The report analyzes the key opportunities, CAGR, and Y-o-Y growth rates to allow readers to understand all the qualitative and quantitative aspects of the Rheumatoid Arthritis Drug market. A competition analysis is imperative in the Rheumatoid Arthritis Drug market and the competition landscape serves this objective. A wide company overview, financials, recent developments, and long and short-term strategies adopted are par for the course. Various parameters have been taken into account while estimating market size. The revenue generated by the leading industry participants in the sales of Rheumatoid Arthritis Drug across the world has been calculated through primary and secondary research. The Rheumatoid Arthritis Drug Market analysis is provided for the international markets including development trends, competitive landscape analysis, and key regions development status.

By Regions:

* North America (The US, Canada, and Mexico)

* Europe (Germany, France, the UK, and Rest of the World)

* Asia Pacific (China, Japan, India, and Rest of Asia Pacific)

* Latin America (Brazil and Rest of Latin America.)

* Middle East & Africa (Saudi Arabia, the UAE, , South Africa, and Rest of Middle East & Africa)

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Speculations for sales:

The report contains historical revenue and volume that backing information about the market capacity, and it helps to evaluate conjecture numbers for key areas in the Rheumatoid Arthritis Drug market. Additionally, it includes a share of every segment of the Rheumatoid Arthritis Drug market, giving methodical information about types and applications of the market.

Key point summary of the Rheumatoid Arthritis Drug market report:

This report gives a forward-looking prospect of various factors driving or restraining market growth.

It presents an in-depth analysis of changing competition dynamics and puts you ahead of competitors.

It gives a six-year forecast evaluated on the basis of how the market is predicted to grow.

It assists in making informed business decisions by creating a pin-point analysis of market segments and by having complete insights of the Rheumatoid Arthritis Drug market.

This report helps users in comprehending the key product segments and their future.

Strategic Points Covered in TOC:

Chapter 1: Introduction, market driving force product scope, market risk, market overview, and market opportunities of the global Rheumatoid Arthritis Drug market

Chapter 2: Evaluating the leading manufacturers of the global Rheumatoid Arthritis Drug market which consists of its revenue, sales, and price of the products

Chapter 3: Displaying the competitive nature among key manufacturers, with market share, revenue, and sales

Chapter 4: Presenting global Rheumatoid Arthritis Drug market by regions, market share and with revenue and sales for the projected period

Chapter 5, 6, 7, 8 and 9: To evaluate the market by segments, by countries and by manufacturers with revenue share and sales by key countries in these various regions

Finally, the report global Rheumatoid Arthritis Drug market describes Rheumatoid Arthritis Drug industry expansion game plan, the Rheumatoid Arthritis Drug industry knowledge supply, appendix, analysis findings and the conclusion. It includes a through explanation of the cutting-edging technologies and investments being made to upgrade the existing ones.

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Rheumatoid Arthritis Drug Market 2020 | Growth Drivers, Challenges, Trends, Market Dynamics and Forecast to 2026 - Cole of Duty

LEXINGTON, Ky. (WKYT/WYMT) As the COVID-19 pandemic continues to sweep the globe and death tolls keeps increasing, miraculous stories of survival are coming to light as well.

A Berea native who currently lives in Florida is currently fighting the disease and spoke to sister-station WKYT about her experience and how it changed her life.

"I feel like I am a walking miracle," says Kendra Wiggins.

Weeks following her diagnosis, she is now on the road to recovery.

As part of her effort, she signed up for an experimental double-blind drug trial after her diagnosis.

"It was just like breath in, cough, breath in, cough, that I couldn't get enough oxygen out," she says. "I took the 80 percent chance that I would get medication over the 20 percent chance that I wouldn't because with that 20 percent chance I still had what I thought was 50-50 with a ventilator."

The trial was for a drug known as Kevzara- typically used as a treatment for rheumatoid arthritis and consisted of three groups; some received a full dose, others received a half dosage, and the third group was given a placebo instead of the actual drug.

"I woke up about a half an hour into the medication with the worst heartburn ever. It was terrible. And all I could do was say 'Praise the Lord I got the real medication! If this had been saline, I wouldn't have felt anything, so I was so excited that I had heartburn. Never been excited for heartburn in my life," says Wiggins.

Wiggins says the treatment saved her life, and she hopes her experience will give hope to future COVID patients.

"Flattening the curve gave the medical community a chance to have guinea pigs, she says. I signed up willingly to be a human guinea pig and the information that they got from me is going to benefit you or someone you know."

Read more here:
Rheumatoid arthritis drug may have helped Kentucky native recover from COVID-19 - WYMT News

While the COVID-19 pandemic dominates the headlines and, of course, continues to change our lives, but the calendar has changed to May, which is Arthritis Awareness Month. So let's talk a little bit about those aches and pains and what you can do about them.

Let's start with the basics - what is arthritis and do your aches and pains indicate arthritis? According to Dr. Adrienne Hollander, a rheumatologist with Virtua Health, osteoarthritis is usually found in the hands, thumbs, knees, hips and back and symptoms include:

You can get details on those symptoms and possible treatment on the Virtua website.

If so, the problem may not be arthritis, but trigger finger.

According toDr. Andrew Sattel, a Virtua hand surgeon, you don't need to shoot a gun to get trigger finger. It's a common hand condition that affects all kinds of people, and it's easily treated. Symptoms are usually worse in the morning and include finger stiffness and a popping or clicking sensation as you bend your finger.

Learn all about the symptoms and treatment for trigger finger here.

Speaking of your hand, do you have pain in your thumb? According to Dr. Eric Strauss, a Virtua hand surgeon, that could indicate basal thumb arthritis. He said it's important that you know you don't have to "just deal with it." This condition is treatable through conservative management, and in advanced cases, surgery.

Basal thumb arthritis is common in women age 40 and older, but men also are affected.

Learn about the symptoms and treatments for basal thumb arthritis here.

If you know you have arthritis, you should know that there are ways you can ease your discomfort without medication or clinical treatments.

Sounds simple, doesn't it? Get all the details on how to use these five steps to improve your quality of life.

At some point, arthritis pain may require some over-the-counter medication. Finding them isn't difficult, but sorting through the seemingly endless options can be daunting.

Dr. Samuel Weiner, a Virtua family physician, said over-the-counter medication options aren't as complicated as they may seem.

"It can get confusing with the number of brands available on the market," he said. "But there are only four major over-the-counter pain-killing products - aspirin, acetaminophen, ibuprofen and naproxen. Each has a different overall effect on the body."

While each of the four major products has its own array of individual brands, Dr. Weiner advises not getting wrapped up in the hype.

"I encourage my patients to look for generics," he said. "Generic over-the-counter pain relievers are less expensive, and they are just as effective as the name brands."

If you're looking for more information on Arthritis Awareness Month, you can check out this website.

Virtua has created a COVID-19 resource hub that includes up-to-date information about the pandemic, changes to the health system's operating guidelines - including visitation, ways to connect with care - including a self-assessment tool, and the answers to frequently asked questions.

There, you will also find useful information such as:

All of these and many more can be found on Virtua's resource hub.

You can get news, information, tips, and guidelines for healthy living on any health or lifestyle topic that's important to you - by subscribing to Virtua's Good Vibes newsletter. You can customize the content to match your interests and receive a monthly email that will help you be well, get well, and stay well.

Read more from the original source:
Arthritis flaring up during the COVID-19 pandemic? - Patch.com

By Dr. Zorba Paster For The Spokesman-Review

Keeping up to date that is the goal of every health care provider. We do it on the web, by reading books and journals, going to lectures, etc. Everyone has their own method.

Family doctors need 50 hours, minimum, of education each year to keep up our certification. Mayo Clinic has great meetings. They start super early, 7 a.m., and end at 11:30 p.m.

Now what would motivate you to go to something that early? Well, their meetings arent in Rochester, Minnesota, where Mayo is based. Theyre in Hawaii in Maui this year, to be exact.

What a shame, I know, but someone has to go. And this year it was me and fortunately it was before the coronavirus pandemic kept us home.

So with that introduction, let me share some of the updates I learned in no particular order.

The Heart and Estrogen/Progestin Replacement Study research from more than a decade ago seemed to show that women who take estrogen have more heart attacks. That basically was the death knell for the company that made Prempro, which was the most common estrogen preparation on the market with something like 85% of the share.

Well, guess what: Looking at the data now, and looking at what we know about heart disease, we may have been wrong.

Yes, there might be a small increase in heart attacks among women who take estrogen, but it might just be a subgroup of women. And a woman who suffers from menopausal symptoms might not exercise as much and might not sleep as well. She might not, well, she just might not be as healthy because she has menopausal symptoms.

For some lucky women, the symptoms never happen or go away in a few months. But for others, they can last seven to 10 years or even forever.

The most effective treatment, by far, is estrogen. The safest way is to take an estrogen patch, one designed for menopause, not for contraception. That one is much stronger, accompanied by micronized natural progesterone of 100 milligrams daily.

Now who should get estrogen? Thats a question I wont answer. Its one that every woman who still has symptoms should discuss with her health care provider.

Its important that they know the data has changed. So if you talk to them, ask if they have read the latest data. The estrogen used in the study, Prempro, is not the estrogen recommended today, and it was oral estrogen and not the estrogen patch. Those two facts may have played a major role into the outcome of the study.

Believe me if you go into that office armed with information you could print it out for them that will be an eye -opener. And, believe it or not, if they know youre looking over their shoulder with good, reliable scientific evidence, youll get better medical care.

I kid you not. Whether you like it or not, health literacy the ability to discuss your health issues scientifically with your provider pays off. Try it.

This was a very expensive gel back in the day, but its off patent now. This is an anti-inflammatory in a topical form. You can get a large tube for about $25.

Youll need a prescription for this. Studies have shown, shockingly in my eyes, this gel works as well as oral anti-inflammatories for many patients with arthritis.

The gel is as good as the pill but without the side effects of the pill no worries about stomach pain, bleeding ulcers, elevated blood pressure and kidney problems. It can cause your kidneys distress, that is if youre prone to it, older or on certain medications.

And its cheap, cheaper than CBD oil and much more effective, with efficacy proven by scientifically well-controlled studies.

My spin: It might not be as sexy as CBD, but its cheaper and it works. If you have joint pain, call your doctor and get it. Im using it for my hand arthritis, and my hands feel more like 55 than 72.

More updates next in the next column. Stay well.

Dr. Zorba Paster is a family physician and host of the public radio program Zorba Paster on Your Health. He can be reached at askzorba@doctorzorba.com.

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Dr. Zorba Paster: New information emerges on treating menopause, arthritis - The Spokesman-Review

Rebecca Wynne has spent 25 years battling a painful condition which has often left her bedbound.

She was just 11-years-old when she was diagnosed with arthritis - a condition which largely affects adults in their 40s and upwards.

Now 35, she is still facing the daily challenge that arthritis brings. It became so bad that she couldn't even hold her kids when they were born.

When she tells people about her arthritis, the mum-of-two from Saffron Walden, Essex, is often faced with the look of shock in people's faces who simply cannot believe someone so young could have it.

This is the story from her diagnosis through to the struggles she has faced in her adult life.

Rebecca was 11 when she started suffering with pain and swelling in her joints.

Her parents took her to the GP and it was there that she was diagnosed with juvenile idiopathic arthritis.

She said: "It was a real shock. No one in my family had ever had it.

"It was just before I started secondary school.

"I wasn't a confident kid, so I didn't want anything that was going to make me stand out."

It is something that has, at some point, touched all our lives.

From cradle to grave, the National Health Service, and the incredible professionals within it who care for us, is a part of British life.

Today, more than ever, we should cherish those who dedicate themselves to our care, heedless of own health as they work tirelessly to care for people in the face of the coronavirus pandemic.

We have never needed our doctors, nurses, pharmacists and other carers more.

So lets show them some love, and create a living map of gratitude from every corner of Britain - visitwww.thanksamillionnhs.co.ukto drop a heart on the map wherever you are in the world.

By dropping a heart on the map, youre saying you appreciate the efforts undertaken daily in the NHS.

Thanks a million, NHS workers - we love you.

Her diagnosis meant she wasn't allowed to take part in PE lessons at school and she had to wear trainers rather than less comfortable school shoes.

At the time, she says didn't really notice the impact it had on her. But as an adult, she has been able to fully take stock on the debilitating effect it's had on her life.

"I have had to bend my life around it," she said. "Of course to me it's not weird at all, it's just my life.

"Pretty much everyone I meet that finds out can't believe that I have arthritis. That has been the challenge since I was 11."

Her arthritis affects every single joint in her body, though some hurt more than others.

But it was after she gave birth to her second child, Lottie, three years ago that Rebecca's hips became really painful.

She already had one daughter, Emilia - who is now five - so had no reason to believe having another baby would make her condition worse.

But after Lottie came along, Rebecca couldn't bend down and was in constant agony, so much so that she was left unable to pick up her children.

It was heartbreaking for her and left her feeling like she couldn't fulfill her duties as a mother.

She added: "This has been the hardest part for me. After I had Lottie, the arthritis seemed to take control of my life.

"I couldn't take care of my children. It felt like all of a sudden I couldn't be the mum I wanted to be, I couldn't pick them off or doing anything for them.

"I could barely leave the house, not being able to care for my children was heartbreaking."

Being so young, Rebecca says her girls can't understand what is happening to their mum, but says they are amazing.

"They are very demanding, as young children are, but they don't understand what I am really suffering with," she said.

"Lottie has had to deal with this all as a toddler.

"It's different when it is just affecting you but as a parent it becomes a burden on your children.

"I feel a guilt that never goes away."

Rebecca also never thought she would have to depend so much on someone like she has with her husband, Tom.

Rebecca explained: "I have always been fiercely independent.

"All of a sudden I was being cared for by my husband.

"Perhaps I was a bit naive to live day by day, I hadn't considered how it was damaging my joints.

"That day came and it was awful."

Rebecca was offered a double hip replacement, a huge operation for someone to have so young.

The operation has dramatically improved her quality of life and she is no longer in the constant pain she once was.

Rebecca said: "It ate away at my hips so they had to be replaced.

"My hips are great now, they are my best joint.

"The hip replacement has been life changing, it was amazing."

Rebecca also suffers with her knees and has had to go to hospital to have them drained more times that she can remember.

She explained: "I have severe damage in my feet and ankles, I can't walk very far.

"Some days it is bearable but others it is horrendous.

"I am in pain every day.

"It feels like a throbbing, like my joints are on fire."

"The damage gets worse throughout the day.

"I'm always in some sort of pain, the daily pain from my feet and ankles is a joke."

Unfortunately there is not a common operation available for her feet like her hip surgery.

For now, Rebecca is focusing on controlling the pain.

The inflammatory part of arthritis is what tends to affect Rebecca in the mornings.

She wakes up stiff, puffy and in pain, but her medication is very effective at calming it down.

As the day goes on the joint pain only gets worse.

But one of the hardest parts about her condition isn't the pain it causes - it's the lack of understanding.

Although arthritis is very well known, and quite common, people aren't used to hearing about it in a young person.

However, two thirds of the 10 million people in the UK with arthritis are aged under 65.

She's even had people accuse her of lying about her condition during her commute to and from work.

She said: "I used to commute to work in London, that was hell.

"At that time I looked normal, but I was in so much pain.

"There were never any seats on the train home.

"I'm not someone who shouts about my condition, but sometimes I had to as I needed to sit down.

"Some of those times where I would speak up I would have people tell me that I couldn't have arthritis and that I was lying."

The lack of understanding of her illness also caused problems in Rebecca's work.

She is an architect and says that past employers have been good to her, though she doesn't think they fully understand what she goes through.

Rebecca explained: "It's difficult for people to understand. One day I will seem okay as it's under control, but the next I will be bed-ridden.

"I don't like having to answer for my condition.

"It feels like you are making excuses all of the time, when you just can't physically get out of bed."

For the past few years, Rebecca has been self-employed, meaning she can manage her work and her illness alongside each other.

Taking the step to work for herself was a big leap, but Rebecca says it was what she needed to do.

She said: "I can now take on as much work as I can manage.

"Working for myself was the right decision for me by far."

Whilst the coronavirus pandemic continues, we are all being told to stay at home where we can.

For Rebecca, Covid-19 is more even more serious.

The drugs she takes for her arthritis are immuno-suppressing, meaning she is more at risk of contracting the virus because of her weakened immune system.

She and her family are having to isolate together to protect her health and means none of them can leave the house.

Rebecca said: "The fear is huge. Being told that you are extremely vulnerable is horrible.

"It means my children can't go out, that's particularly hard.

"I feel guilty about it."

Her day-to-day life hasn't changed much, as she is often trapped indoors because of her illness.

The big difference is that her children are at home with her all of the time.

She said: "I feel lucky that I have this time with my children, but for us this can't be a short-term thing.

"The girls aren't going to be able to go to school for a long time.

"I'm having to take it day by day.

"The nature of my disease is that I have stress-related flare ups so I try to not let it get to me.

"I stay as positive as I can otherwise I could turn bitter."

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Or stay up to date with the latest EssexLive news on our Facebook page which you can find here.

Rebecca has now joined forces with the charity Versus Arthritis to help raise awareness for arthritis.

Their latest campaign It's not alright, it's arthritis aims to widen people's understanding that arthritis can affect anyone.

The charity are keen to get rid of the stigma that arthritis is just 'wear and tear'.

Rebecca said: "It feels amazing to have someone in your corner fighting for awareness.

"It's just a relief to know they are there.

"So many people will be turning to them right now as they they don't want to add strain to their GP.

"The charity will also be under pressure like never before, so it's so important that the public understand their work."

A spokesperson for Versus Arthritis said: "We just want to raise awareness and dispel the myth that it's part of aging.

"We often run campaigns but this one is about asking the public to pledge support for those living with arthritis.

Continue reading here:
Essex mum's 25-year battle with arthritis which became so bad she couldn't hold her children - Essex Live

OBJECTIVE:

This study was undertaken to uncover the pathophysiologic role of discoidin domain receptor 2 (DDR-2), a putative fibrillar collagen receptor, in inflammation promotion and joint destruction inrheumatoid arthritis(RA).

In synovial tissue from patients with RA and from mice with collagen antibody-inducedarthritis(CAIA) (using Ddr2-/-and DBA/1 mice), gene and protein expression levels of DDR-2, interleukin-15 (IL-15), and Dkk-1 were measured by quantitative reverse transcription-polymerase chain reaction, Western blotting, and immunohistochemistry. Gene knockdown of DDR2 in human RA fibroblast-like synoviocytes (FLS) was conducted via small interfering RNA. Interaction between the long noncoding RNA H19 and microRNA 103a (miR-103a) was assessed in RA FLS using RNA pulldown assays. Cellular localization of H19 was examined using fluorescence in situ hybridization assays. Chromatin immunoprecipitation and dual luciferase reporter assays were applied to verify H19 transcriptional and posttranscriptional regulation by miR-103a.

DDR2 messenger RNA (mRNA) expression was significantly associated with the levels of IL-15 and Dkk-1 mRNA in the synovial tissue of RA patients (r2= 0.2022-0.3293, all P < 0.05; n = 33) and with the serum levels of IL-15 and Dkk-1 in mice with CAIA (P < 0.05). In human RA FLS, activated DDR-2 induced the expression of H19 through c-Myc. Moreover, H19 directly interacted with and promoted the degradation of miR-103a.

These results indicate a novel role for activated DDR-2 in RA FLS, showing that DDR-2 is responsible for regulating the expression of IL-15 and Dkk-1 in RA FLS and is involved in the promotion of inflammation and joint destruction during pathophysiologic development of RA. Moreover, DDR-2 inhibition, acting through the H19-miR-103a axis, leads to reductions in the inflammatory reaction and severity of joint destruction in mice with CAIA, suggesting that inhibition of DDR-2 may be a potential therapeutic strategy for RA

Follow this link:
Blockade of Discoidin Domain Receptor 2 as a Strategy for Reducing Inflammation and Joint Destruction in Rheumatoid Arthritis Via Altered...

TEL AVIV, Israel & PARSIPPANY, N.J. & INCHEON, South Korea--(BUSINESS WIRE)--Teva Pharmaceuticals USA, Inc., a U.S. affiliate of Teva Pharmaceutical Industries Ltd. (NYSE and TASE: TEVA), and Celltrion Healthcare, Co., Ltd. (KRX KOSDAQ:091990), today announced that TRUXIMA (rituximab-abbs) injection is now available in the United States for the treatment of:

TRUXIMA is the only biosimilar to the reference product Rituxan1 (rituximab) available to treat rheumatoid arthritis in the United States. See important safety information below including Boxed Warning regarding fatal infusion-related reactions, severe mucocutaneous reactions, hepatitis B virus reactivation and progressive multifocal leukoencephalopathy.

We are proud to make TRUXIMA available to patients and providers as a treatment option for these indications, especially as this is the only rituximab biosimilar indicated for rheumatoid arthritis, said Brendan OGrady, Executive Vice President, North America Commercial, Teva. Following the launch of our other biosimilar earlier this year, we remain focused on our commitment to lower healthcare costs and increase price competition through the availability of biosimilars.

Celltrion Healthcare and Teva Pharmaceutical Industries Ltd. entered into an exclusive partnership in October 2016 for Teva to commercialize TRUXIMA in the U.S. and Canada. In May 2019, TRUXIMA was approved by the U.S. Food and Drug Administration (FDA) to match all of the reference products oncology indications described below.

We are pleased that patients in the United States can now have access to TRUXIMA for these new indications, said Mr. Hyoung-Ki Kim, Vice Chairman at Celltrion Healthcare. We believe that the continued use of biosimilars in the U.S. market will contribute to addressing unmet needs for patients and providers.

Earlier this year, the Centers for Medicare and Medicaid Services (CMS) granted pass-through status for TRUXIMA in the hospital outpatient setting. The Wholesale Acquisition Cost (WAC or list price) for TRUXIMA will be 10 percent lower than the reference product. TRUXIMA is expected to be available through primary wholesalers at a WAC of $845.55 per 100mg vial and $4,227.75 per 500mg vial. Actual costs to individual patients and providers for TRUXIMA are anticipated to be lower than WAC because WAC does not account for additional rebates and discounts that may apply. Savings on out-of-pocket costs may vary depending on the patients insurance payer and eligibility for participation in the assistance program.

Teva also offers dedicated patient support services through the CORE program. CORE is available to help eligible patients, caregivers and healthcare professionals navigate the reimbursement process. CORE offers a range of services, including benefits verification and coverage determination, support for precertification and prior authorization, assistance with coverage guidelines and claims investigation, and support through the claims and appeals process. A savings program is also available for eligible commercially insured patients. To learn more, please visit TevaCORE.com.

Please see the Important Safety Information below including the Boxed Warning regarding fatal infusion-related reactions, severe mucocutaneous reactions, hepatitis B virus reactivation and progressive multifocal leukoencephalopathy. For more information, please see the full prescribing information.

IndicationsTRUXIMA (rituximab-abbs) is indicated for the treatment of adult patients with:

Non-Hodgkins Lymphoma (NHL)

Chronic Lymphocytic Leukemia (CLL)

Rheumatoid Arthritis (RA)

Granulomatosis with Polyangiitis (GPA) (Wegeners Granulomatosis) and Microscopic Polyangiitis (MPA)

Important Safety Information

WARNING: FATAL INFUSION-RELATED REACTIONS, SEVERE MUCOCUTANEOUS REACTIONS, HEPATITIS B VIRUS REACTIVATION and PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY

Infusion-Related Reactions: Administration of rituximab products, including TRUXIMA, can result in serious, including fatal, infusion-related reactions. Deaths within 24 hours of rituximab infusion have occurred. Approximately 80% of fatal infusion-related reactions occurred in association with the first infusion. Monitor patients closely. Discontinue TRUXIMA infusion for severe reactions and provide medical treatment for Grade 3 or 4 infusion-related reactions

Severe Mucocutaneous Reactions: Severe, including fatal, mucocutaneous reactions can occur in patients receiving rituximab products

Hepatitis B Virus (HBV) Reactivation: HBV reactivation can occur in patients treated with rituximab products, in some cases resulting in fulminant hepatitis, hepatic failure, and death. Screen all patients for HBV infection before treatment initiation, and monitor patients during and after treatment with TRUXIMA. Discontinue TRUXIMA and concomitant medications in the event of HBV reactivation

Progressive Multifocal Leukoencephalopathy (PML), including fatal PML, can occur in patients receiving rituximab products

WARNINGS AND PRECAUTIONS

Infusion-Related Reactions - Rituximab products can cause severe, including fatal, infusion-related reactions. Severe reactions typically occurred during the first infusion with time to onset of 30-120 minutes. Rituximab product-induced infusion-related reactions and sequelae include urticaria, hypotension, angioedema, hypoxia, bronchospasm, pulmonary infiltrates, acute respiratory distress syndrome, myocardial infarction, ventricular fibrillation, cardiogenic shock, anaphylactoid events, or death

Premedicate patients with an antihistamine and acetaminophen prior to dosing. For RA, GPA, and MPA patients, methylprednisolone 100 mg intravenously or its equivalent is recommended 30 minutes prior to each infusion. Institute medical management (e.g. glucocorticoids, epinephrine, bronchodilators, or oxygen) for infusion-related reactions as needed. Depending on the severity of the infusion-related reaction and the required interventions, temporarily or permanently discontinue TRUXIMA. Resume infusion at a minimum 50% reduction in rate after symptoms have resolved. Closely monitor the following patients: those with pre-existing cardiac or pulmonary conditions, those who experienced prior cardiopulmonary adverse reactions, and those with high numbers of circulating malignant cells (25,000/mm3)

Severe Mucocutaneous Reactions - Mucocutaneous reactions, some with fatal outcome, can occur in patients treated with rituximab products. These reactions include paraneoplastic pemphigus, Stevens-Johnson syndrome, lichenoid dermatitis, vesiculobullous dermatitis, and toxic epidermal necrolysis. The onset of these reactions has been variable and includes reports with onset on the first day of rituximab exposure. Discontinue TRUXIMA in patients who experience a severe mucocutaneous reaction. The safety of re-administration of rituximab products to patients with severe mucocutaneous reactions has not been determined

Hepatitis B Virus Reactivation - Hepatitis B virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure and death, can occur in patients treated with drugs classified as CD20-directed cytolytic antibodies, including rituximab products. Cases have been reported in patients who are hepatitis B surface antigen (HBsAg) positive and also in patients who are HBsAg negative but are hepatitis B core antibody (anti-HBc) positive. Reactivation also has occurred in patients who appear to have resolved hepatitis B infection (i.e., HBsAg negative, anti-HBc positive and hepatitis B surface antibody [anti-HBs] positive)

HBV reactivation is defined as an abrupt increase in HBV replication manifesting as a rapid increase in serum HBV DNA levels or detection of HBsAg in a person who was previously HBsAg negative and anti-HBc positive. Reactivation of HBV replication is often followed by hepatitis, i.e., increase in transaminase levels. In severe cases increase in bilirubin levels, liver failure, and death can occur

Screen all patients for HBV infection by measuring HBsAg and anti-HBc before initiating treatment with TRUXIMA. For patients who show evidence of prior hepatitis B infection (HBsAg positive [regardless of antibody status] or HBsAg negative but anti-HBc positive), consult with physicians with expertise in managing hepatitis B regarding monitoring and consideration for HBV antiviral therapy before and/or during TRUXIMA treatment

Monitor patients with evidence of current or prior HBV infection for clinical and laboratory signs of hepatitis or HBV reactivation during and for several months following TRUXIMA therapy. HBV reactivation has been reported up to 24 months following completion of rituximab therapy

In patients who develop reactivation of HBV while on TRUXIMA, immediately discontinue TRUXIMA and any concomitant chemotherapy, and institute appropriate treatment. Insufficient data exist regarding the safety of resuming TRUXIMA treatment in patients who develop HBV reactivation. Resumption of TRUXIMA treatment in patients whose HBV reactivation resolves should be discussed with physicians with expertise in managing HBV

Progressive Multifocal Leukoencephalopathy (PML) - JC virus infection resulting in PML and death can occur in rituximab product-treated patients with hematologic malignancies. The majority of patients with hematologic malignancies diagnosed with PML received rituximab in combination with chemotherapy or as part of a hematopoietic stem cell transplant. Most cases of PML were diagnosed within 12 months of their last infusion of rituximab

Consider the diagnosis of PML in any patient presenting with new-onset neurologic manifestations. Evaluation of PML includes, but is not limited to, consultation with a neurologist, brain MRI, and lumbar puncture

Discontinue TRUXIMA and consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML

Tumor Lysis Syndrome (TLS) - Acute renal failure, hyperkalemia, hypocalcemia, hyperuricemia, or hyperphosphatemia from tumor lysis, sometimes fatal, can occur within 12-24 hours after the first infusion of rituximab products in patients with NHL. A high number of circulating malignant cells ( 25,000/mm3) or high tumor burden, confers a greater risk of TLS

Administer aggressive intravenous hydration and anti-hyperuricemic therapy in patients at high risk for TLS. Correct electrolyte abnormalities, monitor renal function and fluid balance, and administer supportive care, including dialysis as indicated

Infections - Serious, including fatal, bacterial, fungal, and new or reactivated viral infections can occur during and following the completion of rituximab product-based therapy. Infections have been reported in some patients with prolonged hypogammaglobulinemia (defined as hypogammaglobulinemia >11 months after rituximab exposure). New or reactivated viral infections included cytomegalovirus, herpes simplex virus, parvovirus B19, varicella zoster virus, West Nile virus, and hepatitis B and C. Discontinue TRUXIMA for serious infections and institute appropriate anti-infective therapy. TRUXIMA is not recommended for use in patients with severe, active infections

Cardiovascular Adverse Reactions - Cardiac adverse reactions, including ventricular fibrillation, myocardial infarction, and cardiogenic shock may occur in patients receiving rituximab products. Discontinue infusions for serious or life-threatening cardiac arrhythmias. Perform cardiac monitoring during and after all infusions of TRUXIMA for patients who develop clinically significant arrhythmias, or who have a history of arrhythmia or angina

Renal Toxicity - Severe, including fatal, renal toxicity can occur after rituximab product administration in patients with NHL. Renal toxicity has occurred in patients who experience tumor lysis syndrome and in patients with NHL administered concomitant cisplatin therapy during clinical trials. The combination of cisplatin and TRUXIMA is not an approved treatment regimen. Monitor closely for signs of renal failure and discontinue TRUXIMA in patients with a rising serum creatinine or oliguria

Bowel Obstruction and Perforation - Abdominal pain, bowel obstruction and perforation, in some cases leading to death, can occur in patients receiving rituximab in combination with chemotherapy. In postmarketing reports, the mean time to documented gastrointestinal perforation was 6 (range 1-77) days in patients with NHL. Evaluate if symptoms of obstruction such as abdominal pain or repeated vomiting occur

Immunization - The safety of immunization with live viral vaccines following rituximab product therapy has not been studied and vaccination with live virus vaccines is not recommended before or during treatment

Prior to initiating TRUXIMA physicians should ensure patients vaccinations and immunizations are up-to-date with guidelines. Administration of any non-live vaccines should occur at least 4 weeks prior to a course of TRUXIMA

Embryo-Fetal Toxicity - Based on human data, rituximab products can cause fetal harm due to B-cell lymphocytopenia in infants exposed to rituximab in-utero. Advise pregnant women of the risk to a fetus. Females of childbearing potential should use effective contraception while receiving TRUXIMA and for 12 months following the last dose of TRUXIMA

Concomitant Use With Other Biologic Agents and DMARDS Other Than Methotrexate

Observe patients closely for signs of infection if biologic agents and/or DMARDs are used concomitantly as limited safety data is available.

Use of concomitant immunosuppressants other than corticosteroids has not been studied in GPA or MPA patients exhibiting peripheral B-cell depletion following treatment with rituximab products

Use in RA Patients Who Have Not Had Prior Inadequate Response to TNF Antagonists

TRUXIMA should only be used in patients who have had a prior inadequate response to one or more TNF antagonist

Most common adverse reactions in clinical trials of NHL (25%) were: infusion-related reactions, fever, lymphopenia, chills, infection, and asthenia

Most common adverse reactions in clinical trials of CLL (25%) were: infusion-related reactions and neutropenia

Most common adverse reactions in clinical trials of RA (10%) were: upper respiratory tract infection, nasopharyngitis, urinary tract infection, and bronchitis (other important adverse reactions include infusion-related reactions, serious infections, and cardiovascular events)

Most common adverse reactions in clinical trials of GPA and MPA (15%) were: infections, nausea, diarrhea, headache, muscle spasms, anemia, peripheral edema, and infusion-related reactions

Nursing Mothers - There are no data on the presence of rituximab in human milk, the effect on the breastfed child, or the effect on milk production. Since many drugs including antibodies are present in human milk, advise a lactating woman not to breastfeed during treatment and for at least 6 months after the last dose of TRUXIMA due to the potential for serious adverse reactions in breastfed infants

About TRUXIMA TRUXIMA (rituximab-abbs) is a U.S. Food and Drug Administration (FDA)-approved biosimilar to RITUXAN (rituximab) for the treatment of: adult patients with CD20-positive, B-cell NHL to be used as a single agent or in combination with chemotherapy or CLL in combination with fludarabine and cyclophosphamide (FC); for rheumatoid arthritis (RA) in combination with methotrexate in adult patients with moderately-to severely-active RA who have inadequate response to one or more TNF antagonist therapies; and granulomatosis with polyangiitis (GPA) (Wegeners Granulomatosis) and microscopic polyangiitis (MPA) in adult patients in combination with glucocorticoids

TRUXIMA has the same mechanism of action as Rituxan and has demonstrated biosimilarity to Rituxan through a totality of evidence.

About Celltrion Healthcare, Co. Ltd.Celltrion Healthcare conducts the worldwide marketing, sales and distribution of biological medicines developed by Celltrion, Inc. through an extensive global network that spans more than 120 different countries. Celltrion Healthcares products are manufactured at state-of-the-art mammalian cell culture facilities, designed and built to comply with the US Food and Drug Administration (FDA) cGMP guidelines and the EU GMP guidelines.

About Teva Teva Pharmaceutical Industries Ltd. (NYSE and TASE: TEVA) has been developing and producing medicines to improve peoples lives for more than a century. We are a global leader in generic and specialty medicines with a portfolio consisting of over 3,500 products in nearly every therapeutic area. Around 200 million people around the world take a Teva medicine every day, and are served by one of the largest and most complex supply chains in the pharmaceutical industry. Along with our established presence in generics, we have significant innovative research and operations supporting our growing portfolio of specialty and biopharmaceutical products. Learn more at http://www.tevapharm.com.

Teva's Cautionary Note Regarding Forward-Looking StatementsThis press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 regarding the launch of TRUXIMA Injection for Rheumatoid Arthritis in the United States, which are based on managements current beliefs and expectations and are subject to substantial risks and uncertainties, both known and unknown, that could cause our future results, performance or achievements to differ significantly from that expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences include risks relating to:

and other factors discussed in our Annual Report on Form 10-K for the year ended December 31, 2019, including in the sections captioned "Risk Factors and Forward Looking Statements. Forward-looking statements speak only as of the date on which they are made, and we assume no obligation to update or revise any forward-looking statements or other information contained herein, whether as a result of new information, future events or otherwise. You are cautioned not to put undue reliance on these forward-looking statements.

1 RITUXAN is a registered trademark of Genentech and Biogen.

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Teva and Celltrion Healthcare Announce the Launch of TRUXIMA (rituximab-abbs) Injection for Rheumatoid Arthritis, the Only Biosimilar to Rituxan...

A Co Down woman is behind a mobile app to support teens and young adults living with arthritis during the coronavirus pandemic.

eading charity Versus Arthritis is launching the app today in the hope that it will help young people living with the debilitating condition, including the 15,000 children under the age of 16 who have juvenile idiopathic arthritis (JIA).

The arthritis tracker - which provides 24/7 access to trusted information and advice for young people between 13 and 25 - will help them to rate and record their arthritis symptoms in seconds and track their pain, medication side effects, fatigue, physical activity, sleep and emotional wellbeing.

Along with tracking their arthritis symptoms and wellbeing, the app also connects sufferers with other teenagers and young people who know what it is like to live with arthritis.

Hope Graham, from Warrenpoint, came up with the idea for the app as a result of her own painful experience of JIA.

She said: "Having an app that can help track symptoms is such a huge help.

"I have been in a lot of pain previously, but whenever I go to the doctor, I tend to say 'I'm okay, I'm not feeling that bad', but actually, I won't have been able to walk up the stairs a couple of weeks ago.

"I will be using the app all the time now. Being part of its development has already helped me to ensure I get the treatment I need when I visit my doctor. And being able to link up with other young people has completely changed the way I feel about my condition. I used to feel very alone.

"I hope that this app helps other young people to become part of a community, who are here to support each other."

An estimated 2.98m people under the age of 35 in the UK are living with a musculoskeletal condition like arthritis and the app will help young people enduring pain, fatigue and the isolation of arthritis, while also dealing with the everyday challenges of growing up.

Many people living with arthritis take immunosuppressant drugs and, as a result, they are amongst the 1.8m across the UK who currently have to shield themselves from Covid-19.

As a result, they have been unable to attend face-to-face hospital appointments and there are concerns this has made it more difficult to explain their symptoms. It is hoped the app, which is available from the Versus Arthritis website, will help to address this.

Belfast Telegraph

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Down woman's arthritis tracker app for young adults aims to help and connect sufferers during coronavirus pandemic - Belfast Telegraph

On March 16, Leonard Whitehurst was admitted to the Royal Cornwall hospital with a confirmed case of COVID-19. His doctor, Giorgio Gentile, said that Whithurst's condition has deteriorated, describing it as "very grim."

Thankfully, the 72-year-old was saved after his doctors decided to give him a promising arthritis drug that is under clinical trials by doctors worldwide. Tocilizumab showed promising results in treating COVID-19 patients in Italy.

The drug is marketed as RoZctemra or Actemra, used to suppress the immune system of patients with rheumatoid arthritis. Its effect on COVID-19 has the potential to halt the cytokine storm that happens when the immune system goes into overdrive and begins attacking the body.

Mr. Whitehurst's condition instantly improved after he received the drug as a last-ditch attempt, and is now recovering at home. Dr. Gentile believes that Whitehurst us the first to try the arthritis drug in the UK back in March following the advice of doctors from other countries.

The tocilizumab drug is now part of the three major trials on British coronavirus patients, expecting its first results by June or July.

Dr. Gentile is a consultant nephrologist from Italy who has worked at the Royal Cornwall Hospitals Trust since 2015.

He said that Mr. Whitehurst was in critical condition, needing 19 liters of oxygen but had not been put on a ventilator. The 72-year-old patient was deteriorating quickly, and putting him into the intensive care unit was not an option as the patient was not prepared to be artificially ventilated, his outlook was very grim at that time.

Dr. Gentile was so desperate to save his patient that he gave him tocilizumab, which seemed the only option left to try and save his patient's life. He regularly reads medical literature of COVId-19 from different countries that are also battling the disease.

Furthermore, he became aware of the drug's multiple anecdotal reports of people having severe conditions that had dramatically improved because of the medication. He said that the AIFA- Italian equivalent of the Medicines and Healthcare products Regulatory Agency- had just approved a large scale test trial with tocilizumab and was actively recruiting people.

Another promising study of 20 patients from China claimed the efficacy of the drug, which cured 95% of critically ill patients.

Read Also: This Drug Is Voted As the Most Effective Coronavirus Cure Possible By 6,000 Doctors Worldwide

According to Dr. Gentile, Mr. Whitehurst had all the laboratory signs of the so-called "cytokine storm." With approval from the hospital and the patient, he decided to give him tocilizumab, which was administered quickly.

Mr. Whitehurst received two infusions of tocilizumab 12 hours apart, but before he was given the drug, his oxygen saturation was 75%, which is below the normal reading that should be between 80 and 100. His oxygen saturation improved very quickly after receiving the drug and kept improving gradually and steadily over the next days.

Mr. Whitehurst was discharged from the hospital last week, smiling and overjoyed, after spending more than a month in the hospital.

Tocilizumab is part of three major trials involving British patients. Results are expected by June or July, reported by MailOnline.

One of the big trials is the Recovery trial, which is testing four promising treatments such as HIV, malaria, and antibiotic drugs. They have already recruited about 6,000 NHS patients, which makes it the most extensive study looking at repurposing existing therapies to treat COVId-19. The drug will be administered to patients whose lungs have been severely damaged due to the virus.

Meanwhile, Chinese doctors were the first to try tocilizumab on patients given routine therapies who were diagnosed as severe or critical. After a few days, the patients' fever returned to normal and improved dramatically, according to Dr. Xiaoling Xu and his colleagues.

CT also showed damage to the lungs reduced significantly around the fourth and fifth day of treatment. The authors concluded that tocilizumab is an effective treatment among patients with severe cases of COVID-19.

Read More: Italian Scientists Claim the World's First COVID-19 Vaccine That Can Neutralize Coronavirus in Human Cells

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COVID-19: Arthritis Drug Saves 72-year-old Critically Ill Patient with Grim Condition - Science Times

A Dundee University student is among those being helped by a new mobile app aimed at helping teenagers and young adults with arthritis through Covid-19 self-isolation.

Melissa Tavendale said she had already felt the benefit of the Arthritis Tracker which provides round-the-clock access to information and advice, helping those affected to rate and record symptoms in seconds and track their pain, medication side effects, fatigue, physical activity, sleep and emotional well-being.

An estimated 2.98 million people under the age of 35 in the UK are living with a musculoskeletal (MSK) condition and the charity Versus Arthritis has launched the app.

Versus Arthritis digital engagement officer, Sophie Mullen said; Arthritis is too often dismissed as an old persons disease, but it doesnt discriminate by age two thirds of people with arthritis are under 65.

Technology is helping us bridge the gap to those who were already isolated, and who face more restrictions to their life because of Covid-19.

Most will never have met other young people their age with the condition, who understand what theyre going through. This app will help us change that.

Melissa, 19, was recently diagnosed with Seronegative inflammatory arthritis after experiencing painful joints and stiffness for more than a year.

Now living with her parents in the north east during lockdown, she has already had one medical appointment cancelled during the pandemic.

The app is very easy to use and seems to be working very well. I like the extra info with tips and advice about managing my condition, she said.

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Coronavirus: New app developed to help young arthritis sufferers through pandemic - The Courier

AIMS:

Adalimumab-adbm is a monoclonal antibody developed as a biosimilar to adalimumab (Humira, AbbVie Inc.). The key objectives of this study were using a population pharmacokinetic (PPK) approach to assess pharmacokinetic (PK) similarity between adalimumab-adbm and Humira in patients with activerheumatoid arthritis(RA), to quantify the effects of potential covariates on adalimumab PK, and to assess the impact of switching treatment from Humira to adalimumab-adbm on PK.

A PPK model was firstly developed using intensive PK data from the phase 1 study in healthy subjects (NCT02045979). PPK models were developed separately for phase 3 base study (NCT02137226) and its extension study (NCT02640612) in patients with active RA.

PPK models were developed for adalimumab from adalimumab-adbm and Humira treatment in healthy subjects and RA patients. Weight and anti-drug antibodies (ADA) were found to be important predictors of adalimumab clearance. Adalimumab PK was similar between adalimumab-adbm and Humira. The estimated effect of Humira on clearance, relative to the adalimumab-adbm, was 1.02 (i.e., Humira has 0.02 greater clearance). Similarly, the effect of treatment arms (switching) on clearance was estimated to be 1.00 and 0.997 for Humira:Humira:BI and Humira:BI:BI arms, respectively, relative to the BI:BI:BI arm (BI refers to adalimumab-adbm) in the phase 3 extension study.

PK similarity between adalimumab-adbm and Humira in patients with active RA was demonstrated using PPK approach. Adalimumab PK was also similar when switching treatment from Humira to adalimumab-adbm at either week 24 or 48.

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Population pharmacokinetics of adalimumab biosimilar adalimumab-adbm and reference product in healthy subjects and patients with rheumatoid arthritis...

In a sun-dappled dance studio with floor-to-ceiling windows in Summit, NJ, Teresa D'Angelo is leading a class full of female students through a series of graceful, flowing moves. They raise their arms to the sky and sway side to side, their heads tossed back with abandon. They bow down towards their bare feet, sweeping their hands along the floor as if gathering leaves from a garden, then transition into a series of sensual shoulder rolls.

Now, the pace changes. DAngelo, who rocks a blonde pixie cut and has a radiant, infectious smile, begins performing a series of sidekicks, upward blocks, and other martial arts-inspired moves. The women follow along, full of fierce determination, but the grins never once leaving their faces. After 60 minutes, they end class in a warm group embrace, beaming and trading words of support and encouragement.

After everyone had gone home, DAngelo spends a bit more time in the studio, this time dancing solo. In her hands is a pumpkin-colored silk scarf, which she traces through the air as she completes a series of balletic twirls, dipping down low then rising up on her tiptoes. With the sun streaming in and the scarf billowing in the air, she looks like a triumphant butterfly.

You would never know that several years prior, DAngelo spent her days lying on a couch in her living room, racked by excruciating joint pain and inflammation from rheumatoid arthritis (RA). She needed a cane to make it to another room and moved up and down the stairs by scooting on her bottom. Turning a doorknob was impossible.One day, she caught sight of herself hunched over in a mirror and thought, Oh my God, is this what the rest of my life is going to be like?

The answer, she ultimately decided: Hell, no. This is the story of her transformation, made possible by a chance encounter with a doctor and a decision DAngelo, now 58, made to listen to her body and start moving the way it wanted to.

In 2005, DAngelo was working for an international accounting and consulting firm in a job that paid well but required sitting at a desk for up to 10 hours a day and left her feeling boxed in and spiritually stifled. None of this was a great fit for the former ballet dancer who, as a young girl in the 70s, had aspired to become a prima ballerina. Her hopes were extinguished at the age of 15 by an instructor named Miss J, who always wore black leotards, black rock-star eyeliner, and raised her voice a lot. If she yelled at you, it meant she took interest, DAngelo recalls. I don't remember being yelled at a lot.

After that, she threw her energy into high school and college, where she discovered a new love, communications. She was a radio DJ in undergrad, a weekend weather anchor while earning her masters degree, and later, a managing editor. Im not shy, but Ive always been on the quieter side, so I loved how these jobs gave me the chance to speak out and communicate with many people at once, she says.

In May of 2005 DAngelo began experiencing some brain fog. I was having trouble absorbing information and struggling to react quickly at work, which was impacting my job because it was a stressful, high-performing environment, DAngelo recalls now. After a few months of mental fuzziness, another bizarre symptom hit. One day I noticed some swelling and pain in my left foot, she says. It came out of nowhere.

She told her naturopathic doctor, who directed her to a primary-care doctor, who in turn suggested she see a rheumatologist. That specialist diagnosed DAngelo with psoriatic arthritis (PsA), an autoimmune disease characterized by joint pain and stiffness plus psoriasis, a skin condition that causes red lesions that can burn, sting, or itch. (DAngelo didnt have lesions, but says her doctor based the diagnosis on bloodwork and her description of her pain. Some patients with PsA dont have the skin component.)

The doctor prescribed a biologic medication, a type of potent anti-inflammatory. DAngelo, who had for decades relied on herbal tinctures, green juices, probiotic-rich foods and other alternative therapies to maintain her health, initially balked at the suggestion. But when even her naturopathic doctor said he didnt think he could help her, DAngelo filled the prescription and, to her surprise and delight, began to feel better. The relief, she says, made her a bit cocky and she stopped taking the drug without asking her physician. It turned out to be the wrong move.

By the fall of 2005, pain and swelling began to hit her wrists and knees. The fact that her new symptoms were double-sided did not go unnoticed by her doctors. They said rheumatoid arthritis usually affects the joints symmetrically, but psoriatic arthritic tends to be just one-sided. That, along with further bloodwork, prompted DAngelos rheumatologist to change her diagnosis to RA and prescribe prednisone.

The powerful steroid worked intermittentlyDAngelo, at this point 43 years old, would have good days, going to work and the gym and playing catch outside with her son, Michaeland bad days, where her knees would swell with fluid, forcing her to use a cane.

At a routine appointment with her naturopath (I was still throwing everything I could at my RA in addition to my medication, she says), DAngelos doctor, noticing her increasing stiffness, said: You need to start moving your body. What do you like to do? She mentioned that she used to be a dancer. That prompted him to mention a movement-based mind-body practice called Nia.

Blending movements and philosophies from the worlds of dance, martial arts, and mindfulness, Nia is a non-impact workout thats performed barefoot, set to a diverse array of music (Latin, Jazz, Indian, and hip-hop, to name a few), and based on the premise that health can be discoveredor re-discoveredthrough conscious, meditative movement.

Exhilarated by the notion, DAngelo took a Nia class and instantly fell in love with it. It was like nothing Id ever done before. In ballet, I was always told exactly how to move. In Nia, youre given permission to move exactly how your body tells you.

During that first class, DAngelo noticed her body soften. The pain and stiffness were still there, but I felt peaceful and connected to myself. A sense of joy and relief flooded her body. I thought, Oh my gosh, Im moving again.

With more classes came more self-discovery and introspectionand some RA symptom relief. Like so many people, I started life as a vibrant soul with fantastic dreams and a creative imagination. But over time, the real me, the passionate and lively me, started to become quiet. My voice shut down and my body soon followed.

Now, dabbling in Nias 52 classic moveswhich at times resemble belly dancing, tai chi, ballet, and even salsa dancingthe old DAngelo was back. Through these shapes and movements, I could say and show what was going on inside of me. I was expressing through my body what had been bottled inside for many yearsmy voice.

Her love of dance rekindled, DAngelo signed up to become a Nia instructor herself. She made it halfway through her weeklong training in November of 2005, only to be sidelined by pain. I was on the floor of the studio, crying because it hurt to move, and a trainer, who I loved, said, Its OK, dont push yourself. Rest. It will be OK. Devastated, she reluctantly pulled out of training.

In early 2006, after a few months of rest combined with home Nia practice (I would pull myself together and practice one routine a night), DAngelo became officially certified as a Nia White Belt Instructor. (Like martial arts, Nia certification levels involve different colored belts). She soon began teaching a regular Saturday class at a local wellness center. Her dance dreams were finally coming to fruition.

One night shortly thereafter, DAngelo woke up screaming in pain. It felt like razor blades were cutting my wrists from the inside, she says. As her new husband Mike (they had married in August) tried to comfort her, she prayed out loud, begging for relief.

This cycle was the first of many highs and lows that were to come over the next two years, as DAngelo continued working for her firm and teaching Nia on Saturdays. On one hand, she had the satisfaction of knowing she was helping other womensome living with chronic illnessfind a release from stress, and often pain (many Nia practitioners discover the class during a chronic-pain journey). On the other hand, she would spend weeks off and on steroids and never knew when the inflammation would hit. I could have a great class one day, tons of energy, no pain, then wake up the next morning and have trouble getting out of bed.

Things took a turn for the worse between 2008 and 2011. Her wrists and occasionally ankles hurt. Her knee needed to be drained with a needle every few weeks to release fluid build-up. A headache so bad she feared it was a brain tumor sent her to the emergency room. When travelling on firm business, shed leave team dinners early to go to bed and strategically wore a neoprene arm brace so colleagues and new associates wouldnt shake her hand, as doing so would leave me screeching in pain. She took three leaves of absence from work between 2005-2011.

In 2011, after several months of being couch-bound and unable to teach Nia, let alone work, DAngelo had a doctors appointment. She was surprised to learn her rheumatologist was out and shed be seeing a different specialist that day. That fresh set of eyes turned out to be a blessing for DAngelo. She said, Lets take you off these high doses of prednisone and try to find another medication that actually will help you.

The next few months were spent experimenting with multiple RA drugs. No luck. Then, in January of 2012, the doctor wanted to try yet another. The whole process had been intimidating. But so was the thought of not being able to sway and twirl and be in her body the way Nia allowed her to be.

At home that day, lying on the couch, I remember asking God, What do you want me to do? she recalls. And like a waterfall of calm, I felt the words, Take the medicine wash over me.

Around the same time, a friend who is an integrative psychotherapist visited Teresa at home. She asked me, What is your vision of yourself? I said, I see myself as a ballet dancer, leaping over the moon. DAngelos friend replied, Hold that vision.

Together, those two key events convinced her to try the new treatment.Slowly, she began feeling less fatigued. Her joint inflammation lessened. Her pain reduced. By March, about two months after starting, she started to feel like herself again and was cleared by her rheumatologist to return to work.

Just a few days later, she received a call from human resources; she was being laid off. DAngelos response?

I put the phone on mute, pumped my fist, and said YES! That job had been so stressful for so many years. I thought maybe now I could start helping people who were like me and show them how to use movement to regain their life and wellness. Maybe, she thought, she could even turn it into a business.

In 2014, she launched Live Love Move, a company based in her hometown of Summit, NJ that offers mindful movement classes, workshops, and retreats for women, particularly those living with chronic pain. Now a first-degree black-belt instructor and certified massage instructor whos also working on her certification in dance movement therapy, DAngelo works with students who range from teachers and nurses to CEOs and stay-at-home moms. When they start to move, they sometimes cry simply because the act of lifting your hands to the sky can feel so empowering and releasing, she describes. The trauma of their illness has been locked inside. Now, they feel heard and seen.

DAngelo, is still taking the same medicine and is more or less pain-free. She does have osteoporosis in her right hip, which her doctor believes is a result of years of steroid use, and occasional morning stiffness, which she describes as crankiness in my knees and wrists.

Nutrition plays a big role in her life; she follows an anti-inflammatory diet, avoids gluten and tries to limit sugar to what she gets from fruit. My doctor tells me: Whatever youre doing, keep doing it.

Equally important has been recasting her RA diagnosis as a gift, something she says took her nearly a decade to do. Ultimately, though, the pain of not being able to move, of believing my body betrayed me, it helped me to seek and find the gift of my voice through dance. I not only feel better physically, but I handle stress better. Now, its my mission to educate and inspire othersanybody who hasnt moved in a long time or wants to move differently.

When meeting with a new group, she usually kicks things off with these words: Hi, Im Teresa DAngelo. I help support people who are in pain to help them feel better through healing movement. Even if you can just move a finger, ankle, or toe, know that pain is not the end of your story.

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How One Woman Found Freedom From RA - HealthCentral.com