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Archive for the ‘Arthritis’ Category

Rheumatoid Arthritis Care and the Option of Telemedicine – Rheumatology Advisor

Thursday, November 7th, 2019

Video telemedicine may be anoption for care inrheumatoid arthritis (RA) for patients who have high disease activity andpositive perceptions of telemedicine, and for physicians who frequently utilizetelemedicine technologies, according to research published inArthritis Care and Research.

Using data from patients within the Alaska Tribal Health System, researchers sought to determine the baseline factors associated with the use of telemedicine for RA. Adults 18 and older with an RA diagnosis who were seen at the Alaska Native Medical Center between August 2016 and March 2018 were invited to participate in the study.

Throughout the baseline enrollment period,rheumatology-specific telemedicine was available in the form of synchronousvideo teleconference. Physicians were briefly and generally trained on the useof the telemedicine equipment. Telemedicine was made available to patients in 2different scenarios: Those residing in rural areas could use the videoteleconference to reduce travel burden, or care was provided at the AlaskaNative Medical Center in Anchorage from a rheumatologist who wasvideo-conferenced in from out of state.

In total, 122 patients participated in the study. In boththe telemedicine and in-person groups, patient demographics were similar withrespect to age, sex, and disease duration (mean 10 years). A majority ofparticipants across both groups had positive autoantibodies (>85% positivefor rheumatoid factor and anticyclic citrullinated peptide), and almost allpatients had been prescribed disease-modifying antirheumatic drugs within thelast year.

Both groups had a mean number of rheumatology visits withinthe past year higher than 2; however, the telemedicine group had more visitsoverall (mean 2.95 vs 2.39;P=.011).The telemedicine group also had higher survey scores, which indicated morepositive perceptions of telemedicine and a higher mean rheumatologisttelemedicine rate, indicating that they were seeing a rheumatologist whoperformed telemedicine visits more frequently.

Investigators conducted a multivariate analysis for age,sex, number of rheumatologist visits in the past year, Routine Assessment ofPatient Index Data 3score, telemedicine survey score, ever seen bytelemedicine by any provider, and mean rheumatologist telemedicine rate. Thestrongest association with patient use of telemedicine was the meanrheumatologist telemedicine rate (odds ratio [OR] 4.14; 95% CI, 2.35-8.00).Additional strong associations were observed between the telemedicineperception survey score and use of telemedicine (OR 2.76; 95% CI, 1.32-6.18),the number of rheumatologist visits in the past year, and Routine Assessment ofPatient Index Data 3 score.

In addition, patient perceptions of telemedicine were an important factor associated with the choice to use telemedicine for RA follow up vs in-person care only. Survey results indicated that patients who had ever been seen by telemedicine responded more favorably than those who had not. Overall, patients still preferred to be seen by a specialist in person, regardless of group (61% of the telemedicine group and 74% of the in-person-only group), but those in the telemedicine group were more likely to feel that care provided via video was as good as care provided in person.

Limitations to the study included the observational natureof the research, possible unmeasured staff or provider biases that contributedto patient choice, and the unique setting that may prevent a generalization ofresults to other populations.

Future studies will investigate disease activity over time and quality of care for RA in the setting of telemedicine compared [with] usual care and will help inform practice further, the researchers concluded.

Reference

Ferruci ED, Holck P, Day GM, Choromanski TL, Freeman SL.Factors associated with use of telemedicine for follow-up of rheumatoid arthritis[published online August 17, 2019].Arthritis Care Res.doi: 10.1002/acr.24049

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Rheumatoid Arthritis Care and the Option of Telemedicine - Rheumatology Advisor

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Offaly doctor speaks at national arthritis event – Photo 1 of 2 – Offaly Express

Thursday, November 7th, 2019

A large attendance from across the midlands turned out last Wednesday, November 6, for an information evening in Athlone about ankylosing spondylitis (AS).

The inflammatory arthritis affects 4,000-6,000 people in Ireland and is most frequently diagnosed in young men.

The talk by Dr Killian ORourke, consultant rheumatologist at the Midlands Regional Hospital, Tullamore, was part of an awareness campaign about the condition organised by Arthritis Ireland.

Dr ORourke outlined that some of the early signs and symptoms of the condition include pain and stiffness in the lower back and buttocks; early morning stiffness; fatigue and poor form; pain and tenderness in the ribs, shoulder blades, hips, thighs and heels; weight loss; fever; mild to moderate anaemia; inflammation of the bowel; and iritis or uveitis.

As ankylosing spondylitis advances, it can affect a persons ability to work. It is estimated that a third of people with AS may be unable to work at all. Around one in six may need to make changes to their working life in order to continue working.

While its not yet known what causes ankylosing spondylitis, there can be a genetic element. However, the condition isnt passed directly from a parent to their children.

Head of communications and advocacy at Arthritis Ireland, Brian Lynch, said: When people are informed about their condition, they are better able to manage the day-to-challenge of living with it. Since ankylosing spondylitis affects people when they are in the prime of their lives, it can be hugely disruptive in terms of their education, careers, relationships, past times.

Our work as a patient organisation is about educating people so that they are aware of symptoms and can take early action. Equally, it is about helping people regain control of their lives through education and support, Lynch said.

Living with Ankylosing Spondylitis is supported by Novartis.

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Offaly doctor speaks at national arthritis event - Photo 1 of 2 - Offaly Express

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Which chronic health issues plague Greater Lansing? Read the list, learn how to beat them – Lansing State Journal

Thursday, November 7th, 2019

LANSING Dr. Karen Kent VanGorder sees a lot of patients who aren't compelled to manage their health because they don't have troubling symptoms.

"The mostcommon thing I hear as a doctor is someone looks at me and shrugs and says, 'I feel good," VanGorder, who servesas Sparrow Health System's chief medical officer, said.

That can be an issue with chronic conditions like high cholesterol that often don't have symptoms until they lead to major issues like stroke or heart attack, she said.

VanGorder saidshe tries to help patients understand "the natural history of a chronic condition absolutely applies to them" and they need to think about how they'll feel in 10, 15 or even 20 years.

"Lucky is not a plan," she said.

VanGorder works to motivate patients to eliminate risk from their life, comparing it to teaching a kid to look both ways before crossing the street and she said the good news isthat it can besimple.

It can be as easy as walking every day, she said, stressing that increasing activity is free and doesn't require an appointment or insurance.

"The more we move in mid-Michigan, the healthier we're going to be," she said.

And people's health does impact the community in various ways, VanGorder said.

When people have chronic conditions, it affects family, friends, co-workers, neighbors and more, she said.

And according to a state survey that tracks the prevalence of medical conditions, among other topics, some of those conditions affect around a third of the adults in the Lansing area.

People with high cholesterol and high blood pressureare much more likely to have a heart attack, stroke or another vascular issue because of damage to blood vessels.

Prevalence: According to the Centers for Disease Control, 68 million American adults a little less than 33% have high cholesterol and about 32% have high blood pressure.

Show caption Hide caption Michael Ranville, 74, of Charlotte, works out Wednesday, April 25, 2018, at ALIVE! in Charlotte. He suffered a massive heart attack in 1984, and...Michael Ranville, 74, of Charlotte, works out Wednesday, April 25, 2018, at ALIVE! in Charlotte. He suffered a massive heart attack in 1984, and had a heart transplant in 2015. Ranville works out for 35-40 minutes three days a week.MATTHEW DAE SMITH/Lansing State Journal

Issues with both cholesterol and blood pressure are more common in Michigan. According to data from the Michigan Department of Health and Human Services, 36.5% of Michiganders have high cholesterol and 33.9% have been diagnosed with hypertension.

High cholesterol ratesUSA Today Network

Regionally, it's about as prevalent 36.7% of people in the Lansing area and nearby counties said they have had their cholesterol checked within the last five years and had a health professional tell them they have high cholesterol. And 35.1% of respondents in the Lansing area said a health professional has told them they have high blood pressure.

It's more prevalent in Barry and Eaton Counties, where 41.4% of respondents self-identified as having high cholesterol and43.4% said they've been diagnosed with high blood pressure.

Issues with cholesterol and blood pressure are least prevalent in Ingham County, where 34.6% of people said they've been diagnosed with high cholesterol and30.2% of respondents indicated a health professional has told them they have high blood pressure.

Cost: According to a study published last year in the Journal of the American Heart Association, adults with high blood pressure spend nearly $2,000 more each year on health care.

According to that same study, health care for adults with high blood pressure costs an extra $131 billion annually than it does for those without hypertension.

Another report commissioned by the American Heart Association found that in 2010, heart disease cost the country $273 billion in direct medical costs and $172 billion in lost productivity.

High blood pressure ratesUSA Today Network

Treatment and Prevention: Lifestyle plays a major factor in people's cholesterol and blood pressure levels. To help avoid or manage either condition, people can:

People with high blood pressure also can benefit from reducing stress, limiting how much alcohol they drink and eating food that's rich in potassium, including fruits like bananas and oranges, cooked vegetables like broccoli and spinach and some fish such as tuna and trout.

When lifestyle changes aren't enough, medication can help. Drugs known as statins are the primary medication used to treat high cholesterol.

There are many more types of drugs that can treat high blood pressure, from diuretics that get rid of excess sodium to beta-blockers that reduce heart rate to vasodilators that relax the walls of blood vessels.

Impact on everyday life: Hear from Dr. Awais Kang, a cardiologist with McLaren Greater Lansing, about helping patients with high cholesterol and high blood pressure avoid more serious heart problems and regain heart function.

Heather Tompkins-Herber talks about managing her arthritis Friday, Oct. 18, 2019.Robert Killips | Lansing State Journal

Prevalence: About 23% of Americans have arthritis, according to the CDC.

The inflammatory disorder is more common in Michigan, where 30.8% of respondents to a statewide survey say a health professional has diagnosed them with arthritis.

And it's about as common in the Lansing region, with 29.5% of respondents saying they've been diagnosed.

It's more common in Barry, Eaton, Clinton, Ionia and Montcalm counties, where 33.5% of people said they have arthritis.

Arthritis ratesUSA Today Network

And it's less common in Ingham County, where 26.3% of respondents said a health professional has diagnosed them with arthritis.

Cost: According to a study published in 2017, adults with arthritis spent an extra $2,117 in medical costs and missed out on $4,040 in potential wages each, on average, in 2013.

Nearly half of all medical costs went to outpatient care, which can include diagnosis, consultation, treatment and rehabilitation.

Treatment: There are various ways to treat the symptoms of arthritis.

Some might opt for medication. Most drugs used to treat arthritis help relieve pain and inflammation.

Others might choose to take supplements and herbs to treat pain, stiffness and inflammation or opt for other treatments like massage or electrical stimulation as an alternative to drugs.

Joint surgery and otherprocedures arealso an option, but areusually recommended only after trying other treatment methods.

Prevention: According to the Arthritis Foundation, there's no sure way to prevent the condition.

But there are ways to reduce risk factors and delay the potential onset of any of the various 100 forms of arthritis, including:

Impact on everyday life: Learn how Heather Tompkins-Herber, a Charlotte residentdiagnosed with arthritis in her early thirties, manages nearly constant pain in her neck and spine.

Prevalence: According to the CDC, 7.7% of Americans have "current asthma." That means they've been diagnosed with asthma at some point in their life and have been told they still have the condition.

Asthma is more common in Michigan, with 10.7% of survey respondents saying they still struggle with the condition.

Eric Ware, of Lansing, pictured with medicines he must carry in case of an asthma attack. He has battled asthma since he was 5.Matthew Dae Smith/Lansing State Journal

Locally, it's less common in Clinton, Ionia and Montcalm counties, where 8.1% of respondents say they still have asthma.

It's more common in Ingham County, where 12.1% of people say they have current asthma.

Cost: A CDC study published last year found the total annual cost of asthma including medical care, absenteeism and mortality was $81.9 billion.

That breaks down to $3,266 per person, on average:

The study found adults with asthma missed a combined 8.7 million work days and lost an average of $214 in potential earnings.

Treatment: There are a variety of medicines that can help people control their asthma.

The American Lung Association breaks them into five categories:

Asthma ratesUSA Today Network

Prevention: According to the Mayo Clinic, it isn't clear why some people get asthma and others don't, but there are risk factors that might increase the chance of getting asthma.

Some of those you can't necessarily control, such as whether a parent or sibling has asthma or whether you have an allergic condition like eczema.

Others, though, are based on behavior or environment:

The U.S. has third-highest rate of child asthma cases linked to traffic-related air pollution

A shocking 4 million cases of children developing asthma per year could stem from traffic-related air pollution.

Buzz60

Impact on everyday life: Eric Ware was diagnosed with asthma at 5. Learn about how he's managed it, including just accepting it as a lung disease.

Prevalence:According to the CDC, 9.3% of American adults have diabetes.

State figures show it's more common in Michigan, with 11% of survey respondents saying they've been diagnosed with either Type 1 or Type 2 diabetes.

It's slightly less common in the region, with 10.3% of people surveyed saying they have diabetes.

That's swayed by Ingham County, where it's much less prevalent 7.9% of people said they've been diagnosed with diabetes.

It's more common in Barry and Eaton counties, where 13.4% say they've been diagnosed, and Clinton, Ionia and Montcalm counties, where 12.2% say they have either of the two main types of diabetes.

Cost:According to the American Diabetes Association, people with diabetes have medical expenses about 2.3 times higher than those without diabetes.

ADA organization estimates diagnosed diabetes costs around$9.7 billioneach year in Michigan alone, based on data from 2017:

Treatment: People with any type of diabetes need to check their blood sugar levels multiple times a day. Treatment, though, can vary from person to person.

Diabetes ratesUSA Today Network

Some people can manage their diabetes with healthy eating and exercise. Others need to take medication to lower their blood sugar or inject prescription insulin to help their body regulate blood sugar levels by either using or storing glucose.

Prevention: Different kind of diabetes have different causes, including the most common Type 1 and Type 2.

The American Diabetes Association identifies two factors that are key in causing both types: Inheriting a predisposition to the disease and environmental triggers.

For example, research has shown people who live in places with cold climates develop Type 1 diabetes more often, but in most cases, people also need to inherit risk factors from both parents.

Lifestyle is more influential in developing Type 2 diabetes. Studies have shown those at risk of developing Type 2 can delay or prevent it with exercise and weight loss.

ADA recommends learning your risk and they have a quick online test anyone can take atdiabetes.org/risk-test. People also can ask their doctor about the A1C test, a blood test that can help identify prediabetes or diagnose either Type 1 or Type 2 diabetes.

Impact on everyday life: Learn how Hillary Coleman, a 28-year-old Lansing resident, manages herType I diabetes.

Contact reporter Megan Banta at (517) 377-1261 or mbanta@lsj.com. Follow her on Twitter @MeganBanta_1.

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Depression And Anxiety In Patients With Juvenile Idiopathic Arthritis: | OARRR – Dove Medical Press

Thursday, November 7th, 2019

Danielle C Fair,1 Martha Rodriguez,2 Andrea M Knight,3 Tamar B Rubinstein4

1Division of Pediatric Rheumatology, Medical College of Wisconsin: Childrens Hospital of Wisconsin, Milwaukee, WI, USA; 2Division of Pediatric Rheumatology, Indiana University School of Medicine, Indianapolis, IN, USA; 3Division of Pediatric Rheumatology, Hospital for Sick Children, Toronto, ON, Canada; 4Division of Pediatric Rheumatology, Albert Einstein College of Medicine: Childrens Hospital at Montefiore, Bronx, NY, USA

Correspondence: Danielle C FairMCW Pediatric Rheumatology, Childrens Corporate Center, 999 N 92 nd St., Suite C465, Wauwatosa, WI 53226, USATel +1 414-266-2036Fax +1 414-266-6695Email dfair@mcw.edu

Abstract: Depression and anxiety are prevalent in children with rheumatologic diseases, including juvenile idiopathic arthritis (JIA). However, prevalence rates and the relationship with disease outcomes, including quality of life are conflicting in the early literature. To review the current literature, determine gaps in our knowledge, and identify areas in need of further investigation, we conducted a systematic review of studies examining depression and anxiety symptoms among children with JIA and the impact these symptoms may have on disease outcomes and quality of life. Six electronic databases were searched up until January 2019. Of 799 potential articles, 60 articles were included with the main focus on 28 articles from 2009 to 2019, to concentrate on the most current evidence. We found that JIA patients experience symptoms of depression and anxiety similar to other childhood chronic diseases and at higher rates than in healthy children. Patients who experience these symptoms have worse quality of life, with some evidence pointing to depression and anxiety symptoms having a greater impact on quality of life than other disease features, such as active joint count. Family members of JIA patients experience high rates of anxiety and depression symptoms which may impact their childs mental health and pain symptoms related to JIA. Conflicting reports of associations between depression/anxiety symptoms and disease features/disease outcomes and a paucity of longitudinal studies investigating the impact of treatment on mental health symptoms indicate areas in need of further research to effectively identify patients at greatest risk of depression and anxiety and to better understand how to treat and prevent these symptoms in youth with JIA. Family mental health should also be considered in investigations concerning mental health and disease outcomes of children with JIA.

Keywords: pediatric rheumatology, mental health, mood disorder, arthritis, autoimmune disease

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

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In Alaska, Telehealth is Popular With Those Who Have Already Used It – mHealthIntelligence.com

Thursday, November 7th, 2019

November 07, 2019 -Telehealth services are proving equal to in-person care in studies all across the country, but only if all the stars are aligned.

The latest example comes from Alaska, where a program launched for people living with rheumatoid arthritis found that virtual visits compared just as favorably to in-person care, as long as both provider and patient were familiar with telehealth.

The telehealth service also proved popular with patients who deal with frequent flare-ups, as it offered them a more convenient means of getting in front of a care provider.

When offered as an option for rheumatology care, video telemedicine was more likely to be used by RA patients with higher disease activity, more positive perceptions of telemedicine, and whose physicians used telemedicine more often, the researchers, led by Elizabeth D. Ferucci, of Community Health Services and the Alaska Native Tribal Health Consortium, wrote in the August edition of Arthritis Care & Research.

The intimation is that telehealth has to be familiar in order to be embraced. And that means more people providers and patients have to be introduced to telehealth in order to become familiar with its benefits.

For their study, Ferucci and her colleagues gathered data from 122 Alaskans being treated for RA in the Alaska Tribal Health System between August of 2016 and March of 2018. The participants were given a choice of in-person care at the Alaska Native Medical Center in Anchorage (with an out-of-state rheumatologist participating via video) or virtual visits.

According to the researchers, those using virtual visits met more often with their care providers. In addition, they had a more positive perception of telehealth, and they were seeing a rheumatologist who used telemedicine more frequently.

Also, both groups indicated they preferred to see a specialist in person for follow-up care 61 percent of those who used telehealth and 74 percent of those who visited the hospital. But those within the telehealth group also said their virtual care experience was just as good as in-person care.

The study points out that telehealth is embraced by those who have already tried it, but isnt high on the to-do list for those who havent used it yet. That falls in line with the many surveys that find telehealth to be popular in concept but not in use.

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Rheumatoid Arthritis and Lupus Treatments Market 2019 Global Industry Size, Share, Comprehensive Study, Trends, Demand Status, Forecast to 2024 -…

Thursday, November 7th, 2019

The market research study titled Global Rheumatoid Arthritis and Lupus Treatments Market Growth (Status and Outlook) 2019-2024specialized in current industry updates covers exclusive and analytical data through the span of seven years between 2019-2024. The research report has examined global market trends with recently obtainable data relevant to the amount of both market businesses and their market share. The report studies how the challenges, risks, current approaches, and social problems could limit the market. It serves an excellent guide with the help of bar-graphs, pie charts, product figures, tables. It will offer an exact outlook of the industry for interested users.

Going further, the report presents a deep investigation of key Rheumatoid Arthritis and Lupus Treatments market players, market drivers and restraints procedures for business, and variables driving the development as well as various stakeholders like investors, suppliers, traders, CEOs, and others. It gives special importance to the key strategy, methodologies, and the approaches of the top vendors in order to help businesses explore the new market opportunity. The market is further divided with respect to product type and applications/end industries to analyze the top players in the global market.

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Market Segments Coverage:

Geographically, this report is divided into many key regions, with production, consumption, revenue (million USD), and market share in these regions, from 2019 to 2024 (forecast), covering:Americas (United States, Canada, Mexico, Brazil), APAC (China, Japan, Korea, Southeast Asia, India, Australia), Europe (Germany, France, UK, Italy, Russia, Spain), Middle East & Africa ( Egypt, South Africa, Israel, Turkey, GCC Countries).

This portion appraises the market based on top vendors, their organization detailing, volume, areas, supply-demand scheme, and development trends. Top players are: AbbVie, Amgen, Bayer, Biogen Idec, Roche, Johnson and Johnson, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer.

Split by type, this report focuses on consumption, market share and growth rate in each application can be divided into Rheumatoid Arthritis Treatments, Lupus Treatments.

Split by application, this report focuses on consumption, market share and growth rate of Rheumatoid Arthritis and Lupus Treatments in each application, can be divided into Hospitals and Clinics, Ambulatory Surgery Centers, Homecare Settings.

Important Points Featured In This Report Are:

Manufacturing Analysis Rheumatoid Arthritis and Lupus Treatments market synopsis is given concerning the top countries, types, and applications. In addition, the section also covers price analysis of varied market vital players.

Revenue and Sales Evaluation Both, earnings and sales are studied for different elements of this market. Here, price plays an important role in the sales creation that can be analyzed for several regions.

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Competition In this section, many global industry-leading players have been studied based on their company profile, product portfolio, capacity, price, price, and earnings.

In conclusion, the report gives the analysis of the parent market supported key players, present, past and artistic movement information which will guide industry competitors. Additionally, a point-to-point notion of some important criterions like item value supply & distribution channels, profit and loss figures, production capability, and others are also given in this report. It will act as a profitable platform for users who aims to grasp each and every single opportunity of the Rheumatoid Arthritis and Lupus Treatments.

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Rheumatoid Arthritis and Lupus Treatments Market 2019 Global Industry Size, Share, Comprehensive Study, Trends, Demand Status, Forecast to 2024 -...

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Psoriatic arthritis prevention: Tips and management – Medical News Today

Tuesday, November 5th, 2019

Psoriatic arthritis causes joint pain and inflammation, usually in people who already have psoriasis. It is impossible to predict who will get psoriatic arthritis, however, and there is no surefire strategy for preventing it.

About 30% of people with psoriasis eventually develop psoriatic arthritis.

Preventive strategies for psoriasis focus on identifying triggers and treating symptoms early. Doing so may prevent psoriasis from transitioning to psoriatic arthritis.

In this article, learn about treatment and prevention strategies for psoriatic arthritis, as well as the risk factors for developing it.

Doctors do not know how to prevent psoriatic arthritis.

Currently, no treatment can guarantee that a person with psoriasis will not develop this form of arthritis.

Also, because a small number of people develop psoriatic arthritis without skin symptoms of psoriasis, it can be difficult to identify everyone who is at risk.

A 2019 medical review article highlights the many challenges that doctors face in trying to prevent psoriatic arthritis. Doctors do not fully understand how or why the disease progresses or who is at risk.

More research could, one day, answer these questions. For now, controlling the symptoms of psoriasis before it progresses into arthritis may help reduce the severity of both diseases.

People with psoriatic arthritis typically develop symptoms about 10 years after they get psoriasis.

Anyone with concerns about the progression of the disease should speak with a doctor about the outlook and managing the symptoms.

No specific treatment can prevent psoriatic arthritis, but the right treatment may lessen the severity of the disease.

Both psoriasis and psoriatic arthritis are autoimmune diseases, which means that they occur when the body attacks healthy tissue.

People with psoriatic arthritis develop active inflammation in the joints, as well as markers of inflammation in the blood.

Tests for inflammation may help assess whether a person is at risk of psoriatic arthritis, and working to prevent inflammation may help reduce symptoms of the disease.

For people who develop psoriatic arthritis, the right treatment can minimize disease activity. It may also reduce markers of the disease enough to achieve remission.

A 2010 study explored the outcomes of treatment with antitumor necrosis factor alpha which involves using biologic medication to reduce inflammation in people with psoriatic arthritis or rheumatoid arthritis.

The researchers found that, after 1 year of treatment, psoriatic arthritis was in remission in 58% of the people with the disease, compared with 44% of the people with rheumatoid arthritis.

Most people experience psoriatic arthritis as a series of symptom flares. The characteristics of these flares vary from person to person, but many notice a specific pattern.

For example, some people find that psoriasis skin symptoms get worse, or that they feel more fatigued before their joints start to ache.

Tracking symptoms can help a person and their doctor identify the pattern of flares. It may help to take note of meals and new foods, weather changes, stress levels, exercise, and other lifestyle and environmental factors, both between and during flares.

Some common flare triggers include:

Some people find that the following strategies help reduce the severity and frequency of flares:

Some people choose to avoid certain triggering foods or to follow an anti-inflammatory diet.

The Arthritis Foundation recommend eating foods that can reduce inflammation, including:

Reducing salt and alcohol intake may also help curb inflammation. Learn more about an anti-inflammatory diet in this article.

While lifestyle changes can make a big difference, they are not always enough to treat symptoms or prevent flares.

A doctor can offer a wide range of treatments to help with pain and stiffness. Biologic medications, for example, are highly effective for many people.

A doctor may also recommend:

If a person thinks that they may have early symptoms of psoriatic arthritis, they should speak to a doctor.

Also, consult a doctor about:

Psoriatic arthritis damages the joints, intensifying the severity of subsequent flares. Once it happens, arthritis-related joint damage cannot be reversed.

Medication may not cure psoriatic arthritis, but it can prevent joint damage. This means that early, aggressive treatment may offer lasting benefits.

People who develop joint pain or stiffness should see a doctor, even if they do not think that they have psoriasis.

During a person's first few flares, frequent and regular communication with a doctor can help them better understand the disease and identify effective treatments.

Do not stop taking psoriatic arthritis medication without talking to a doctor. When symptoms clear up, it is a sign that the treatment is working, not that it is time to stop the treatment. Some people find that their flares get much worse when they stop using their medication.

Psoriasis and psoriatic arthritis are complex diseases. They likely develop due to a combination of genetics, inflammation, factors such as skin and joint injuries, and specific psoriasis triggers.

There is no psoriatic arthritis prevention strategy, but getting prompt and effective treatment can help reduce the frequency and severity of symptoms.

A rheumatologist can identify risk factors for psoriatic arthritis and help minimize the chances of developing the disease.

However, there is no way to predict who will get psoriatic arthritis and no surefire way to prevent this inflammatory joint disease.

Doctors, loved ones, and support groups can help a person manage stress and their psoriatic arthritis symptoms.

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Psoriatic arthritis prevention: Tips and management - Medical News Today

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AbbVie eyes 2nd Rinvoq nod as it hits its marks in psoriatic arthritis – FiercePharma

Tuesday, November 5th, 2019

AbbVie blockbuster-to-be Rinvoq only just hit the scene in rheumatoid arthritis, but its already on its way to a second indication.

Thursday, the Illinois drugmaker said its newcomer had hit its primary endpoint in a phase 3 psoriatic arthritis (PsA) trial, topping placebo at reducing symptoms. At Week 12, 57% of patients taking a 15 mg dose and 64% of patients on a 30 mg dose hit ACR20, a benchmark on a commonly used scale from the American College of Rheumatology to measure joint swelling and more. Just 24% of placebo patients reached the same mark.

Full results from the trial, dubbed Select-PsA2, will roll out at a future medical meeting and in a peer-reviewed publication, AbbVie said. Theyll also support regulatory submissions for Rinvoq in PsA, Michael Severino, M.D., company vice chairman and president, said in a statement.

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RELATED:AbbVie scores blockbuster approval for RA med Rinvoq, its crucial Humira follow-up

"Too many people living with psoriatic arthritis still fail to achieve their treatment goals, underscoring a clear medical need for additional therapeutic options," he added.

Those therapeutic options have multiplied recently with the advent of the IL-17A class, beginning with a PsA nod for Novartis Cosentyx in early 2016. Eli Lillys Taltz followed up with its own late the following year, and the two have been battling it outin the market ever since.

AbbVie isnt afraid of a little competition in the anti-inflammatory market, though. After all, its positioning Rinvoq as a follow-up to Humira, the worlds best-selling drug. Analysts expect the med to hit $2.2 billion in annual sales per year by 2023, helping AbbVie fill the gap left by Humira biosimilars.

RELATED:AbbVie's Rinvoq label portends safety warnings for future JAKsincluding Gilead's

Theres just one potential snag: Rinvoq is a member of the JAK inhibitor class, which has recently been plagued by safety issues.

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Meet University of Arizona Arthritis Center researchers – Jewish Post

Tuesday, November 5th, 2019

Conquering Arthritis Meet the University of Arizona Arthritis Center Researchers will be presented Wednesday, Nov. 6, 6-7:15 p.m., at the Health Sciences Innovation Building on the UA Health Science campus, 1670 E. Drachman St., Tucson.

This event features a look into the future of care, prevention, and ultimately a cure, for this debilitating disease. A panel discussion with UArizona Arthritis Center Director C. Kent Kwoh, MD, pain management specialist Mohab Ibrahim, PhD, MD, and mind-body medicine pioneer Esther Sternberg, MD, will follow the researcher open house and poster displays.

The U.S. Centers for Disease Control and Prevention estimate nearly 55 million Americans have some form of arthritis, including almost half of those over age 65. Arthritis affects more women than men and can affect children as young as 6 months old. It is the leading cause of disability in the United States.

The UArizona Arthritis Center is Arizonas only multi-disciplinary center of excellence dedicated to research and education into the causes, treatments and eventually a cure for arthritis. The center conducts basic, translational and epidemiological research to understand why patients get arthritis, the risk factors for who gets arthritis and analyzes the outcomes to understand how arthritis impacts the patients quality of life.

Featured UArizona Arthritis Center researchers who will present at the event include:

Research topics will include:

Seating for the lecture is limited and prior registration is requested. For more information or to register, visit the UArizona Arthritis Center website, arthritis.arizona.edu, or call 520-626-5040 or email [emailprotected]

Free parking is available after 5 p.m. in the Lot Specific 2012 parking lot next to the Health Sciences Innovation Building and the Lot Specific 2147 parking lot across the street on Cherry Avenue between Helen and Mabel Streets, as well as in all Lot Specific parking lots on the UArizona Health Sciences campus and the Health Sciences Garage (formerly the Banner University Medical Center Tucson Visitor/Patient Parking Garage) at 1501 N. Campbell Ave. For disabled parking, or drop off location next to the Health Sciences Innovation Building, please email [emailprotected], or call 520-626-5040.

If you have questions concerning access, wish to request a Sign Language interpreter or disability-related accommodations, contact Tracy Shake, 520-626-5040, email: [emailprotected]

The lecture is part of the Living Healthy with Arthritis series of free monthly talks presented by the UArizona Arthritis Center at the UArizona College of Medicine Tucson and supported through the Susan and Saul Tobin Endowment for Research and Education in Rheumatology.

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Meet University of Arizona Arthritis Center researchers - Jewish Post

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Changes in Opioid Utilization Following Tumor Necrosis Factor Inhibitor Initiation in Patients with Rheumatoid Arthritis – DocWire News

Tuesday, November 5th, 2019

INTRODUCTION:

Pain control is one of the most important aspects ofrheumatoid arthritis(RA) management from the patients perspective. Newer generations of RA treatment including tumor necrosis factor inhibitor (TNFi) have the potential to alleviate pain and thus reduce opioid utilization. However, patterns of opioid utilization before and after TNFi initiation have not been well characterized. This study aims to examine multiple measures of change in opioid utilization after the initiation of TNFi.

Patients aged 18years with RA and 24months continuous enrollment between January 2007 and December 2015 who newly initiated a TNFi in IQVIA Health Plan Claims Data were included in our study. Opioid utilization at baseline and during follow-up were identified and compared.

Of 2330 patients with RAthat were included in the study, 38.8% of patients used opioids in both baseline and follow-up periods. From pre-index to post-index, the proportion of patients receiving any opioid decreased from 54.0 to 51.0%. In addition, the proportion of those who received 50mg median daily MED decreased from 12.6 to 10.6% during pre-post periods.

This real-world study of commercially insured patients with RA suggests that opioid use among thesepatients is prevalent. There was a small decrease in overall opioid utilization after TNFi initiation.

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Changes in Opioid Utilization Following Tumor Necrosis Factor Inhibitor Initiation in Patients with Rheumatoid Arthritis - DocWire News

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Health Beat: 5 things that make arthritis more painful – WFMZ Allentown

Friday, October 25th, 2019

ATLANTA - If you have arthritis, you know all about the pain, swelling, and stiffness that the disease brings on.

"We're seeing arthritis at an earlier age, not only in the knees, but shoulders, really everywhere," said Dr. Mathew Pombo of Emory Orthopedics & Spine Center. "It's becoming an epidemic of sorts."

But did you know certain habits can make your symptoms worse? Staying still is the first mistake that can intensify your pain. Regular physical activity makes your joints more flexible, but too much exercise can also be a bad thing.

"We also have a lot of younger people participating in sports, and we know that prior injury leads to post-traumatic arthritis," Pombo continued.

Try swimming, biking or walking for about 30 minutes a day. Ignoring your dental health may also lead to worse problems. One study found the bacterium that causes periodontal disease increases the severity of rheumatoid arthritis.

The wrong foods can also cause inflammation in the body and trigger symptoms. Some ingredients to avoid: sugar, saturated fats, refined carbs, omega-six fatty acids, MSG, gluten, aspartame, and alcohol.

Lastly, stress could make your symptoms worse. A trauma or stressful situation can actually trigger the development of certain types of arthritis. Yoga, meditation, and getting enough sleep can help you manage your stress levels.

Smoking is another bad move. Recent research shows both current and past smokers with arthritis had worse symptoms and more joint damage than those who never smoked.

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Health Beat: 5 things that make arthritis more painful - WFMZ Allentown

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Arthritis: whats the weather got to do with it? – The Week UK

Friday, October 25th, 2019

Scientists have discovered an unusual link between the severity of arthritis-related pain and weather.

For years, health experts have suspected that weather may play a key role in the severity of arthritic symptoms.

The BBCsays that hearing someone say their knee is playing up because of the weather is pretty common - usually because of the cold, adding thatsome say they can even predict the weather based on how their joints feel. However, there has been no scientific consensus on the subject.

But this week, the University of Manchester published a study of around 2,500 people suffering from arthritis in all 124 postcode areas of the UK, which asked them to record their levels of distress on a daily basis using their smartphone, The Telegraph says.

To their surprise, the researchers found that sufferers were 20% more likely to be in pain on days that were humid and windy with low atmospheric pressure than they were on days with average weather.

For a round-up of the most important stories from around the world - and a concise, refreshing and balanced take on the weeks news agenda - try The Week magazine. Get your first six issues for 6

The BBC reports that if someoneschances of a painful day with average weather were five in 100, they would increase to six in 100 on a damp and windy day.

However, the researchers were also keen to stress that they found no link between temperature and pain, or rain and pain, but that a mixture of factors such as wind, humidity and low atmospheric pressure did have an effect.

The study, called Cloudy with a Chance of Pain, was funded by the charity Versus Arthritis and ran from January 2016 to April 2017.There were more than five million pieces of data submitted.

Professor Will Dixon, who led the study, said that weather has been thought to affect symptoms in patients with arthritis since Hippocrates and added that around three quarters of people living with arthritis believe their pain is affected by the weather.

The analysis showed that on damp and windy days with low pressure the chances of experiencing more pain, compared to an average day, was around 20%.

He also suggested that the findings mightallow people who suffer from chronic pain to plan their activities, completing harder tasks on days predicted to have lower levels of pain.

Dr Stephen Simpson, director of research at Versus Arthritis, said: We know that of the 10 million people in the UK with arthritis, over half experience life-altering pain every day.

Supporting effective ways of self-managing pain can make all the difference for people with arthritis, helping them to get and stay in work, to be full members of the community and simply to belong.

This research will help us understand the bigger picture of the complexity of pain caused by arthritis and how people with the condition can take control of it.

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Arthritis: whats the weather got to do with it? - The Week UK

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Weather, or not? Study finds chronic pain tends to be worse on humid, but not cold, days – MinnPost

Friday, October 25th, 2019

People with painful chronic conditions such as arthritis tend to experience more pain on humid days than on dry ones, according to a British study published Thursday in the journal NPJ Digital Medicine.

When days are windy and have low atmospheric pressure, pain is also more likely to increase, although to a lesser extent than when the humidity is high, the study also reports.

No evidence was found linking cold days with more pain unless those days were also damp and windy.

The results of this study could be important for patients in the future for two reasons, said William Dixon, the lead author of the research and an epidemiologist at the University of Manchester, in a released statement. Given we can forecast the weather, it may be possible to develop a pain forecast knowing the relationship between weather and pain. This would allow people who suffer from chronic pain to plan their activities, completing harder tasks on days predicted to have lower levels of pain.

The dataset will also provide information to scientists interested in understanding the mechanisms of pain, which could ultimately open the door to new treatments, he adds.

As Dixon and his co-authors point out in their paper, people with arthritis have blamed weather for worsening their symptoms since at least the fifth century BCE, when the Greek physician Hippocrates was writing his medical treatises. Today, about three-quarters of individuals living with arthritis believe weather affects their pain.

Past studies have investigated these claims, but with conflicting results most likely because such studies have tended to involve a small number of people (fewer than 100) and/or a short time frame (a month or less).

The current study, according to its authors, is the first to use a large dataset one collected from smartphones to look at the relationship between local weather and daily pain among people with chronic conditions over a long period of time.

For the study, Dixon and his colleagues analyzed data collected from 2,658 people, aged 17 and older, from across the United Kingdom. All had a painful, chronic medical condition, such as arthritis, fibromyalgia, migraine or neuropathy. Most, however, had arthritis.

At the start of the study, participants were asked to download a smartphone app, which asked them each evening to answer a series of questions about symptoms they had experienced that day. The participants did so on most days for about six months.

The researchers used the smartphones GPS to determine the local weather for each patient on each day. They then looked for correlations between various weather factors and the patients reported symptoms.

High humidity had the strongest link with increased pain, although high wind and low atmospheric pressure also showed significant associations.

And when all three of those weather elements occurred together, there was a kind of pain trifecta, the data revealed.

The analysis showed that on damp and windy days with low pressure the chances of experiencing more pain, compared to an average day, was around 20 percent, says Dixon. This would mean that, if your chances of a painful day on an average weather day were 5 in 100, they would increase to 6 in 100 on a damp and windy day.

That may seem like a small increase, but, as Dixon and his colleagues note, it could be a meaningful change for many people living with chronic pain.

The study found no link between temperature alone and pain symptoms.

And although weather is known to affect day-to-day mood and physical activity, those factors were not found to have much of an impact on the studys findings.

The research comes with caveats. Most notably, it involved only people living in the United Kingdom, so its findings may not be applicable to other populations. In addition, the study began with about 10,000 participants, but most failed to complete enough of the daily questionnaires to be included in the final analysis. There may be something different between the people who stayed in the study and those who dropped out a difference that may make the studys results less reliable.

Still, the findings are intriguing. They may also offer some reassurance to people who struggle with controlling chronic pain.

So many people live with chronic pain, affecting their work, family life and their mental health. Even when weve followed the best pain management advice, we often still experience daily pain, says Carolyn Gamble, one of the authors of the study and a graduate student at the University of Manchester, in a released statement. Gamble has a form of arthritis known as ankylosing spondylitis.

Knowing how the weather impacts on our pain can enable us to accept that the pain is out of our control, it is not something we have done, or could have done differently in our own self-management, she adds.

FMI: You can read the study in full on NPJ Digital Medicines website. The study was funded by Versus Arthritis, a British nonprofit.

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Weather, or not? Study finds chronic pain tends to be worse on humid, but not cold, days - MinnPost

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Learn how to curb the pain, stop the falls with tai chi program this fall – Chicago Daily Herald

Friday, October 25th, 2019

The CDC estimates that more than 1 in 4 adults age 65 or older will fall each year. Out of these falls, 1 in 5 will result in serious injury, such as broken bones and head injuries.

In addition, the Arthritis Foundation estimates that over 50 million adults suffer from one of the many forms of arthritis resulting in pain, stiffness, swelling and decreased ability to perform normal daily tasks.

The "Tai Chi for Arthritis and Fall Prevention" is an evidence-based program recommended by both the Arthritis Foundation and the National Council on Aging to manage arthritis and reduce fall risk, increase balance and flexibility, and decrease stress.

The program was developed by Dr. Paul Lam, a family physician in Sydney, Australia who developed arthritis while still in his teens due to the malnutrition he experienced while growing up in China. Dr. Lam used tai chi to manage his own arthritis and eventually worked with tai chi, medical and education experts to create this program.

The Tai Chi for Arthritis and Fall Prevention program uses the Sun style of tai chi which has been modified to make it gentle on the joints, easy to learn, and significantly safer for older adults than other forms of tai chi. Often described as "meditation in motion," it consists of slow, continuous movements with a focus on body awareness, posture, weight shifting, and calming the mind. While the movements appear gentle and graceful, they contain a surprising internal power. Dr. Lam describes it as being like a calm, flowing river that has the power and strength to reshape the earth under its surface.

The power of the "Tai Chi for Arthritis and Fall Prevention" program has been demonstrated in numerous medical studies by showing a significant decrease both in falls and in the pain and stiffness of arthritis.

It is performed using a higher stance than most other forms of tai chi and martial arts moves with higher risk have been modified or replaced with safer alternatives. This makes it both easier and safer for arthritis sufferers and those at risk for falls.

Instructor Diana Nielsen, certified teacher of the "Tai Chi for Arthritis and Fall Prevention" program, says, "I love introducing people to this program and watching their balance and confidence improve. I have practiced other styles of tai chi for years but find this form is best for my own arthritis."

Each class consists of warm up and cool down exercises, a review of previously learned moves, and the learning of one or two new moves in a positive learning atmosphere. Over the course of the program, participants will build the balance and muscular strength that is important in both preventing falls and in stabilizing and protecting arthritic joints. The slow movement against gentle resistance also develops strength in the body's core stabilizer muscles which is critical to good posture and back health.

One does not need to have arthritis or a history of falls to benefit from this program. It is geared toward adults age 55 and older who would like a gentle, low-impact program that will increase their balance, mobility, flexibility, and lower body strength while decreasing stress.

Tai chi student Beverly Adams of Elk Grove Village states that this program has been "very rewarding" and that the "classes have been extremely helpful in my rehabilitation from knee and hip replacement surgery."

The Tai Chi for Arthritis and Fall Prevention program is being offered at the Amita Health Alexian Rehabilitation Hospital, 935 Beisner Road in Elk Grove Village.

It consists of 6 one-hour class sessions and is taught by Diana Nielsen, a licensed occupational therapy assistant and a certified instructor of the Tai Chi for Arthritis and Fall Prevention program.

A new class will be starting at 11 a.m. Tuesday, Nov. 5. Register in advance by calling (847) 981-5556, option 2. All participants for this program must be able to walk unassisted for at least 100 feet for safety.

For questions on this program including additional class times and locations, please email TCAFP.DN@gmail.com.

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Learn how to curb the pain, stop the falls with tai chi program this fall - Chicago Daily Herald

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Arthritis pain is linked to the weather, new study confirms – Gloucestershire Live

Friday, October 25th, 2019

People with arthritis are more likely to feel pain on humid, windy days, new research suggests.

Scientists from the University of Manchester found sufferers were 20% more likely to be in pain on days that are humid and windy with low atmospheric pressure than on days with average weather.

The study, funded by the charity Versus Arthritis, examined data from 2,658 people, who provided daily data on pain levels on most days for around six months via their smartphones.

The group had a range of different health issues, predominantly arthritis, but also including fibromyalgia, migraine and neuropathic pain.

According to the research, humid days were the most likely to be painful, whereas dry days were the least likely.

Low pressure and higher wind speed were also linked to more painful days, although to a lesser extent than humidity.

The researchers found no solid link with changing temperature or rainfall, although cold days that were also damp and windy could be more painful.

As part of the study, participants used a dedicated smartphone app to record daily symptoms which were then compared with local weather reports based on the phone's GPS.

Professor Will Dixon, from the University of Manchester, who led the study, said: "Weather has been thought to affect symptoms in patients with arthritis since Hippocrates.

"Around three quarters of people living with arthritis believe their pain is affected by the weather.

"Yet, despite much research examining the existence and nature of this relationship, there remains no scientific consensus.

"Our analysis showed that on damp and windy days with low pressure the chances of experiencing more pain, compared to an average day, was around 20%.

"Given we can forecast the weather, it may be possible to develop a pain forecast knowing the relationship between weather and pain.

"This would allow people who suffer from chronic pain to plan their activities, completing harder tasks on days predicted to have lower levels of pain."

Dr Stephen Simpson, director of research at Versus Arthritis, said: "We know that of the 10 million people in the UK with arthritis, over half experience life-altering pain every day.

"Supporting effective ways of self-managing pain can make all the difference for people with arthritis, helping them to get and stay in work, to be full members of the community and simply to belong.

"This research will help us understand the bigger picture of the complexity of pain caused by arthritis and how people with the condition can take control of it."

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Arthritis pain is linked to the weather, new study confirms - Gloucestershire Live

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Polyarticular JIA Patients Show Lesser Inflammation, Affected Joints with Early Use of Infliximab, Study Says – Juvenile Arthritis News

Friday, October 25th, 2019

Early treatment with infliximab sold under the brand name Remicade, among others leads to lower inflammation and fewer joints showing active disease over 12 months in children and adolescents with polyarticular idiopathic arthritis (pJIA), a single center study in China suggests.

But to be effective for a full year, treatment soon after disease onset seems essential, its researchers wrote.

The study, Infliximab therapy and outcomes in patients with polyarticular juvenile idiopathic arthritis: a single-center study in China, was published in the World Journal of Pediatrics.

Advances in the development and approval of biologic therapies over the last two decades have had a significant impact on the outcome of children with pJIA.

Compared to other disease types, pJIA patients are more likely tofail to respond to initial treatment withdisease-modifying anti-rheumatic drugs (DMARDs). But biologic DMARDs have helped to manage disease activity and lessen symptoms.

Among JIA patients, pJIA patients especially those withhigh risk factors [that include]arthritis of the hip or cervical spine, and radiographic damage have more aggressive disease and worse functional outcomes, the team wrote.

Infliximabis a biologic DMARD designed to specifically target and block TNF-alpha, a protein that promotes inflammation and is involved in autoimmunity. This type of therapy has shown efficacy in people with pJIA, but differences exist as to an optimal treatment regimen, the researches noted.

The teamreviewed the long-term impact of treatment with infliximab in 40 children (ages 2 to 13 at diagnosis) with pJIA. All were treated and followed at ChildrensHospital of Chongqing Medical University over an eight year-period starting in January 2010.

Patients were divided into three groups based on their disease course and when they started on infliximab. Nine (group A) started treatment within three months of disease onset, 13 (group B) between three months and one year of onset, while the remaining 18 (group C) initiated treatment more than one year after disease onset.

All patients were given at least four doses of infliximab (36 mg/kg) over three months. Twenty-six received six doses (over six months), and eight patients had nine doses of infliximab, which corresponds to a 12-month treatment period.

Results showed that the erythrocyte sedimentation rate (ESR) an indicator of active inflammation was significantly lower in all groups after three and six months of therapy, compared to pre-treatment values. But this benefit, after 12 months, was only maintained in patients with early treatment (group A).

Children in group A were also the only ones to show stable decreases over 12 months in the number of joints with active disease defined as joints that were tender or painful to move, were swollen, or had limited motion. Also used was the 27-point juvenile arthritis disease activity score (JADAS-27), which includes a physician assessment, a parent/patient global evaluation, ESR rates, and an active joint count.

Patients in groups B and C alsoshowed fewer joints with active disease and a lower JADAS-27 score up to six months of treatment, but experienced increases in both assessments at 12 months. These increases were statistically significant when treatment was started more a year after disease onset (group C).

Overall, infliximab can dramatically improve the outcomes in polyarticular JIA patients, and it should be introduced early during the clinical course, the team wrote.

Total Posts: 11

Jos is a science news writer with a PhD in Neuroscience from Universidade of Porto, in Portugal. He has also studied Biochemistry at Universidade do Porto and was a postdoctoral associate at Weill Cornell Medicine, in New York, and at The University of Western Ontario in London, Ontario, Canada. His work has ranged from the association of central cardiovascular and pain control to the neurobiological basis of hypertension, and the molecular pathways driving Alzheimers disease.

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Polyarticular JIA Patients Show Lesser Inflammation, Affected Joints with Early Use of Infliximab, Study Says - Juvenile Arthritis News

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Arthritis risk linked to obesity may be passed down through generations – Washington University School of Medicine in St. Louis

Thursday, October 24th, 2019

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Mouse studies show effects can linger at least two generations

Multiple generations of mice studied in the lab of Farshid Guilak, PhD, at Washington University School of Medicine in St. Louis indicate obesity has an impact on arthritis risk of future generations.

Arthritis affects one in five Americans, but according to the Centers for Disease Control and Prevention, that number jumps to one in three among people with obesity. Now, new research from Washington University School of Medicine in St. Louis suggests obesity may increase arthritis risk not only in obese people but in their children and grandchildren, too.

Studying mice that became obese after being fed a high-fat diet, the research team found that the animals had an elevated risk for osteoarthritis, a condition that causes cartilage in the joints to break down and is the most common type of arthritis.

Surprisingly, they also found that the mices offspring, even when fed a diet lower in fat, tended to gain nearly 20% more weight than the offspring of their littermates that had never been overweight. In addition, they were at higher risk for arthritis. The same was true for the next generation of mice as well, which gained up to 10% more weight.

The study is published online Oct. 24 in the journal Arthritis & Rheumatology.

This study tells us that environmental factors can influence how genes behave and influence the risk for arthritis for multiple generations, said senior investigator Farshid Guilak, PhD, a professor of orthopedic surgery. Arthritis prevalence is affecting many more people than it used to, more than 250 million people worldwide, and these findings suggest that obesity may help explain why the disorder is becoming so much more common.

Guilak and his team analyzed more than 120 mice whose parents had consumed a high-fat diet. The researchers found that the offspring despite having eaten a low-fat diet were significantly heavier and had more body fat than the offspring of mice that hadnt consumed a high-fat diet.

Then, when those mice had pups the grandchildren of the original mice that third generation of mice also had higher levels of inflammatory molecules and cells in their systems than their littermates, despite never having been fed a high-fat diet. Higher amounts of those molecules, called cytokines, are linked to a variety of problems, including arthritis. In fact, the third-generation mice had higher levels of molecules that cause inflammation, and lower levels of molecules that protect against inflammation. The children and grandchildren of the obese mice in the study also were more likely to have bone and cartilage changes that put them at risk for osteoarthritis.

We cant assume everything we found in these mice will turn out to be true for people, said first author Natalia S. Harasymowicz, PhD, a postdoctoral fellow in Guilaks lab. But theres more and more evidence that when parents eat a bad diet or smoke or abuse alcohol, the next generation is more likely to inherit a predisposition for diabetes, cancer or other diseases. Here, weve shown the same appears to be true for arthritis.

Guilak, who also is director of research at Shriners Hospitals for Children St. Louis, said that in the past, scientists had assumed that the relationship between obesity and osteoarthritis was a mechanical one: More weight puts stress on joints, eventually leading to the pain and stiffness of arthritis.

Weve known for years that obesity is the No. 1 preventable risk factor for osteoarthritis, Guilak said. It turns out, however, that obesity also increases arthritis risk in body parts that dont bear weight, like the hand or the thumb.

Guilaks lab has determined that inflammation plays a much more important role.

What we find is that changes in mechanical loading that occur with obesity dont seem to be the primary risk factors for arthritis, he said. Almost all of the risk is coming from either metabolic or dietary influences, and that risk is then passed down to subsequent generations.

The animals genetic makeup doesnt change to cause increased risk of arthritis. Rather, scientists refer to the changes as epigenetic, meaning that behavior in this case, consuming a high-fat diet changes the way genes work. Its those changes that are passed on.

Poor diet and bad habits may affect not only the individual who has such habits but also future generations, Harasymowicz said. However, recognizing that potential risk may convince people to take steps to be healthier and to reduce their weight, potentially lowering risks for their children and grandchildren.

Harasymowicz NS, Choi YR, Wu CL, Iannucci L, Tang R, Guilak F. Intergenerational transmission of diet-induced obesity, metabolic imbalance, and osteoarthritis in mice. Arthritis & Rheumatology, published online Oct. 24, 2019.

This work was supported by 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, AG46927, AR073752, OD10701, AR060719, AR057235. Additional funding was provided by Shriners Hospitals for Children, 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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Arthritis risk linked to obesity may be passed down through generations - Washington University School of Medicine in St. Louis

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Curb the Pain, Stop the Falls (Session starting Nov 7) – Chicago Daily Herald

Thursday, October 24th, 2019

The CDC estimates that more than 1 in 4 adults aged 65 years and older will fall each year. Out of these falls,1in 5 will result in serious injury, such as broken bones and head injuries. In addition, the Arthritis Foundation estimates that over 50 million adults suffer from one of the many forms of arthritis resulting in pain, stiffness, swelling and decreased ability to perform normal daily tasks.

Tai Chi for Arthritis and Fall Prevention is an evidence-based program recommended by both the Arthritis Foundation and the National Council on Aging to manage arthritis and reduce fall risk, increase balance and flexibility, and decrease stress. The Tai Chi for Arthritis and Fall Prevention program was developed by Dr. Paul Lam, a family physician in Sydney, Australia who developed arthritis while still in his teens due to the malnutrition he experienced while growing up in China. Dr. Lam used tai chi to manage his own arthritis and eventually worked with tai chi, medical and education experts to create this program.

The Tai Chi for Arthritis and Fall Prevention program uses the Sun style of tai chi which has been modified to make it gentle on the joints, easy to learn, and significantly safer for older adults than other forms of tai chi. Often described as "meditation in motion," it consists of slow, continuous movements with a focus on body awareness, posture, weight shifting, and calming the mind. While the movements appear gentle and graceful, they contain a surprising internal power. Dr. Lam describes it as being like a calm, flowing river that has the power and strength to reshape the earth under its surface.

The power of the Tai Chi for Arthritis and Fall Prevention program has been demonstrated in numerous medical studies by showing a significant decrease both in falls and in the pain and stiffness of arthritis. It is performed using a higher stance than most other forms of tai chi and martial arts moves with higher risk have been modified or replaced with safer alternatives. This makes it both easier and safer for arthritis sufferers and those at risk for falls. Instructor Diana Nielsen, certified teacher of the Tai Chi for Arthritis and Fall Prevention program, says, "I love introducing people to this program and watching their balance and confidence improve. I have practiced other styles of tai chi for years but find this form is best for my own arthritis."

Each class consists of warm up and cool down exercises, a review of previously learned moves, and the learning of one or two new moves in a positive learning atmosphere. Over the course of the program, participants will build the balance and muscular strength that is important in both preventing falls and in stabilizing and protecting arthritic joints. The slow movement against gentle resistance also develops strength in the body's core stabilizer muscles which is critical to good posture and back health.

One does not need to have arthritis or a history of falls to benefit from this program. It is geared towards adults age 55 and older who would like a gentle, low-impact program that will increase their balance, mobility, flexibility, and lower body strength while decreasing stress. Tai chi student Beverly Adams of Elk Grove Village, IL states that this program has been "very rewarding" and that the "classes have been extremely helpful in my rehabilitation from knee and hip replacement surgery."

The Tai Chi for Arthritis and Fall Prevention program is being offered at the AMITA Health Alexian Rehabilitation Hospital located at 935 Beisner Road in Elk Grove Village, IL. It consists of 6 one-hour class sessions and is taught by Diana Nielsen, a licensed occupational therapy assistant and a certified instructor of the Tai Chi for Arthritis and Fall Prevention program. A new class will be starting on Tuesday, November 5th at 11 am; please register in advance by calling 847-981-5556, option 2. All participants for this program must be able to walk unassisted for at least 100 feet for safety. For questions on this program including additional class times and locations, please email TCAFP.DN@gmail.com.

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Curb the Pain, Stop the Falls (Session starting Nov 7) - Chicago Daily Herald

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Dr. Roach: The link between Lyme disease and arthritis – The Detroit News

Thursday, October 24th, 2019

Keith Roach, To Your Health Published 12:00 a.m. ET Oct. 22, 2019

Dear Dr. Roach: What is known about arthritis later in life for someone who had early treatment for Lyme disease? I had it as a teenager in the late 1980s and was told by my doctor that arthritis could be an issue later. I was treated with an IV antibiotic, which I believe was the go-to treatment at the time.

J.A.

Dear J.A.: Lyme disease, a bacterial infection transmitted by the deer tick, causes arthritis in about half of people with untreated Lyme disease. Among those who are recognized and treated early, joint and muscle pains are common, but inflammation of the joints, along with the possibility of joint damage, is unusual. So, if you were recognized and treated early, the likelihood of developing any joint problems should be no different from your risk if you had never had Lyme disease.

Lyme arthritis most commonly affects one knee, but it can affect other joints, such as the shoulder, ankle, elbow or jaw (TMJ). Eleven percent of untreated Lyme disease patients developed permanent joint damage, but only 2% developed permanent joint disability. This study comes from a time when Lyme disease frequently went unnoticed and untreated.

Diagnosing Lyme disease can be a challenge, especially when a rash has gone unnoticed or was never present at all. A doctor needs vigilance and appropriate laboratory testing to find undiagnosed Lyme disease. Conjunctivitis, damage to the nerves of the face or eyes, Lyme meningitis and abnormal electrocardiograms (including heart block) all are occasional manifestations of Lyme disease and should prompt a clinician to consider the diagnosis.

Early treatment of Lyme disease was, and is still, most commonly oral doxycycline.

Dear Dr. Roach: I just completed a bone density scan that showed that I have osteopenia. My doctor has suggested that I take both vitamin D and calcium. I read your recent column that said this can increase stroke risk, which my doctor did not tell me. I am confused that she would suggest I take vitamin D and calcium if it would increase risk of stroke.

L.B.

Dear L.B.: Taken together, calcium and vitamin D reduce the risk of fracture in women with osteoporosis. Naturally, your doctor is concerned about your bones and wants to prevent a fracture, which can be devastating.

However, there is a substantial and growing body of literature suggesting that calcium supplements, but not dietary calcium, increase the risk of heart disease, and a new study showed an increased risk of stroke among those taking calcium supplements and vitamin D. However, there are other studies that have NOT shown an association between calcium supplements and heart attack or stroke. Experts are divided.

There is then a question of competing risks: The benefit of a decreased fracture risk you get in taking the calcium and vitamin D versus the possible harm in stroke and heart disease. Your doctor may have balanced the risk and felt the calcium was more benefit than harm. She may also be in the school that feels calcium supplements have little or no risk.

I am risk-averse for my patients and feel that, when possible, taking calcium through food, not supplements, gives the best of both worlds: reduced fracture risk without increasing the risk of heart disease and stroke. This may require a broader change in diet, which may be inconvenient to some. Calcium-fortified foods are another option.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.

Read or Share this story: https://www.detroitnews.com/story/life/advice/2019/10/22/keith-roach-health/40354979/

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Dr. Roach: The link between Lyme disease and arthritis - The Detroit News

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Janssen seeks to expand Tremfya in arthritis – PharmaTimes

Thursday, October 24th, 2019

Janssen has submitted a Type II Variation Application to the European Medicines Agency (EMA), seeking first-in class approval of its Tremfya (guselkumab) for adult patients with active psoriatic arthritis (PsA).

If approved, it will mark the second approved indication for the human monoclonal antibody in the European Union.

Janssen, a division of Johnson & Johnson, says the submission is based on data from the Phase III DISCOVER-1 and DISCOVER-2 studies, a programme that comprises the first-ever Phase III studies evaluating a human monoclonal antibody targeting the p19 subunit of IL-23 in patients with active PsA.

Previous to this submission, the medicines was approved in the European Union for the treatment of adult patients with moderate to severe plaque psoriasis in November 2017, and has also been approved in the US, Canada, Japan and several other countries worldwide.

Its estimated that up to a third of the 14 million people who are living with psoriasis in Europe will also develop PsA, a chronic, immune-mediated inflammatory disease characterised by both joint inflammation and the skin lesions associated with psoriasis.

Because of this, the submission the toe EMA is an important milestone for people with psoriatic arthritis, who currently have limited treatment options that improve the signs and symptoms of the condition, said Alyssa Johnsen, vice president, rheumatology disease area leader, Janssen.

She continued, With this filing, we hope to offer clinicians a new and innovative treatment option for people living with psoriatic arthritis.

Psoriatic arthritis is a chronic, immune-mediated inflammatory disease characterised by both joint inflammation and the skin lesions associated with psoriasis.

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Janssen seeks to expand Tremfya in arthritis - PharmaTimes

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