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Found 5 results

  1. Cannabinoids for RA: What Rheumatologists Need to Know Linda Peckel Nov 12, 2018 Studies indicate the benefits of treatment with cannabinoids for rheumatic diseases in general.1-3 In rheumatoid arthritis (RA), the target of cannabinoid therapy has been pain reduction. Clinical data do not currently support an indication for reduction of disease severity, although new studies continue to explore this potential. References: 1. Katz-Talmor D, Katz I, Porat-Katz BS, Shoenfeld Y. Cannabinoids for the treatment of rheumatic diseases - where do we stand? Nat Rev Rheumatol. 2018 Jun 8. doi: 10.1038/s41584-018-0025-5. [Epub ahead of print] 2. Gui H, Tong Q, Qu W, Mao CM, Dai SM. The endocannabinoid system and its therapeutic implications in rheumatoid arthritis. Int Immunopharmacol. 2015;26:86-91. 3. Richards BL, Whittle SL, Buchbinder R. Neuromodulators for pain management in rheumatoid arthritis (review). Cochrane Database Syst Rev. 2012;1:CD008921. http://www.rheumatologynetwork.com/arthritis/cannabinoids-ra-what-rheumatologists-need-know?rememberme=1&elq_mid=4976&elq_cid=1830808
  2. UK rheumatologists use factors other than NICE guidelines to treat patients with RA June 27, 2016 LONDON — Rheumatologists from the United Kingdom consider other factors apart from the National Institute for Health and Care Excellence, or NICE, clinical guidelines on cost to make decisions on anti-tumor necrosis factor therapy prescription doses, according to a speaker here at the EULAR Annual Congress. “Rheumatologists’ … experiences come into some of this as well, so if they are used to using one particular treatment they would be more likely to use it subsequently,” Sean Gavan, PhD, of the Manchester Centre for Health Economics, United Kingdom,said during a press conference. “There was a sense from all of my participants that, to some extent, NICE guidance was restrictive of what they could do, and so to combat this, they were selective to what treatments they gave patients earlier on to free up more treatments down the line. Occasionally, they would manipulate the DAS28 score to give [anti-tumor necrosis factor] therapy to patients who, according to NICE guidance, would not be allowed to have that treatment.” Gavan and colleagues conducted telephone interviews with 11 consultant rheumatologists from hospitals in England. Rheumatologists were asked to speak of factors that influence their decisions for treatment of patients with rheumatoid arthritis (RA), which included the decision to initiate anti-tumor necrosis factor (anti-TNF) therapy, choice of first-line anti-TNF therapy and treatment options in remission. Investigators used thematic framework analysis to analyze interview transcripts. Results showed that the participants’ choice for first-line anti-TNF treatment was rarely influenced by costs, except when local service commissioners offered a less expensive anti-TNF. Gavan and colleagues found when it came to first-line biosimilar anti-TNF agents, participants’ expressed cautious optimism due to potential cost savings. Participants’ tried to maintain clinical autonomy and involved patients in decision-making when use of cheapest anti-TNF was considered. “A lot of the participants suggested the clinical evidence base was, perhaps, slightly ahead of what NICE was saying currently in its guidance, but then when they decided to implement certain treatments decisions they were selective over which pieces of evidence they used to guide certain decisions,” Gavan said. – by Monica Jaramillo Reference: Gavan S, et al. Abstract #OP0198-HPR. Presented at: EULAR Annual Congress; June 8-11, 2016; London. Disclosure: Gavan reports no relevant financial disclosures.
  3. Israeli autoimmune disease treatment with parasitic worms has ‘marvelous’ results Professor Yehuda Schoenfeld of Tel-Aviv University, co-founder of medical startup TPCera, uses parasitic worms to treat autoimmune diseases, and the results have been “marvellous.” An expert in SLE & autoimmune diseases, such as MS & Rheumatoid Arthritis.
  4. Pneumococcal Vaccine PPSV23 Does Not Protect RA patients News | February 13, 2017 | Rheumatoid Arthritis By Aisha T. Langford, PhD, MPH The 23-valent pneumococcal polysaccharide vaccine (PPSV23) does not prevent pneumonia in rheumatoid arthritis patients, a new study finds. This study appears in the January 25 online issue of Arthritis Research & Therapy. “While PPSV23 vaccination is recommended for adults who are at least 65 years of age, our results suggest uncertainty regarding its effectiveness for pneumonia in rheumatoid arthritis patients at high risk for infections. Clinicians should keep in mind the patient’s age and the presence of interstitial pneumonia because such patients are at an increased risk of developing pneumonia,” researchers wrote. This was a prospective, double-blind, randomized, placebo-controlled trial conducted with 900 rheumatoid arthritis patients treated with biological or immunosuppressive agents. The goal of the study was to evaluate the effectiveness of PPSV23 in preventing overall pneumonia in high risk patients. Patients were recruited between December 2012 and March 2014 from 32 hospitals across Japan and randomized in a 1:1 ratio to the vaccine group receiving 0.5 ml of PPSV23 or the placebo group. The two primary endpoints were pneumonia and pneumococcal pneumonia. Additionally, demographic and clinical characteristics were evaluated for potential associations with risk for developing pneumonia. Patients were monitored for 12 months after enrollment. In total, 17 of 464 patients in the vaccine group, or 3.7 percent, and 15 patients of 436 in the placebo group, or 3.4 percent, developed pneumonia. There was no significant difference between the two groups. Independent of group assignment, researchers found that the presence of interstitial pneumonia and older age were significantly associated with increased risk of developing pneumonia. It should be noted that neither glucocorticoid dosage or biologic disease-modifying anti-rheumatic drugs usage predicted risk of developing pneumonia in this study. Patients with rheumatoid arthritis are at higher risk for developing pneumonia compared to the general population. Pneumonia is a vaccine-preventable condition in most patients and PPSV23 has been demonstrated to be effective at preventing invasive pneumococcal disease in older adults. However, the efficacy of PPSV23 in patients undergoing immunotherapy is not well researched or understood. To date, few of the clinical trials that have evaluated the effectiveness of PPSV23 have included patients with autoimmune diseases. Given that pneumonia is a leading cause of death among patients with rheumatoid arthritis, a better understanding of how and when to use PPSV23 with this population is needed. This is one of the first-known studies to evaluate a pneumonia vaccine in patients with autoimmune disease. “Our study confirmed that polysaccharide vaccine alone is not effective for prevention of pneumonia. Therefore, sequential administration of PCV13 and PPSV23 could also be an appropriate approach for the prevention for pneumonia in RA patients receiving immunosuppressive treatments,” wrote Kiyoshi Migita, of the Japanese National Hospital Organization, and colleagues. DISCLOSURES This research was supported by a grant from the Japanese National Hospital Organization Evidence-based Medicine study group. REFERENCES Yasumori Izumi, Manabu Akazawa, Yukihiro Akeda, et al. “The 23-valent pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis: a double-blinded, randomized, placebo-controlled trial,” Arthritis Research & Therapy. Published online January 25, 2017. DOI: 10.1186/s13075-016-1207-7. http://www.rheumatologynetwork.com/news/pneumococcal-vaccine-ppsv23-does-not-protect-ra-patients?GUID=&XGUID=&rememberme=1&ts=14022017 Full Report URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5264490/
  5. Common Genetic Pathways Implicated RA and SLE Rheumatoid arthritis and lupus are distinct conditions that present in unique ways, but they do share various genetic risk factors. A recent study revealed a new risk locus for both diseases. Previously, the genetic overlap between the two hadn’t been thoroughly examined. But, a study published in the May Annals of Rheumatic Diseasesidentified additional risk loci that are shared between rheumatoid arthritis and lupus. Using genome-wide association studies, the study, “A combined large-scaled meta-analysis identifies COG6 as a novel shared risk locus for rheumatoid arthritis and systemic lupus erythematosus,” revealed the genetic variant rs9603612 is located near the COG6 (component of oligomeric Golgi complex6) gene. COG6 is located on chromosome 13q14.11, and it’s crucial to proper protein sorting and glycosylation. However, its role in immune-mediated disorders remains unknown. This study is the first comprehensive, large-scale analysis that looks into the genetic overlap between both disorders. Small sample sizes has been a limiting factor to-date. “Our results highlight the existence of a relevant genetic correlation between both diseases, as well as the influence of common molecular mechanisms in their pathophysiology,” the authors wrote. “Since common genetic pathways are implicated in rheumatoid arthritis and lupus, a reclassification of patients from a genetic point of view will lead to more specific and effective therapeutic procedures.” Overall, researchers included 17,552 patients with rheumatoid arthritis, 4,194 patients with lupus, and 46,907 control patients. Data came from Sweden, the United Kingdom, Germany, Italy, Spain, The Netherlands, and the United States. Through silico expression quantitative trait locus analysis, researchers learned the associated polymorphism acts like a regulator variant that influences COG6 expression. In particular, rs9603612 impacts the transcription factor binding and is linked to gene target expression, most likely regulating COG6 expression in monocytes. According to investigators, the protein-protein interaction and gene ontology enrichment analyses pointed to an overlap with specific biological processes. Results pointed specifically to the type I interferon signaling pathway. Additionally, the genetic correlation and polygenic risk score analyses showed cross-phenotype associations between rheumatoid arthritis and lupus. Bivariate analysis revealed a significant genetic correlation between rheumatoid arthritis and lupus. Polygenic risk score analysis showed significant differences between the case groups and controls and that lupus cases had a significant enrichment of rheumatoid arthritis-risk alleles. The findings, they said, point to rs9603612 being a good candidate for being the casual variant involved in the genetic predisposition of autoimmune disorders. Measure Measure Related Notes Laboratory Evaluation of Rheumatic Diseases Laboratory Evaluation of Rheumatic Diseases Marina Magrey Abby Abelson Published: August 2010 The diagnosis of rheumatologic diseases is based on clinical information, blood and imaging tests, and in ... A 'sneaky' disease that affects mostly older women - Business & Innovation - Jerusalem Post A 'sneaky' disease that affects mostly older women Sjogren’s syndrome affects at least 80,000 Israelis, but is under-diagnosed and gets too little attention in medical schools and from drug companies... Systemic lupus erythematosus. SLE. DermNet NZ Systemic lupus erythematosus. SLE What is systemic lupus erythematosus? Lupus erythematosus (LE) is a group of diverse persistent autoimmune inflammatory diseases. Systemic lupus erythematosus (SLE)...
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