Antidepressants can play a key role in alleviating painful conditions like osteoarthritis and may result in fewer side effects than traditionally prescribed drug regimes, such as anti-inflammatories and opioids, according to a perspective paper published online ahead of print publication by the International Journal of Clinical Practice. American doctors Leslie Citrome and Amy Weiss-Citrome analysed the latest clinical evidence on duloxetine, a well-established antidepressant that received US Food and Drug Administration (FDA) approval in 2010 for use with chronic musculoskeletal pain, including osteoarthritis. "It is not uncommon to treat osteoarthritis with a combination of drugs that work in different ways" explains Dr Leslie Citrome, Clinical Professor of Psychiatry and Behavioural Sciences at New York Medical College, Valhalla, New York, USA.
Neutrophil granulocytes comprise important defences for the immune system. When pathogenic bacteria penetrate the body, they are the first on the scene to mobilise other immune cells via signal molecules, thereby containing the risk. To this end, they release serine proteases - enzymes that cut up other proteins to activate signal molecules. Scientists at the Max Planck Institute of Neurobiology in Martinsried have now discovered a new serine protease: neutrophil serine protease 4, or NSP4. This enzyme could provide a new target for the treatment of diseases that involve an overactive immune system, such as rheumatoid arthritis. The functioning of the immune system is based on the complex interplay of the most diverse cells and mediators. For example, neutrophil granulocytes (a group of specialized white blood cells) react to bacteria by releasing substances called serine proteases.
Add lower gastrointestinal (GI) problems such as ulcers, bleeding and perforations to the list of serious complications facing many rheumatoid arthritis patients. They are at greater risk for GI problems and gastrointestinal-related death than people without the disease, a Mayo Clinic study shows. Researchers say their findings point out the need for new ways to prevent and treat lower GI disease in rheumatoid arthritis patients; the incidence of lower gastrointestinal complications is rising even as upper GI problems decrease significantly among rheumatoid arthritis patients. Smoking, the use of steroids known as glucocorticoids, prior upper GI disease and abdominal surgery were associated with lower GI problems in rheumatoid arthritis patients, the study found. The research was published online in The Journal of Rheumatology.
A working group convened by the American College of Rheumatology (ACR) has evaluated more than 60 disease activity measures for rheumatoid arthritis (RA). The group narrowed the number of RA disease activity measures and the recommended six for use in U.S. clinical practice are detailed in Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the ACR. RA is a systemic inflammatory disease, affecting more than 1 million Americans according to ACR estimates. Medical evidence has shown significant improvement in RA treatment over the last two decades, making disease remission possible for many patients. While many health care stakeholders advocate standardized assessments for RA disease activity, uniform measures of RA activity are not currently used by U.S. rheumatologists.
Patients with rheumatoid arthritis (RA) who discontinue use of statin therapy are at increased risk of death from cardiovascular disease and other causes. According to the findings of a population-based study now available in Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR), RA patients should be advised of the importance of compliance to their statin therapy to reduce cardiovascular disease (CVD) mortality risk. A report from the World Health Organization (WHO) estimates that RA affects up to one percent of the population in developed countries. Studies have shown that death rates among those with RA are 1.5-fold higher than in the general population, with CVD cited at the leading cause of mortality in this patient group.