New data suggest that
patients with osteoarthritis pain of the knee treated with 60 mg and 120 mg
Cymbalta (duloxetine HCl) once daily experienced significant pain
reduction. Patients taking duloxetine reported significant pain improvement
compared to placebo within the first week of treatment that lasted
throughout the 13-week trial.(1) Results from the study of 231 patients
were presented today at the annual congress of the European League Against
Rheumatism (EULAR) in Paris, France.
Duloxetine showed statistically significant improvement in pain
associated with osteoarthritis of the knee according to the primary
efficacy measure of mean 24-hour average pain scores. Fifty-nine percent of
duloxetine-treated patients experienced a 30 percent improvement in pain
compared with 45 percent of patients taking placebo. Forty-seven percent of
duloxetine-treated patients experienced a 50 percent improvement in pain
compared with 29 percent of placebo-treated patients.
Treatment with duloxetine also was associated with improved patient
outcomes compared with placebo as measured by the Patient Global
Impressions of Improvement (PGI-I) and physical functioning as measured by
the Western Ontario and McMaster Universities (WOMAC) physical functioning
subscale.
In this study, the most common adverse events (occurred at a rate of
greater than or equal to 3 percent and at least twice the rate of placebo)
were nausea, fatigue, somnolence, dizziness, hypertension, constipation and
decreased libido.
"These data are important because it's the first time duloxetine has
been studied in a large, placebo-controlled trial in what's classified as
an inflammatory disease state," said Amy Chappell, M.D., lead study author
and medical fellow II, Eli Lilly and Company. "Although the exact mechanism
of action is unknown, this study may provide important insights into the
treatment of pain in the central nervous system."
It is estimated that 27 million adults in the United States have
osteoarthritis and the prevalence increases with age.(2) Osteoarthritis of
the knee is a common type of this disorder, impacting the lives of
approximately 10 million Americans.(2) Other symptoms of osteoarthritis in
addition to pain include aching, stiffness and limited range of motion of
the joint.(3)
Additional Study Highlights:
- Compared with patients receiving placebo, patients receiving duloxetine
experienced significant improvement in symptom severity associated with
osteoarthritis pain of the knee, including:
Significantly greater reduction in Brief Pain Inventory (BPI)
average pain severity (p
воскресенье, 9 октября 2011 г.
четверг, 6 октября 2011 г.
RA Individuals From Lower GDP Countries Keep Working Despite Worse Symptoms Than Richer Countries
Individuals diagnosed with rheumatoid arthritis (RA) in lower gross domestic product (GDP) countries (GDP below $11,000) are more likely to continue working despite higher disease activity and functional disability scores compared to their counterparts in higher GDP countries (GDP >$24,000) according to a new multinational study presented today at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark.
Among 1,650 individuals from 30 countries whose symptoms had begun during the 2000's and who remained working after RA diagnosis, disability levels according to the Health Assessment Questionnaire (HAQ*) were 0.25 vs. 0.82 in men and 0.50 vs. 0.94 in women (p
Among 1,650 individuals from 30 countries whose symptoms had begun during the 2000's and who remained working after RA diagnosis, disability levels according to the Health Assessment Questionnaire (HAQ*) were 0.25 vs. 0.82 in men and 0.50 vs. 0.94 in women (p
понедельник, 3 октября 2011 г.
Risk Of Heart Attacks And Strokes Reduced By Arthritis Medications
Patients prescribed drugs to treat rheumatoid arthritis could be at a reduced risk of heart attacks and strokes, according to a study published in the open access journal Arthritis Research & Therapy.
An international team of researchers led by Antonio Naranjo of the University of Las Palmas de Gran Canaria, Spain, and colleagues in Argentina, Europe, and the USA have analyzed data from the QUEST-RA (Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis) study. From this study, including 4,363 patients from 48 sites in 15 countries, the team has examined the causes and effects of rheumatoid arthritis, as well as the potential benefits of medications.
Rheumatoid arthritis is a known risk factor for hardening of the arteries and so can lead to stroke and heart attacks occurring in sufferers ten years earlier than in people without the condition. However, earlier studies have shown that treating rheumatoid arthritis with disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, may reduce this risk. The current research quantifies this risk reduction in thousands of patients in the QUEST-RA study.
Naranjo and colleagues found that risk, when adjusted for age, sex, disease activity, and traditional risk factors such as lack of exercise, smoking, diabetes, and high cholesterol levels, correlated strongly with the use of drugs to treat rheumatoid arthritis. Taking methotrexate - the most widely used DMARD - for just one year for example was found to be associated with an 18% reduction in risk of heart attack and an 11% decrease in risk of stroke, the researchers say.
"Our study provides further support of the influence of both traditional and RA specific risk factors in the development of cardiovascular events, especially heart attack" the researchers conclude, "As assessed by this study, the risk was lower with the prolonged use of methotrexate, sulfasalazine, glucocorticoids, leflunomide and TNF-?± blockers."
In an accompanying editorial, Dr Ronald van Vollenhoven of Karolinska Institute, Sweden, reviews the research article. "The possibility that antirheumatic therapy decreases the risk for cardiovascular complications is tantalizing," writes the author. "The current study, while not exactly proving this point, adds a further measure of support to the concept, and suggests that it must now be formally addressed.
1. Cardiovascular disease in patients with rheumatoid arthritis. Results from the QUEST-RA study Antonio Naranjo, Tuulikki Sokka, Miguel A Descalzo, Jaime Calvo-Alen, Kim Horslev-Petersen, Reijo K Luukkainen, Bernard Combe, Gerd R Burmester, Joe Devlin, Gianfranco Ferraccioli, Alessia Morelli, Monique Hoekstra, Maria Majdan, Stefan Sadkiewicz, Miguel Belmonte, Ann-Carin Holmqvist, Ernest Choy, Recep Tunc, Aleksander Dimic, Martin Bergman, Sergio Toloza and Theodore Pincus
Arthritis Research & Therapy (in press)
Article available at journal website: arthritis-research/
All articles are available free of charge, according to BioMed Central's open access policy.
2. Arthritis Research & Therapy is an international, peer-reviewed online and print journal, publishing original research, reviews, commentaries and reports. Studies relate to the rationale and treatment of arthritis, autoimmune disease and diseases of bone and cartilage. The journal is edited by Prof Peter E Lipsky (USA) and Prof Sir Ravinder N Maini (UK) and has an Impact Factor of 3.8.
3. BioMed Central (biomedcentral/) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.
Source: Charlotte Webber
BioMed Central
An international team of researchers led by Antonio Naranjo of the University of Las Palmas de Gran Canaria, Spain, and colleagues in Argentina, Europe, and the USA have analyzed data from the QUEST-RA (Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis) study. From this study, including 4,363 patients from 48 sites in 15 countries, the team has examined the causes and effects of rheumatoid arthritis, as well as the potential benefits of medications.
Rheumatoid arthritis is a known risk factor for hardening of the arteries and so can lead to stroke and heart attacks occurring in sufferers ten years earlier than in people without the condition. However, earlier studies have shown that treating rheumatoid arthritis with disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, may reduce this risk. The current research quantifies this risk reduction in thousands of patients in the QUEST-RA study.
Naranjo and colleagues found that risk, when adjusted for age, sex, disease activity, and traditional risk factors such as lack of exercise, smoking, diabetes, and high cholesterol levels, correlated strongly with the use of drugs to treat rheumatoid arthritis. Taking methotrexate - the most widely used DMARD - for just one year for example was found to be associated with an 18% reduction in risk of heart attack and an 11% decrease in risk of stroke, the researchers say.
"Our study provides further support of the influence of both traditional and RA specific risk factors in the development of cardiovascular events, especially heart attack" the researchers conclude, "As assessed by this study, the risk was lower with the prolonged use of methotrexate, sulfasalazine, glucocorticoids, leflunomide and TNF-?± blockers."
In an accompanying editorial, Dr Ronald van Vollenhoven of Karolinska Institute, Sweden, reviews the research article. "The possibility that antirheumatic therapy decreases the risk for cardiovascular complications is tantalizing," writes the author. "The current study, while not exactly proving this point, adds a further measure of support to the concept, and suggests that it must now be formally addressed.
1. Cardiovascular disease in patients with rheumatoid arthritis. Results from the QUEST-RA study Antonio Naranjo, Tuulikki Sokka, Miguel A Descalzo, Jaime Calvo-Alen, Kim Horslev-Petersen, Reijo K Luukkainen, Bernard Combe, Gerd R Burmester, Joe Devlin, Gianfranco Ferraccioli, Alessia Morelli, Monique Hoekstra, Maria Majdan, Stefan Sadkiewicz, Miguel Belmonte, Ann-Carin Holmqvist, Ernest Choy, Recep Tunc, Aleksander Dimic, Martin Bergman, Sergio Toloza and Theodore Pincus
Arthritis Research & Therapy (in press)
Article available at journal website: arthritis-research/
All articles are available free of charge, according to BioMed Central's open access policy.
2. Arthritis Research & Therapy is an international, peer-reviewed online and print journal, publishing original research, reviews, commentaries and reports. Studies relate to the rationale and treatment of arthritis, autoimmune disease and diseases of bone and cartilage. The journal is edited by Prof Peter E Lipsky (USA) and Prof Sir Ravinder N Maini (UK) and has an Impact Factor of 3.8.
3. BioMed Central (biomedcentral/) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.
Source: Charlotte Webber
BioMed Central
пятница, 30 сентября 2011 г.
What Is Water On The Knee (Knee Effusion)? What Causes Water On The Knee?
Knee effusion, colloquially known as water on the knee, occurs when excess fluid accumulates in or around the knee joint. There are many common causes for the swelling, including arthritis, injury to the ligaments or meniscus, or when fluid collects in the bursa. This condition is known as prepatellar bursitis.
According to Medilexicon's medical dictionary:
Knee effusion is a large bursa between the inferior part of the femur and the tendon of the quadriceps femoris muscle. It usually communicates with the cavity of the knee joint and is pathologically distended with blood or synovial fluid in suprapatellar bursitis ("water on the knee").
A small amount of fluid exists in normal joints. When a joint is affected by arthritis, particularly an inflammatory arthritis such as rheumatoid arthritis (RA), increased abnormal amounts of fluid buildup, the knee appears swollen. The fluid is produced by the tissues that are affected by the arthritis and that line the joint.
What are the symptoms of Knee Effusion?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.
Signs and symptoms of water on the knee depend on the cause of excess fluid build-up in the knee joint. With osteoarthritis, pain occurs when bearing weight. The pain typically subsides with rest and relaxation.
One knee may appear larger than the other. Puffiness around the bony parts of the knee appears prominent when compared with the other knee.
When the knee joint contains excess fluid, it may become difficult to bend or straighten the knee in certain cases.
If an individual has injured his or her knee, he or she may note bruising on the front, sides or rear of the knee. Bearing weight on the knee joint may be impossible and the pain unbearable.
What are the causes of Knee Effusion?
Causes of the swelling can include arthritis, injury to the ligaments of the knee or an accident after which the body's natural reaction is to surround the knee with a protective fluid.
There could also be an underlying disease or condition. The type of fluid that accumulates around the knee depends on the underlying disease, condition or type of traumatic injury that caused the excess fluid. The swelling can, in most cases, be easily cured.
Having osteoarthritis or engaging in high-risk sports that involve rapid cut-and-run movements of the knee, football or tennis for example, means an individual is more likely to develop water on the knee.
In overweight or obese individuals the body places more weight on the knee joint. This causes more wear in the joint. Over time, the body will produce excess joint fluid.
Diagnosing Knee Effusion
An understanding of knee pathoanatomy is an invaluable part of making the correct diagnosis and formulating a treatment plan. Taking a thorough medical history is the key component of the evaluation.
The most common traumatic causes of knee effusion are ligamentous, osseous and meniscal injuries, and overuse syndromes. Atraumatic etiologies include arthritis, infection, crystal deposition and tumor. It is essential to compare the affected knee with the unaffected knee.
Systematic physical examination of the knee, using specific maneuvers, and the appropriate use of diagnostic imaging studies and arthrocentesis establish the correct diagnosis and treatment.
Joint aspiration, also known as arthrocentesis, is a procedure that includes withdrawal of fluid from inside the knee for analysis such as cell count, culture for bacteria, and examination for crystals, such as uric acid or calcium pyrophosphate dihydrate crystals found in gout or pseudogout.
An X-ray is useful to verify that there is no break or dislocation when there is a history of trauma and may show signs of osteoarthritis.
An MRI (Magnetic Resonance Imaging) detects abnormalities of the bone or knee joint, such as a tear in the ligaments, tendons or cartilage.
If the knee is swollen, red and warm to the touch when compared to the other knee, a doctor may be concerned about inflammation due to rheumatoid arthritis or a crystalline arthritis, such as gout or pseudogout, or joint infection. Besides sending the joint fluid to a laboratory for analysis, he or she may request blood tests to determine a white blood cell count, erythrocyte sedimentation rate, and perhaps the level of C-reactive protein or uric acid. If blood tests reveal Lyme's disease antibodies forming, the condition may be attributed to it.
Psoriatic arthritis often undiagnosed cause of joint conditions. Patients with the skin condition psoriasis can also have the related arthritis subtype called psoriatic arthritis. This arthritic condition tends to be overlooked, even in patients with diagnosed psoriasis.
What are the treatment options for Knee Effusion?
Along with any sort of medical care, knee joint effusion responds well to simple self-care measures, such as rest and elevation as well as icing and exercise. As with any sort of injury, ice should be applied to the affected area only for 15 to 20 minutes at a time. With exercise, a series of fitness activities are established by a physical therapist to strengthen the area to support the weakened knee.
Most treatments for knee joint effusion are based on the cause of the condition, making a "standard" approach to care nonexistent. However, many people with water on the knee need to have the excess fluid removed, so one may undergo a procedure known as aspiration.
Finally, one may need a series of corticosteroid injections, non-steroidal anti-inflammatory drugs (NSAIDs) or antibiotics to reduce inflammation or treat an infection. For others, knee surgery or even joint replacement may be necessary.
Preventing Knee Effusion
Avoiding sudden jolting movements and rough running surfaces can help prevent knee injuries. Obesity adds pressure to the vulnerable knee joint, so weight reduction may help.
Exercises considered better for the knees include small (not deep) knee bends and straightening motions done while in supination with most weight on the outside of the foot.
Sports that are easier on the knees include walking, swimming (flutter kicks, knees straight), skating, baseball, cross-country skiing, and, depending on the state of the knee, cycling (seat high, low gear, avoiding hills).
Choose activities to suit your own knee strength and capacity, and remember that sports especially hard on the knees include football, sprinting, soccer, rugby, hockey, squash, volleyball, basketball, downhill skiing, tennis and jogging or anything that pounds, jolts, or twists the knees.
Written by Sy Kraft (B.A.)
According to Medilexicon's medical dictionary:
Knee effusion is a large bursa between the inferior part of the femur and the tendon of the quadriceps femoris muscle. It usually communicates with the cavity of the knee joint and is pathologically distended with blood or synovial fluid in suprapatellar bursitis ("water on the knee").
A small amount of fluid exists in normal joints. When a joint is affected by arthritis, particularly an inflammatory arthritis such as rheumatoid arthritis (RA), increased abnormal amounts of fluid buildup, the knee appears swollen. The fluid is produced by the tissues that are affected by the arthritis and that line the joint.
What are the symptoms of Knee Effusion?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.
Signs and symptoms of water on the knee depend on the cause of excess fluid build-up in the knee joint. With osteoarthritis, pain occurs when bearing weight. The pain typically subsides with rest and relaxation.
One knee may appear larger than the other. Puffiness around the bony parts of the knee appears prominent when compared with the other knee.
When the knee joint contains excess fluid, it may become difficult to bend or straighten the knee in certain cases.
If an individual has injured his or her knee, he or she may note bruising on the front, sides or rear of the knee. Bearing weight on the knee joint may be impossible and the pain unbearable.
What are the causes of Knee Effusion?
Causes of the swelling can include arthritis, injury to the ligaments of the knee or an accident after which the body's natural reaction is to surround the knee with a protective fluid.
There could also be an underlying disease or condition. The type of fluid that accumulates around the knee depends on the underlying disease, condition or type of traumatic injury that caused the excess fluid. The swelling can, in most cases, be easily cured.
Having osteoarthritis or engaging in high-risk sports that involve rapid cut-and-run movements of the knee, football or tennis for example, means an individual is more likely to develop water on the knee.
In overweight or obese individuals the body places more weight on the knee joint. This causes more wear in the joint. Over time, the body will produce excess joint fluid.
Diagnosing Knee Effusion
An understanding of knee pathoanatomy is an invaluable part of making the correct diagnosis and formulating a treatment plan. Taking a thorough medical history is the key component of the evaluation.
The most common traumatic causes of knee effusion are ligamentous, osseous and meniscal injuries, and overuse syndromes. Atraumatic etiologies include arthritis, infection, crystal deposition and tumor. It is essential to compare the affected knee with the unaffected knee.
Systematic physical examination of the knee, using specific maneuvers, and the appropriate use of diagnostic imaging studies and arthrocentesis establish the correct diagnosis and treatment.
Joint aspiration, also known as arthrocentesis, is a procedure that includes withdrawal of fluid from inside the knee for analysis such as cell count, culture for bacteria, and examination for crystals, such as uric acid or calcium pyrophosphate dihydrate crystals found in gout or pseudogout.
An X-ray is useful to verify that there is no break or dislocation when there is a history of trauma and may show signs of osteoarthritis.
An MRI (Magnetic Resonance Imaging) detects abnormalities of the bone or knee joint, such as a tear in the ligaments, tendons or cartilage.
If the knee is swollen, red and warm to the touch when compared to the other knee, a doctor may be concerned about inflammation due to rheumatoid arthritis or a crystalline arthritis, such as gout or pseudogout, or joint infection. Besides sending the joint fluid to a laboratory for analysis, he or she may request blood tests to determine a white blood cell count, erythrocyte sedimentation rate, and perhaps the level of C-reactive protein or uric acid. If blood tests reveal Lyme's disease antibodies forming, the condition may be attributed to it.
Psoriatic arthritis often undiagnosed cause of joint conditions. Patients with the skin condition psoriasis can also have the related arthritis subtype called psoriatic arthritis. This arthritic condition tends to be overlooked, even in patients with diagnosed psoriasis.
What are the treatment options for Knee Effusion?
Along with any sort of medical care, knee joint effusion responds well to simple self-care measures, such as rest and elevation as well as icing and exercise. As with any sort of injury, ice should be applied to the affected area only for 15 to 20 minutes at a time. With exercise, a series of fitness activities are established by a physical therapist to strengthen the area to support the weakened knee.
Most treatments for knee joint effusion are based on the cause of the condition, making a "standard" approach to care nonexistent. However, many people with water on the knee need to have the excess fluid removed, so one may undergo a procedure known as aspiration.
Finally, one may need a series of corticosteroid injections, non-steroidal anti-inflammatory drugs (NSAIDs) or antibiotics to reduce inflammation or treat an infection. For others, knee surgery or even joint replacement may be necessary.
Preventing Knee Effusion
Avoiding sudden jolting movements and rough running surfaces can help prevent knee injuries. Obesity adds pressure to the vulnerable knee joint, so weight reduction may help.
Exercises considered better for the knees include small (not deep) knee bends and straightening motions done while in supination with most weight on the outside of the foot.
Sports that are easier on the knees include walking, swimming (flutter kicks, knees straight), skating, baseball, cross-country skiing, and, depending on the state of the knee, cycling (seat high, low gear, avoiding hills).
Choose activities to suit your own knee strength and capacity, and remember that sports especially hard on the knees include football, sprinting, soccer, rugby, hockey, squash, volleyball, basketball, downhill skiing, tennis and jogging or anything that pounds, jolts, or twists the knees.
Written by Sy Kraft (B.A.)
вторник, 27 сентября 2011 г.
Flexcin Arthritis Remedy Proves Worthy Substitution For Acetaminophen
An advisory panel for the Food and Drug Administration (FDA) recently recommended limiting sales of acetaminophen products like Tylenol and also recommended banning prescription pain medications Vicodin and Percocet. This recommendation will prompt more people to change their habits and focus on joint pain remedy and pain relievers found in the natural vitamin supplements industry for arthritis treatment.
Acetaminophen, along with prescription pain medications like Vicodin and Percocet, have all recently made headlines attracting consumers' attention because the FDA panel believes the drugs pose a risk of liver failure. The headlines underscore why 32 percent more people are now choosing arthritis remedy supplements like Flexcin, which offers the only joint pain treatment with the CM8TM ingredient.
"Like millions of others, I have little interest in taking prescription pain medications because of the uncomfortable and dangerous side effects that can possibly do even more harm to my body," said Lisa Sharron, who takes Flexcin arthritis remedy regularly. "Additionally, I don't want to just put a mask over my pain, I want to repair my arthritis so I can get back to living a normal life, which Flexcin joint pain remedy allows me to do."
Unlike prescription pain medications that work to mask pain, Flexcin with CM8 (cetyl myristoleate) is a natural vitamin supplement that instead works to repair joint damage. Flexcin with CM8 works as an arthritis remedy, joint pain treatment and arthritis treatment for hip pain, shoulder, knee, elbow, hand or foot pain, and muscle pain. Cetyl myristoleate is clinically proven to promote optimal joint health by helping to stimulate the lubricating fluid in the joints, support stronger cartilage and increase total mobility.
Source
Flexcin International, Inc.
Acetaminophen, along with prescription pain medications like Vicodin and Percocet, have all recently made headlines attracting consumers' attention because the FDA panel believes the drugs pose a risk of liver failure. The headlines underscore why 32 percent more people are now choosing arthritis remedy supplements like Flexcin, which offers the only joint pain treatment with the CM8TM ingredient.
"Like millions of others, I have little interest in taking prescription pain medications because of the uncomfortable and dangerous side effects that can possibly do even more harm to my body," said Lisa Sharron, who takes Flexcin arthritis remedy regularly. "Additionally, I don't want to just put a mask over my pain, I want to repair my arthritis so I can get back to living a normal life, which Flexcin joint pain remedy allows me to do."
Unlike prescription pain medications that work to mask pain, Flexcin with CM8 (cetyl myristoleate) is a natural vitamin supplement that instead works to repair joint damage. Flexcin with CM8 works as an arthritis remedy, joint pain treatment and arthritis treatment for hip pain, shoulder, knee, elbow, hand or foot pain, and muscle pain. Cetyl myristoleate is clinically proven to promote optimal joint health by helping to stimulate the lubricating fluid in the joints, support stronger cartilage and increase total mobility.
Source
Flexcin International, Inc.
суббота, 24 сентября 2011 г.
NIH GAIT Study Supports Use Of Glucosamine And Chondroitin For Osteoarthritis Treatment
Arthritis experts and orthopaedic surgeons are discussing the
results of the NIH study that shows a supplement to be as effective as the
most expensive NSAIDs for moderate and severe pain from arthritis.
Dr. Kevin R. Stone, Chairman of the Stone Foundation for Sports Medicine
and Arthritis Research in San Francisco pioneered the use of glucosamine in a
beverage form for athletes and arthritis sufferers and is vocal about the
results of this new study.
"The supplements glucosamine and chondroitin together, which are
inexpensive and have zero negative side effects, performed as well as the very
expensive and somewhat risky Celebrex," said Stone. "I believe the standard
of care in medicine will now be to prescribe the supplements first and if they
are not enough then to add additional medications," Stone said.
The GAIT (Glucosamine/Chondroitin Arthritis Intervention Trial) study
funded by the National Institutes for Health (NIH)) evaluates the use of
glucosamine and chondroitin in treating and preventing osteoarthritis.
(nccam.nih/news/19972000/121100/qa.htm#12)
Published study results indicate that the combination of glucosamine and
chondroitin sulfate might be most effective in osteoarthritis patients who had
moderate to severe knee pain.
As a physician treating patients with glucosamine and chondroitin for more
than a decade, Dr. Stone says, "We recommend it for all our patients, both
athletes and those with arthritis. Many of our patients with arthritis have
given up using nonsteroidal anti-inflammatories because glucosamine has been
effective for them." Stone prescribes 1,500 milligrams a day, taken all at
once in beverage form.
WHO: Harvard- and UNC at Chapel Hill-educated Dr. Kevin R. Stone, founder
of the Stone Clinic and chairman of the Stone Foundation for Sports Medicine
and Arthritis Research (stoneclinic), and inventor and founder of
Joint Juice, the first glucosamine beverage. Dr. Stone has provided
commentary for media ranging from The Wall Street Journal and Newsweek to
USAToday and CBSNews, is the author of numerous scientific articles, and is a
frequent lecturer at leading forums and symposia. He is passionate and
objective about the role of supplements in medical practice.
WHEN: Dr. Stone is available for phone and in-person interviews now.
WHERE: Dr. Stone is based in San Francisco.
Background
Initiated in 1998, GAIT is the first multicenter clinical trial in the
United States to test the effects of the dietary supplements glucosamine and
chondroitin for treatment of knee osteoarthritis.
The study tests whether glucosamine and chondroitin used separately or in
combination are effective in reducing pain in patients with knee
osteoarthritis. GAIT includes an additional study (or sub-study) that will
assess whether glucosamine and chondroitin can reduce or halt the progression
of knee osteoarthritis.
GAIT was designed to rigorously assess the effectiveness and safety of
these supplements when taken separately or in combination. Almost 1,600
patients with painful knee osteoarthritis were recruited from 16 U.S. academic
rheumatology centers for the study.
Results of previous studies in the medical literature have yielded
conflicting results on the effectiveness of glucosamine and chondroitin as
treatments for osteoarthritis. This study tested the short-term (6 months)
effectiveness of glucosamine and chondroitin in reducing pain in a large
number of patients with knee osteoarthritis.
The sub-study will also evaluate the impact of glucosamine and chondroitin
on progression of knee osteoarthritis following an additional 18-month
treatment regimen.
Stone Research Foundation
stoneclinic
results of the NIH study that shows a supplement to be as effective as the
most expensive NSAIDs for moderate and severe pain from arthritis.
Dr. Kevin R. Stone, Chairman of the Stone Foundation for Sports Medicine
and Arthritis Research in San Francisco pioneered the use of glucosamine in a
beverage form for athletes and arthritis sufferers and is vocal about the
results of this new study.
"The supplements glucosamine and chondroitin together, which are
inexpensive and have zero negative side effects, performed as well as the very
expensive and somewhat risky Celebrex," said Stone. "I believe the standard
of care in medicine will now be to prescribe the supplements first and if they
are not enough then to add additional medications," Stone said.
The GAIT (Glucosamine/Chondroitin Arthritis Intervention Trial) study
funded by the National Institutes for Health (NIH)) evaluates the use of
glucosamine and chondroitin in treating and preventing osteoarthritis.
(nccam.nih/news/19972000/121100/qa.htm#12)
Published study results indicate that the combination of glucosamine and
chondroitin sulfate might be most effective in osteoarthritis patients who had
moderate to severe knee pain.
As a physician treating patients with glucosamine and chondroitin for more
than a decade, Dr. Stone says, "We recommend it for all our patients, both
athletes and those with arthritis. Many of our patients with arthritis have
given up using nonsteroidal anti-inflammatories because glucosamine has been
effective for them." Stone prescribes 1,500 milligrams a day, taken all at
once in beverage form.
WHO: Harvard- and UNC at Chapel Hill-educated Dr. Kevin R. Stone, founder
of the Stone Clinic and chairman of the Stone Foundation for Sports Medicine
and Arthritis Research (stoneclinic), and inventor and founder of
Joint Juice, the first glucosamine beverage. Dr. Stone has provided
commentary for media ranging from The Wall Street Journal and Newsweek to
USAToday and CBSNews, is the author of numerous scientific articles, and is a
frequent lecturer at leading forums and symposia. He is passionate and
objective about the role of supplements in medical practice.
WHEN: Dr. Stone is available for phone and in-person interviews now.
WHERE: Dr. Stone is based in San Francisco.
Background
Initiated in 1998, GAIT is the first multicenter clinical trial in the
United States to test the effects of the dietary supplements glucosamine and
chondroitin for treatment of knee osteoarthritis.
The study tests whether glucosamine and chondroitin used separately or in
combination are effective in reducing pain in patients with knee
osteoarthritis. GAIT includes an additional study (or sub-study) that will
assess whether glucosamine and chondroitin can reduce or halt the progression
of knee osteoarthritis.
GAIT was designed to rigorously assess the effectiveness and safety of
these supplements when taken separately or in combination. Almost 1,600
patients with painful knee osteoarthritis were recruited from 16 U.S. academic
rheumatology centers for the study.
Results of previous studies in the medical literature have yielded
conflicting results on the effectiveness of glucosamine and chondroitin as
treatments for osteoarthritis. This study tested the short-term (6 months)
effectiveness of glucosamine and chondroitin in reducing pain in a large
number of patients with knee osteoarthritis.
The sub-study will also evaluate the impact of glucosamine and chondroitin
on progression of knee osteoarthritis following an additional 18-month
treatment regimen.
Stone Research Foundation
stoneclinic
среда, 21 сентября 2011 г.
Pain Is Not A Symptom Of Arthritis, Pain Causes Arthritis: New Study
Pain is more than a symptom of osteoarthritis, it is an inherent and damaging part of the disease itself, according to a study published today in journal Arthritis and Rheumatism. More specifically, the study revealed that pain signals originating in arthritic joints, and the biochemical processing of those signals as they reach the spinal cord, worsen and expand arthritis. In addition, researchers found that nerve pathways carrying pain signals transfer inflammation from arthritic joints to the spine and back again, causing disease at both ends.
Technically, pain is a patient's conscious realization of discomfort. Before that can happen, however, information must be carried along nerve cell pathways from say an injured knee to the pain processing centers in dorsal horns of the spinal cord, a process called nociception. The current study provides strong evidence that two-way, nociceptive "crosstalk" may first enable joint arthritis to transmit inflammation into the spinal cord and brain, and then to spread through the central nervous system (CNS) from one joint to another.
Furthermore, if joint arthritis can cause neuro-inflammation, it could have a role in conditions like Alzheimer's disease, dementia and multiple sclerosis. Armed with the results, researchers have identified likely drug targets that could interfere with key inflammatory receptors on sensory nerve cells as a new way to treat osteoarthritis (OA), which destroys joint cartilage in 21 million Americans. The most common form of arthritis, OA eventually brings deformity and severe pain as patients loose the protective cushion between bones in weight-bearing joints like knees and hips.
"Until relatively recently, osteoarthritis was believed to be due solely to wear and tear, and inevitable part of aging," said Stephanos Kyrkanides, D.D.S., Ph.D., associate professor of Dentistry at the University of Rochester Medical Center. "Recent studies have revealed, however, that specific biochemical changes contribute to the disease, changes that might be reversed by precision-designed drugs. Our study provides the first solid proof that some of those changes are related to pain processing, and suggests the mechanisms behind the effect," said Kyrkanides, whose work on genetics in dentistry led to broader applications. The common ground between arthritis and dentistry: the jaw joint is a common site of arthritic pain.
Study Details
Past studies have shown that specific nerve pathways along which pain signals travel repeatedly become more sensitive to pain signals with each use. This may be a part of ancient survival skill (if that hurt once, don't do it again). Secondly, pain has long been associated with inflammation (swelling and fever).
In fact, past research has shown that the same chemicals that cause inflammation also cause the sensation of pain and hyper-sensitivity to pain if injected. Kyrkanides' work centers around one such pro-inflammatory, signaling chemical called Interleukin 1-beta (IL-1??), which helps to ramp up the bodies attack on an infection.
Specifically, Kyrkanides' team genetically engineered a mouse where they could turn up on command the production of IL-1?? in the jaw joint, a common site of arthritis. Experiments showed for the first time that turning up IL-1?? in a peripheral joint caused higher levels of IL-1?? to be produced in the dorsal horns of the spinal cord as well.
Using a second, even more elaborately engineered mouse model, the team also demonstrated for the first time that creating higher levels of IL-1?? in cells called astrocytes in the spinal cord caused more osteoarthritic symptoms in joints. Past studies had shown astrocytes, non-nerve cells (glia) in the central nervous system that provide support for the spinal cord and brain, also serve as the immune cells of CNS organs. Among other things, they release cytokines like IL-1?? to fight disease when triggered. The same cytokines released from CNS glia may also be released from neurons in joints, possibly explaining how crosstalk carries pain, inflammation and hyper-sensitivity back and forth.
In both mouse models, experimental techniques that shut down IL-1?? signaling reversed the crosstalk effects. Specifically, researchers used a molecule, IL-1RA, known to inhibit the ability of IL-1?? to link up with its receptors on nerve cells. Existing drugs (e.g. Kineret® (anakinra), made by Amgen and indicated for rheumatoid arthritis) act like IL-1RA to block the ability IL-1?? to send a pain signal through its specific nerve cell receptor, and Kyrkanides' group is exploring a new use for them as osteoarthritis treatment.
The implications of this process go further, however, because the cells surrounding sensory nerve cell pathways too can be affected by crosstalk. If 10 astrocytes secrete IL-1?? in response to a pain impulse, Kyrkanides said, perhaps 1,000 adjacent cells will be affected, greatly expanding the field of inflammation. Spinal cord astrocytes are surrounded by sensory nerve cells that connect to other areas of the periphery, further expanding the effect. According to Kyrkanides' model, increased inflammation by in the central nervous system can then send signals back down the nerve pathways to the joints, causing the release of inflammatory factors there.
Among the proposed, inflammatory factors is calcitonin gene related peptide (CGRP). The team observed higher levels calcitonin-gene related peptide (CGRP) production in primary sensory fibers in the same regions where IL-1?? levels rose, and the release of IL-1?? by sensory neurons may cause the release of CGRP in joints. Past studies in Kyrkanides reveal that CGRP can also cause cartilage-producing cells (chondrocytes) to mature too quickly and die, a hallmark of osteoarthritis.
Joining Kyrkanides in the publication from the University of Rochester School of Medicine and Dentistry were co-authors M. Kerry O'Banion, M.D., Ph.D., Ross Tallents, D.D.S., J. Edward Puzas, Ph.D. and Sabine M. Brouxhon, M.D. Paolo Fiorentino was a student contributor and Jennie Miller was involved as Kyrkanides' technical associate. Maria Piancino, led a collaborative effort at the University of Torino, Italy. This work was supported in part by grants from the National Institutes of Health.
"Our study results confirm that joints can export inflammation in the form of higher IL-1?? along sensory nerve pathways to the spinal cord, and that higher IL-1?? inflammation in the spinal cord is sufficient in itself to create osteoarthritis in peripheral joints," Kyrkanides said. "We believe this to be a vitally important process contributing to orthopaedic and neurological diseases in which inflammation is a factor."
Source: Greg Williams
University of Rochester Medical Center
View drug information on Kineret.
Technically, pain is a patient's conscious realization of discomfort. Before that can happen, however, information must be carried along nerve cell pathways from say an injured knee to the pain processing centers in dorsal horns of the spinal cord, a process called nociception. The current study provides strong evidence that two-way, nociceptive "crosstalk" may first enable joint arthritis to transmit inflammation into the spinal cord and brain, and then to spread through the central nervous system (CNS) from one joint to another.
Furthermore, if joint arthritis can cause neuro-inflammation, it could have a role in conditions like Alzheimer's disease, dementia and multiple sclerosis. Armed with the results, researchers have identified likely drug targets that could interfere with key inflammatory receptors on sensory nerve cells as a new way to treat osteoarthritis (OA), which destroys joint cartilage in 21 million Americans. The most common form of arthritis, OA eventually brings deformity and severe pain as patients loose the protective cushion between bones in weight-bearing joints like knees and hips.
"Until relatively recently, osteoarthritis was believed to be due solely to wear and tear, and inevitable part of aging," said Stephanos Kyrkanides, D.D.S., Ph.D., associate professor of Dentistry at the University of Rochester Medical Center. "Recent studies have revealed, however, that specific biochemical changes contribute to the disease, changes that might be reversed by precision-designed drugs. Our study provides the first solid proof that some of those changes are related to pain processing, and suggests the mechanisms behind the effect," said Kyrkanides, whose work on genetics in dentistry led to broader applications. The common ground between arthritis and dentistry: the jaw joint is a common site of arthritic pain.
Study Details
Past studies have shown that specific nerve pathways along which pain signals travel repeatedly become more sensitive to pain signals with each use. This may be a part of ancient survival skill (if that hurt once, don't do it again). Secondly, pain has long been associated with inflammation (swelling and fever).
In fact, past research has shown that the same chemicals that cause inflammation also cause the sensation of pain and hyper-sensitivity to pain if injected. Kyrkanides' work centers around one such pro-inflammatory, signaling chemical called Interleukin 1-beta (IL-1??), which helps to ramp up the bodies attack on an infection.
Specifically, Kyrkanides' team genetically engineered a mouse where they could turn up on command the production of IL-1?? in the jaw joint, a common site of arthritis. Experiments showed for the first time that turning up IL-1?? in a peripheral joint caused higher levels of IL-1?? to be produced in the dorsal horns of the spinal cord as well.
Using a second, even more elaborately engineered mouse model, the team also demonstrated for the first time that creating higher levels of IL-1?? in cells called astrocytes in the spinal cord caused more osteoarthritic symptoms in joints. Past studies had shown astrocytes, non-nerve cells (glia) in the central nervous system that provide support for the spinal cord and brain, also serve as the immune cells of CNS organs. Among other things, they release cytokines like IL-1?? to fight disease when triggered. The same cytokines released from CNS glia may also be released from neurons in joints, possibly explaining how crosstalk carries pain, inflammation and hyper-sensitivity back and forth.
In both mouse models, experimental techniques that shut down IL-1?? signaling reversed the crosstalk effects. Specifically, researchers used a molecule, IL-1RA, known to inhibit the ability of IL-1?? to link up with its receptors on nerve cells. Existing drugs (e.g. Kineret® (anakinra), made by Amgen and indicated for rheumatoid arthritis) act like IL-1RA to block the ability IL-1?? to send a pain signal through its specific nerve cell receptor, and Kyrkanides' group is exploring a new use for them as osteoarthritis treatment.
The implications of this process go further, however, because the cells surrounding sensory nerve cell pathways too can be affected by crosstalk. If 10 astrocytes secrete IL-1?? in response to a pain impulse, Kyrkanides said, perhaps 1,000 adjacent cells will be affected, greatly expanding the field of inflammation. Spinal cord astrocytes are surrounded by sensory nerve cells that connect to other areas of the periphery, further expanding the effect. According to Kyrkanides' model, increased inflammation by in the central nervous system can then send signals back down the nerve pathways to the joints, causing the release of inflammatory factors there.
Among the proposed, inflammatory factors is calcitonin gene related peptide (CGRP). The team observed higher levels calcitonin-gene related peptide (CGRP) production in primary sensory fibers in the same regions where IL-1?? levels rose, and the release of IL-1?? by sensory neurons may cause the release of CGRP in joints. Past studies in Kyrkanides reveal that CGRP can also cause cartilage-producing cells (chondrocytes) to mature too quickly and die, a hallmark of osteoarthritis.
Joining Kyrkanides in the publication from the University of Rochester School of Medicine and Dentistry were co-authors M. Kerry O'Banion, M.D., Ph.D., Ross Tallents, D.D.S., J. Edward Puzas, Ph.D. and Sabine M. Brouxhon, M.D. Paolo Fiorentino was a student contributor and Jennie Miller was involved as Kyrkanides' technical associate. Maria Piancino, led a collaborative effort at the University of Torino, Italy. This work was supported in part by grants from the National Institutes of Health.
"Our study results confirm that joints can export inflammation in the form of higher IL-1?? along sensory nerve pathways to the spinal cord, and that higher IL-1?? inflammation in the spinal cord is sufficient in itself to create osteoarthritis in peripheral joints," Kyrkanides said. "We believe this to be a vitally important process contributing to orthopaedic and neurological diseases in which inflammation is a factor."
Source: Greg Williams
University of Rochester Medical Center
View drug information on Kineret.
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