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The year 2007 witnessed the approval of 15 biopharmaceuticals in the United States and/or European Union (EU). The 15 approvals included six erythropoietin (EPO)-based products, three antibodies, and two hormones, [...]

Objective: To compare the three year safety and efficacy of cyclosporin and parenteral gold in the treatment of early, active, severe rheumatoid arthritis (RA), and to study the reversibility of [...]

Objective: To investigate by a cross sectional study in patients with rheumatoid arthritis (RA) the relationship between measures of impairment, activity limitation, and participation of the model of functioning and [...]

The severity of disease at diagnosis can predict long-term function, according to a study of 133 rheumatoid arthritis patients. Disease activity was a better predictor of disability than the length of time the patient had rheumatoid arthritis.

Rheumatoid arthritis (RA) affects three times as many women as men and can affect decisions such as whether or not to have a family. Pregnancy is not recommended if women are taking anti-rheumatic drugs, but RA does not affect a developing foetus. Women may need help to cope with a baby and midwives should understand RA before seeing and advising the woman. Labour may be difficult if movement is restricted or the hip is affected. Extra care needs to be taken by medical staff.

Background: Therapy with low-dose corticosteroids is commonly used to treat allergic and autoimmune diseases. Long-term use of corticosteroids can lead to loss of bone mineral density and higher risk for vertebral fractures. Calcium and vitamin [D.sub.3] supplementation is rational therapy for minimizing bone loss, but little evidence for its effectiveness exists. Objective: To assess 1) the effects of supplemental calcium and vitamin [D.sub.3] on bone mineral density of patients with rheumatoid arthritis and 2) the relation between the effects of this supplementation and corticosteroid use. Design: 2-year randomized, double-blind, placebo-controlled trial. Setting: University outpatient-care facility. Patients: 96 patients with rheumatoid arthritis, 65 of whom were receiving treatment with corticosteroids (mean dosage, 5.6 mg/d). Intervention: Calcium carbonate (1000 mg/d) and vitamin [D.sub.3] (500 lU/d) or placebo. Measurements: Bone mineral densities of the lumbar spine and femur were determined annually. Results: Patients receiving prednisone therapy who were given placebo lost bone mineral density in the lumbar spine and trochanter at a rate of 2.0% and 0.9% per year, respectively. Patients receiving prednisone therapy who were given calcium and vitamin [D.sub.3] gained bone mineral density in the lumbar spine and trochanter at a rate of 0.72% (P = 0.005) and 0.85% (P = 0.024) per year, respectively. In patients receiving prednisone therapy, bone mineral densities of the femoral neck and the Ward triangle did not increase significantly with calcium and vitamin [D.sub.3] Calcium and vitamin [D.sub.3] did not improve bone mineral density at any site in patients who were not receiving corticosteroids. Conclusion: Calcium and vitamin [D.sub.3] prevented loss of bone mineral density in the lumbar spine and trochanter in patients with rheumatoid arthritis who were treated with low-dose corticosteroids., Vitamin D3 and calcium treatments appear to increase bone formation at some sites in patients with rheumatoid arthritis treated with steroids. Bone formation is measured by bone mineral density. For two years 96 patients with rheumatoid arthritis took one of four treatments including prednisone, vitamin D3, and calcium; prednisone and placebo; vitamin D3, calcium, and placebo; or placebo alone. Bone mineral densities in the upper leg and lower spine increased by 0.85% and 0.72% in patients taking prednisone, calcium, and vitamin D3. These measurements decreased or did not change in the other treatment groups.

There appears to be an association between riboflavin deficiencies and disease activity among patients with rheumatoid arthritis. Erythrocyte glutathione reductase (EGR) activity, a component of the inflammation process, measures riboflavin levels. EGR and disease activity were assessed in 91 patients with rheumatoid arthritis and 220 healthy volunteers (control group). Patients with riboflavin deficiencies tended to have higher measures of disease activity. A similar percentage of the patients with active disease (33%) and control group members (41%) had riboflavin deficiencies.

Patients with arthritis who carry the rheumatoid factor (RF) or those who test positive for RF but do not have arthritis (false positive) may have shorter life expectancies than the general population. RF is an antibody frequently found in the blood of adult patients with rheumatoid arthritis. Doctors performed a series of diagnostic tests, including RF screening, on 3,434 volunteers identified with muscle or bone diseases. They followed the group over a period of 13 to 15 years and recorded dates and causes of death for the participants. More participants with a positive or false positive RF test died during this time period as compared to the whole group. There was a higher risk of death due to heart disease in participants with a false positive RF test. There was no correlation between life expectancy and a negative RF test in participants with arthritis.

Rheumatoid arthritis (RA) appears to affect the ability to work early in the course of the disease. Manual laborers with lower education levels, more disease symptoms, and requiring more intensive treatment appear more likely to be adversely affected. A questionnaire was administered to 119 previously employed RA patients. Results were correlated with medical records. Patients had an average disease duration of two years. Overall, 33% of men and 43% of women had neither quit, taken sick leave, nor were working less. Eighty percent of those no longer working because of RA did manual labor versus 50% of those still working. Each one-step increase in education level associated with a three-fold decrease in likelihood of work disability. Only 10% of those able to work had experienced no change in job performance. Patients not working had more symptoms of disease, took more medications and received more surgical treatments, and scored higher on measures of loss of function.

Zinc and copper are trace elements that play important roles in protecting cells from oxidative damage, and zinc is important for maintaining the proper function of the immune system. Several studies have reported that during tissue inflammation the amount of zinc in the blood decreases and the amount of copper in the blood increases. These studies formed the basis for therapeutic trials with zinc supplements in patients with rheumatoid arthritis (RA) and were based on the assumption that zinc deficiency occurs in patients with RA. One study reported that blood zinc levels decrease in RA because of malnutrition. In an attempt to clarify the relationship between diet, RA and blood levels of zinc and copper, 40 patient with RA were studied. The amount of copper and zinc consumed in the diet was estimated from the foods consumed in a one-week period, and was compared with the amount of dietary copper and zinc consumed by individuals without RA. When this was done it was found that the regular diet of the patients with RA provided the same amount of zinc and copper as a typical diet consumed by people without RA. The regular diets of the RA patients provided the recommended dietary allowance (RDA) of zinc and copper. The amount of zinc and copper in the blood of patients with RA was more greatly influenced by the severity of the disease than by dietary factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patients with rheumatoid arthritis (RA) have derived significant relief from pain when given fish oil supplements. Fish oil is rich in a particular type of polyunsaturated fatty acids, and this is thought to replace another type of unsaturated fatty acid which acts a precursors to prostaglandins, locally released and locally acting hormones which can mediate painful sensations. However, fish oil is also rich in vitamin E, which can alter inflammatory processes which may contribute to pain in RA. The effects of fish oil supplements were compared with those of vitamin E-enriched coconut oil supplements in 27 patients (24 female) with RA. At the end of three months, patients who received fish oil were significantly improved in joint disease. There were no changes in laboratory findings. Patients given coconut oil had significant changes in vitamin E status. Changes in disease activity did not correlate with vitamin E levels. The results suggest that improved status following fish oil supplementation is related to fatty acid consumption rather than vitamin E intake, although vitamin E may enhance the effects of the fish oil. (Consumer Summary produced by Reliance Medical Information, Inc.)

A 72 year old woman presented with a fleeting rash, lasting several days at a time, on both thighs and lower trunk, over a four month period (fig 1). The [...]

By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- ROCHESTER, Minn. - Special echocardiograms show promise for early detection of a potentially deadly complication in rheumatoid [...]

The study investigates if the non-wear threshold and the 'valid day' definition for accelerometer data from the general adult U.S. population are appropriate for accelerometer data from persons with rheumatoid arthritis (RA). Evidence supports increasing the allowed non-wear threshold in the RA sub-population from 60 to 90 minutes, while retaining the 10-hour day as the 'valid day' measure.

Issue Depression is one of the most prevalent psychiatric disorders and when co-occurring with medical illnesses likely creates a vicious circle in which each separate ailment makes treatment outcomes worse [...]

Byline: A. Reimold The arthritis associated with Crohn's disease occurs in up to 26% of those diagnosed with the gut disorder.[1] The inflammatory peripheral arthritis classically involves the knees and [...]

A good night's sleep is a dream for most people with rheumatoid arthritis (RA). Two-thirds report fatigue, and research suggests that drugs inhibit slow-wave sleep, which RA sufferers need. In [...]

Eating a Mediterranean diet can significantly lessen the symptoms of rheumatoid arthritis, according to the results of a small Swedish study reported in the Annals of the Rheumatic Diseases (2003; [...]

Cigarette smoking has been linked to rheumatoid arthritis (RA) in a dose dependent manner. A person who smoked a pack of cigarettes daily for over 40 years was 13 more [...]

Abstract Objectives--To assess work history and labour force participation among patients with rheumatoid arthritis (RA) in the Netherlands. Methods--A random sample of 1056 patients with RA aged 16-59 years from [...]

Background: Although several studies showed that risk of rheumatoid arthritis (RA) is inversely associated with consumption of n-3 fatty acids, the one study showing that olive oil may have a protective role has not yet been confirmed. Objective: We examined the relation between dietary factors and risk of RA in persons from southern Greece. Design: We studied 145 RA patients and 188 control subjects who provided information on demographic and socioeconomic variables, prior medical and family history, and present disease status. Subjects responded to an interviewer-administered, validated, food-frequency questionnaire that assessed the consumption of [is greater than] 100 food items. We calculated chi-square statistics for linear trend and odds ratios (ORs) for the development of RA in relation to the consumption of olive oil, fish, vegetables, and a series of food groups classified in quartiles. Results: Risk of developing RA was inversely and significantly associated only with cooked vegetables (OR: 0.39) and olive oil (OR: 0.39) by univariate analysis. A significant trend was observed with increasing olive oil (chi-square: 4.28; P = 0.03) and cooked vegetable (chi-square: 10.48; P = 0.001) consumption. Multiple logistic regression analysis models confirmed the independent and inverse association between olive oil or cooked vegetable consumption and risk of RA (OR: 0.38 and 0.24, respectively). Conclusions: Consumption of both cooked vegetables and olive oil was inversely and independently associated with risk of RA in this population. Further research is needed to elucidate the underlying mechanisms of this finding, which may include the antioxidant properties or the high n-9 fatty acid content of the olive oil. Am J Clin Nutr 1999;70:1077-82. KEY WORDS Diet, rheumatoid arthritis, olive oil, vegetable consumption, food-frequency questionnaire, Greek diet, Greek Orthodoxy, humans

Synopsis: A bio-engineered version of a naturally occurring human protein, interleukin-1 receptor antagonist (IL-1RA), was more efficacious than placebo in reducing symptoms and signs of synovitis and was associated with [...]

Fibromyalgia and Hepatitis C: Is There an Association? ABSTRACT & COMMENTARY Synopsis: Serologic evidence of hepatitis C infection was reported to be more than six times more prevalent in patients [...]

ABSTRACT & COMMENTARY Synopsis: Rheumatoid arthritis should be recognized as a marker of increased risk for myocardial infarction. Source: Solomon DH, et al. Circulation. 2003;107:1303-1307. IT IS WELL KNOWN THAT [...]