New Clinical Practice Guidelines Developed For Juvenile Idiopathic Arthritis

Main Category: Arthritis / Rheumatology
Also Included In: Pediatrics / Children’s Health
Article Date: 31 Mar 2011 – 0:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article



Patient / Public:not yet rated

Healthcare Prof:not yet rated

The American College of Rheumatology has developed new guidelines for starting and monitoring treatments for children with juvenile idiopathic arthritis. These are the first JIA guidelines endorsed by the ACR, with the goal of broad acceptance within the rheumatology community.

Created as a guide for health care providers, the guidelines focus on the initiation and safety monitoring of multiple medications used in the treatment of JIA, including:

— Non-steroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, and many others)

— Intraarticular glucocorticoid injections (i.e. steroid joint injections)

— Non-biologic disease-modifying antirheumatic drugs: (e.g. methotrexate)

— Biologic disease-modifying antirheumatic drugs: (e.g. abatacept, anakinra and TNF-α inhibitors such as etanercept, adalimumab, infliximab)

— Systemic glucocorticoids: (e.g. prednisone)

It is estimated that one child in every 1,000 will develop a rheumatic disease. Nearly 300,000 American children suffer from juvenile idiopathic arthritis, which begins before patients reach the age of 16 and may involve chronic inflammation of one or many joints. JIA often persists into adulthood and can cause long-term co-existing conditions and disability. However, recent treatment advances have greatly improved short-and medium-term outcomes for these patients.

Recommendations Based on Sound Research

The research team led by Timothy Beukelman, MD, MSCE American College of Rheumatology member and assistant professor of pediatrics in the Division of Pediatric Rheumatology at the University of Alabama at Birmingham developed the guidelines using established processes from the RAND/UCLA Appropriateness Method. The method defines appropriate patient care by combining the best available scientific evidence with the collective judgment of experts.

The research team which included clinicians, researchers and a patient advocate with experience and expertise in JIA reviewed over 200 studies related to JIA treatment and evaluated more than 1,500 clinical scenarios that captured a broad range of medical decisions that are made in the care of JIA patients. The team explicitly considered when the benefits of using certain drugs outweigh any risks. Because JIA can affect each person differently, patients with similar disease characteristics were separated into five different JIA treatment groups to help streamline the recommendations.

“These recommendations were developed by two distinct panels of international pediatric rheumatology experts using a rigorous methodology,” says Dr. Beukelman. “Our goal was to provide evidence and consensus-based guidance that reflects the current state of the field and is useful to clinicians of all levels of experience with the treatment of JIA. The recommendations are important because the treatment of JIA has undergone major changes over the last decade with the introduction of biologic therapeutic agents.”

Recommendation Highlights

The recommendations for initiation of multiple medications for JIA were based on several clinical factors: JIA treatment group; current disease activity level; disease prognosis; and current treatment.

A brief summary of some of the most notable recommendations includes:

— Beginning treatment with TNF-α inhibitors in children with a history of arthritis in four or fewer joints and significant active arthritis despite treatment with methotrexate

— Beginning treatment with TNF-α inhibitors in children with a history of arthritis in five or more joints and any active arthritis following an adequate trial of methotrexate

— Beginning treatment with anakinra in children with systemic arthritis and active fever whose treatment requires a second medication in addition to systemic glucocorticoids

“We expect that knowledge of the safest and most effective treatments for JIA will continue to advance, and we suggest regularly updating these recommendations using newly published evidence,” says Dr. Beukelman. “Ongoing research, both in the clinic and the laboratory, is critical to understanding how to best treat JIA and will help to continue to improve the quality of life for children with the disease.”

Patients should talk to their rheumatologists to determine their best course of treatment.

Source: Wiley – Blackwell, AlphaGalileo Foundation.



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Arthritis / Rheumatology headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Osteoarthritis: What You Know Could Save Your Joints!

Main Category: Arthritis / Rheumatology
Also Included In: Bones / Orthopedics;  Rehabilitation / Physical Therapy
Article Date: 31 Mar 2011 – 3:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article



Patient / Public:not yet rated

Healthcare Prof:not yet rated

According to the Arthritis Foundation, 27 million Americans live with osteoarthritis, the most common form of arthritis which involves a mechanical “wear and tear” of the cartilage that lines the inside of our joints and which, over time, can result in damage to the connective tissue and bone around the joint. The more you know about the condition, the greater your chance for success in finding the help that you need.

“The pain of arthritis is usually described as a deep ache or throbbing joint pain that is often worse upon getting up in the morning. In addition, sufferers may also experience muscle weakness around the arthritic joint and functional limitations, such as difficulty getting up and walking,” says Dr. David Wang, a specialist in Physical Medicine and Rehabilitation at The Kaplan Center for Integrative Medicine in McLean, Virginia.

A variety of non-surgical treatments are available for those who suffer from osteoarthritis:

Physical Therapy and Exercise– An individually customized exercise program coordinated through a physical therapist can reduce the pain and functional limitations caused by osteoarthritis by maximizing strength, balance, and joint stability.

Osteopathic Manipulative Treatment– This specialized, hands-on method of diagnosis and treatment can improve muscle balance, joint alignment, blood flow, and the efficiency of the lymphatic system to naturally remove chronic inflammatory agents and excess fluid.

Anti-Inflammatory Dietand Dietary Supplements – The acute inflammation response after an injury is actually essential to good healing. However, chronic inflammation contributes to many debilitating illnesses, including osteoarthritis. Adopting a proper diet and taking certain nutritional supplements can go a long way toward alleviating inflammation. It is important to take appropriately high levels of vitamins E, C, and D; minerals zinc, magnesium, and copper; omega-3 fatty acids (found in fish and flaxseed oil); oleic acid (present in extra virgin olive oil); glucosamine and chondroitin; and avocado/soybean unsaponifiables(e.g., Avosoy). In addition, it is best to avoid processed foods, including refined starch and sugar, and excessive amounts of high fructose corn syrup, saturated fats, and trans fats, all of which can promote chronic inflammation.

Medications– Anti-inflammatories, including ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and aspirin (Bayer), as well as acetaminophen (Tylenol) are good first-line medications for treating osteoarthritis. Narcotic medications (Codeine, Vicodin, Percocet, etc.) can sometimes be prescribed, but should be done so very judiciously due to side-effects and abuse potential.

Acupuncture – Insertion of thin needles into specific “acupuncture points,” both with and without electrical stimulation, has been shown through multiple, well-controlled, randomized trials over the last 20 years to both reduce pain and improve function in patients with knee and hip osteoarthritis.


Conventional Joint Injections– These injections are commonly done and can provide moderate to significant relief usually for a couple of months at a time. They include steroid (cortisone) and viscosupplementation (e.g. Synvisc, Supartz, Euflexxa, Orthovisc) injections.

Regenerative Injections– Platelet-rich plasma (PRP) therapy and prolotherapy are two unique types of regenerative injections that may actually promote natural healing of the cartilage and surrounding ligaments, tendons and muscles. PRP therapy involves drawing a small amount of a patient’s own blood, centrifuging it to concentrate the platelets – which contain the growth factors responsible for tissue regeneration – and then injecting it into the injured area to optimize healing. This process has successfully helped such athletes as golfer Tiger Woods and Superbowl champion wide-receiver Hines Ward, among others, to recover from their injuries more quickly. Prolotherapy is a similar injection method, which uses simple solutions other than blood for healing injured tendons, ligaments, and joints. A growing body of medical research has demonstrated the effectiveness of these therapies in treating painful conditions of the neck, shoulder, elbow, hand, lower back, hip, knee, and ankle.

“Most people believe that they “just have to live with the pain” brought on by osteoarthritis, but today, that’s just not the case,” says Dr. Wang. “There is a great deal you can do to delay the onset and minimize the impact of osteoarthritis. The key is to find a medical team that truly listens and cares and has expertise in a wide range of diagnostic and treatment options to customize a program that works best for you.”

Source:

The Kaplan Center for Integrative Medicine



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Arthritis / Rheumatology headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Merz Pharmaceuticals Announces New Centers For Medicare And Medicaid Billing Q-Code For Xeomin(R) (IncobotulinumtoxinA)

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Medical Practice Management
Article Date: 31 Mar 2011 – 2:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article

Patient / Public:not yet rated

Healthcare Prof:not yet rated

Merz Pharmaceuticals, LLC announced today that the Centers for Medicare and Medicaid Services (CMS) has granted a unique Healthcare Common Procedure Coding System (HCPCS) billing code, Q2040, for Xeomin®(incobotulinumtoxinA). Merz expects that this unique billing code, which will become effective on April 1, 2011, will help simplify the billing and reimbursement process for prescribers of XEOMIN.

The U.S. Food and Drug Administration (FDA) approved XEOMIN on July 30, 2010, for the treatment of adults with cervical dystonia (CD), to decrease the severity of abnormal head position and neck pain in both botulinum toxin-näive and previously treated patients, and blepharospasm in adults who have been previously treated with Botox® (onabotulinumtoxinA).

“Merz is pleased to report broad interest in XEOMIN at the provider level as well as strong reimbursement coverage by private and public payors,” said Jack Britts, President and CEO of Merz Pharmaceuticals, LLC. “We are confident that the addition of this unique billing code will assist in streamlining billing and reimbursement for XEOMIN.”

As permanent national codes are issued annually, CMS awards Q-codes when it identifies a need to provide a unique code in order to reduce billing confusion before the next national update on January 1 of the following year. Merz has applied for and anticipates receiving a permanent J-code for XEOMIN on January 2, 2012.

For providers and payors, utilizing a unique Q-code is in most circumstances administratively identical to billing under a permanent J-code. The availability of this unique code, Q2040, means that in most instances XEOMIN will no longer be billed under a miscellaneous code.

“This is a significant milestone for the dystonia community and we are so pleased that CMS granted this product-specific code for XEOMIN,” said Janet Hieshetter, Executive Director of the Dystonia Medical Research Foundation (DMRF). “This news follows a recent meeting that several representatives from the dystonia advocacy community had with government officials late last year about the importance of ensuring access to all available treatment options, and we’re all quite grateful that our voices were heard.”

Merz also recently introduced two comprehensive programs to provide patients with financial assistance for XEOMIN. The XEOMIN Patient Co-payment Program is easy-to-use and offers eligible patients assistance for their actual out-of-pocket costs for therapeutic treatment with XEOMIN. Eligible treatment-related costs may include the cost of XEOMIN, associated guidance therapy and related administration fees .


Additionally, the XEOMIN Patient Assistance Program provides XEOMIN at no cost to eligible patients who are experiencing financial hardship, do not have third-party drug coverage, and who are not eligible for government-funded drug programs.

About XEOMIN

In nature, Clostridium botulinum produces the toxin in association with ancillary accessory proteins. Manufacturers utilize this naturally occurring protein complex to produce therapeutic botulinum toxin products. XEOMIN (incobotulinumtoxinA) is manufactured using a proprietary process that isolates the therapeutic component and eliminates accessory proteins.

More than 84,000 patients have been treated with XEOMIN worldwide since 2005. The U.S. is the 20th country to approve XEOMIN for the treatment of cervical dystonia and blepharospasm.

XEOMIN is the only botulinum toxin that does not require refrigeration prior to reconstitution. XEOMIN is available in 50-unit and 100-unit vials, which Merz believes may allow for more precise billing and reduce wastage.

Important Safety Information

WARNING: Distant Spread of Toxin Effect

Postmarketing reports indicate that the effects of XEOMIN and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms. In unapproved uses, including spasticity in children and adults, and in approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and at lower doses.

Contraindications

XEOMIN is contraindicated in patients with a known hypersensitivity to the active substance botulinum toxin type A or to any of the components in the formulation and in the presence of infection at the proposed injection site(s).

Warnings And Precautions

– The potency units of XEOMIN are not interchangeable with other preparations of botulinum toxin products. Therefore, units of biological activity of XEOMIN cannot be compared to or converted into units of any other botulinum toxin products.

– Hypersensitivity reactions have been reported with botulinum toxin products (anaphylaxis, serum sickness, urticaria, soft tissue edema, and dyspnea). If serious and/or immediate hypersensitivity reactions occur further injection of XEOMIN should be discontinued and appropriate medical therapy immediately instituted.

– Treatment with XEOMIN and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or swallowing. When distant effects occur, additional respiratory muscles may be involved [See Boxed Warning]. Deaths as a complication of severe dysphagia have been reported after treatment with botulinum toxin. Dysphagia may persist for several months, and require use of a feeding tube to maintain adequate nutrition and hydration. Aspiration may result from severe dysphagia and is a particular risk when treating patients in whom swallowing or respiratory function is already compromised. These reactions can occur within hours to weeks after injection with botulinum toxin.

– Cervical Dystonia: Patients with smaller neck muscle mass and patients who require bilateral injections into the sternocleidomastoid muscles are at greater risk of dysphagia. Limiting the dose injected into the sternocleidomastoid muscle may decrease the occurrence of dysphagia.

– Blepharospasm: Injection of XEOMIN into the orbicularis oculi muscle may lead to reduced blinking and corneal exposure with possible ulceration or perforation. Lower lid injections should not be repeated if diplopia occurred with previous botulinum toxin injections.

– Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junctional disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome) should be monitored particularly closely when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including severe dysphagia and respiratory compromise from typical doses of XEOMIN.

Adverse Reactions

Cervical Dystonia: The most commonly observed adverse reactions (incidence ≥10% of patients and twice the rate of placebo) for XEOMIN 120 Units and XEOMIN 240 Units, respectively, were: dysphagia (13%, 18%), neck pain (7%, 15%), muscle weakness (7%, 11%), and musculoskeletal pain (7%, 4%).

Blepharospasm: The most common adverse reactions (incidence ≥10% of patients and twice the rate of placebo) for XEOMIN were eyelid ptosis (19%), dry mouth (16%), visual impairment (12%), diarrhea (8%), and headache (7%).

Drug Interactions

Concomitant treatment of XEOMIN and aminoglycoside antibiotics, spectinomycin, or other agents that interfere with neuromuscular transmission (e.g., tubocurarine-like agents), or muscle relaxants, should be observed closely because the effect of XEOMIN may be potentiated.

Use In Pregnancy

Pregnancy Category C: There are no adequate and well-controlled studies in pregnant women. XEOMIN should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Source:

Merz Pharmaceuticals, LLC



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Medicare / Medicaid / SCHIP headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Advanced Prostate Cancer Drug Provenge $93,000 Per Patient Likely To Be Covered By Medicare

Editor’s Choice
Main Category: Prostate / Prostate Cancer
Also Included In: Medicare / Medicaid / SCHIP;  Urology / Nephrology;  Cancer / Oncology
Article Date: 31 Mar 2011 – 9:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article

Patient / Public:not yet rated

Healthcare Prof:not yet rated

Article Opinions: 1 posts

Medicare has indicated that it proposes to cover the $93,000 cost per patient for a four month course of advanced prostate cancer vaccine Provenge (Sipuleucel-T). Provenge is a therapeutic cancer vaccine designed to prolong the life of patients with advanced to late stage prostate cancer, metastatic, asymptomatic, hormone-refractory prostate cancer. Provenge makes it possible for the patient’s immune system to identify and target prostate cancer cells.

According to the Centers for Medicare and Medicaid, Provenge was described as a “reasonable and necessary” medication. This green light means thousands of males will be eligible to receive this drug through the federal government.

In a communiqué, the Centers for Medicare and Medicaid explains that for the next 90 days it will receive comments before making its final decision.

Medicare is supposed to look at patient need rather than cost when considering new therapies. When it decided to review Provenge, which had compelling evidence regarding its benefits for prostate cancer patients, many complained that it was balking at the cost and seeking a reason to turn it down. Some politicians and several advocacy groups were outraged, as was the Dendreon Corporation (makers of the vaccine).

If or when the final favorable decision occurs, industry experts believe Provenge will become a blockbuster, with sales exceeding $1 billion.

Provenge is the first FDA-approved prostate cancer therapy that uses an individual’s own immune cells – it is a type of autologous cellular immunotherapy. It is considered a cancer treatment vaccine. Most people see vaccines as preventative; they prevent people from developing diseases, such as measles or mumps. Vaccines used to treat cancers are different, they do not prevent the disease, but rather attack cancer cell growth.

Source: www.provenge.com, CMS

Christian Nordqvist


Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Prostate / Prostate Cancer headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Big Pharma

posted by C. Alex on 31 Mar 2011 at 9:29 am

I doubt this will be posted in a traditional medical site, but the content of this (helpful) article exposes one more time the power of the pharmaceutical industry. What justification exists for the price of this vaccine? It is nothing new, it has been done in Germany and Mexico for 50 years at moderately low cost.Still is. The american health industry is out of control!

| post followup | alert a moderator |


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Global Health Ventures Announces Interim Data From The European Clinical Trails Of X-Excite Vs. Viagra

Main Category: Clinical Trials / Drug Trials
Also Included In: Erectile Dysfunction / Premature Ejaculation
Article Date: 31 Mar 2011 – 1:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article

Patient / Public:4 stars

4 (2 votes)

Healthcare Prof:not yet rated

Global Health Ventures Inc. (OTCBB:GHLV), a specialty pharmaceutical company, is pleased to announce the interim results of the clinical trials conducted in Europe under the EMEA guideline protocols for its lead therapeutic drug, X-Excite.

Data analysis from a small number of patients showed the drug to meet the three Pharmacokinetics (PK) end points. Blood analysis of the patients receiving X-Excite showed the drug to appear in the blood 173% faster than Pfizer Viagra®. By 10 minutes about one quarter of peak concentration (T max Value) apeared in the blood. Further, X-Excite (blood concentration, C max) never exceeded the C max of Viagra®, a good sign for drug’s acceptability as biosimilar. Additionally the T max was lo! wer (about 15%), and better (wider) spread, a possible sign of less side effects. Finally it appeared that X-Excite remains in the blood slightly longer than Viagra®, possibly due to some gastric absorption, thus may provide a longer performance. Although these are the results of a small number of patients, it indicates a highly positive trend and it is meeting our expectations.

Additional studies are underway and further data will be released upon their availability. In this study we compared the blood profile of X-Excite with Pfizer’s Viagra® in a neck to neck study. In the trials, an open label PK profiling of both drugs were conducted in 24 patients of which 12 received Viagra® and 12 received X-Excite. X-Excite is a sublingual formulation of sildenafil citrate. Sildenafil citrate is used to make one of Pfizer Incorporated’s largest sellers Viagra®.

“We are very pleased with the interim data thus far obtained and looking forward to get additional data, and full blood profiling from our partners in Europe. The data obtained from this small study is highly encouraging and merits the next study to be conducted under FDA guidelines in the United States,” said Dr. Hassan Salari, Global Health President CEO.

About Sublingual Technology

The Company’s sublingual formulation is designed to enhance drugs to be delivered to the body without the need for injection. This design enables the vast majority of pharmaceutical drugs to be rapidly absorbed through the mucosal membrane (tissues of the mouth) quickly and efficiently. This tec! hnology works well for drugs that need faster results and have major side effects associated with gastrointestinal and/or liver breakdown. It is scientifically accepted that sublingual drug delivery route is the fastest and most efficient way of drug delivery after direct injection. The technology is tested against 40 major drugs and all can benefit from it.

Source:

Global Health Venture



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Clinical Trials / Drug Trials headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Experts Exchange Information And Updates On Spondyloarthritis

Main Category: Arthritis / Rheumatology
Also Included In: Bones / Orthopedics
Article Date: 30 Mar 2011 – 0:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article



Patient / Public:not yet rated

Healthcare Prof:not yet rated

Spondyloarthritis (SpA) is a group of inflammatory conditions causing spine and joint pain and deformity, mostly in young men. Important updates on the epidemiology, diagnosis, and treatment of SpA are presented in the April issue of The American Journal of the Medical Sciences (AJMS), official journal of the Southern Society for Clinical Investigation. The journal is published by Lippincott Williams Wilkins, a part of Wolters Kluwer Health.

The special symposium issue includes ten papers presented by a roster of international experts at last year’s Annual Research and Education Meeting of the Spondyloarthritis Research and Therapy Network (SPARTAN), held in Houston, Texas. The symposium Guest Editors are Dr. Luis R. Espinoza of the Louisiana State University Health Science Center, Dr. John D. Reveille of University of Texas-Houston Health Science Center, and Dr. Daniel O. Clegg of University of Utah School of Medicine.

How Frequent Is SpA? SPARTAN Participants Share Country-Specific Data

Spondyloarthritis is a relatively common and disabling inflammatory disease. There are several different forms of SpA, marked by destructive arthritis of the spine and other joints. Spondyloarthritis most commonly develops in adolescent boys and young men. The cause is unknown, but SpA tends to run in families. There is no cure, but effective treatments for SpA are available.

A highlight of the 2010 SPARTAN meeting was a series of presentations that help to clarify the rates and characteristics of SpA across North, South, and Central America. Based on the best available data, the overall prevalence of SpA in the United States may be over one percent of the population.

An ongoing National Health and Nutrition Examination Survey (NHANES) study will soon provide more precise estimates of the total prevalence of SpA, as well as specific subtypes which include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and inflammatory back pain. The symposium also includes a series of reports on the epidemiology of SpA in Brazil, Argentina, Colombia, Central America, and Mexico.

New Findings on Bone Deformity, MRI Diagnosis, and More

Another article provides an in-depth look at the process of bone deformity in SpA. The bone changes in SpA appear similar to those of rheumatoid arthritis (RA), so the two diseases are often treated the same way. However, recent studies suggest that the processes triggering bone deformity in SpA differ from those in RA. Specific signaling molecules have been identified, suggesting it may be possible to develop specific treatments targeting the processes involved in SpA.

The symposium includes an update on the role of magnetic resonance imaging (MRI) in diagnosing SpA. The MRI finding of inflammation in the sacroiliac joint (the joint between the lower spine and pelvis) appears to be a particularly important sign of SpA it’s found in a significant proportion of young patients with back pain, and even those with no symptoms of back pain or arthritis. Educational programs will be needed to help increase physician awareness of new criteria for the diagnosis of SpA, including sacroiliac joint inflammation.

Another presentation highlights the risk of infections with mycobacterial pathogens related to tuberculosis. The infections may be related to SpA treatments that compromise the immune system, or to the disease itself. Evaluation for these “nontuberculous mycobacteria” may be especially important in patients receiving modern “biologic” therapies for SpA (TNF alpha blockers).

The 2010 SPARTAN meeting “proved to be a successful and collegial exchange of information,” Drs. Espinoza, Reveille, and Clegg write in an introductory article. The SPARTAN group is a network of health care professionals dedicated to research, awareness, and treatment of SpA. Members of SPARTAN meet every year to share and disseminate the latest advances in scientific understanding and clinical management of these conditions. The next Annual Research and Education meeting will be held July 29 to 30, 2011, in Portland, Ore.

Source: Lippincott Williams Wilkins



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Arthritis / Rheumatology headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Draft NICE Guidance Does Not Recommend Abatacept For Second-line Use In Rheumatoid Arthritis

Main Category: Arthritis / Rheumatology
Article Date: 30 Mar 2011 – 3:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article



Patient / Public:not yet rated

Healthcare Prof:not yet rated

The National Institute for Health and Clinical Excellence (NICE) has today (30 March 2011) opened a consultation on draft guidance which does not recommend abatacept (Orencia, Bristol-Myers Squibb), in combination with methotrexate, for the treatment of moderate to severe active rheumatoid arthritis in adults whose disease has responded inadequately to one or more conventional non-biological disease modifying anti-rheumatic drugs (DMARDs) including methotrexate.

NICE already recommends adalimumab, etanercept, infliximab and certolizumab pegol for second-line use, the same point in the clinical pathway at which abatacept is being considered in this appraisal. Furthermore, for adults with severe active rheumatoid arthritis who have had an inadequate response to at least one tumor necrosis factor (TNF) inhibitor, NICE also recommends rituximab, and for those people who cannot take rituximab following an inadequate response to at least one TNF inhibitor, NICE recommends adalimumab, etanercept, infliximab, tocilizumab and abatacept.

The manufacturer of abatacept had noted that their product would not be cost-effective for second-line use when compared to adalimumab, etanercept and certolizumab pegol, which are administered by subcutaneous injection. They therefore suggested that abatacept should be compared with infliximab, the only other intravenous treatment option at this stage in the pathway of care. However, the Committee did not consider this to be a relevant comparison since route of administration rarely determines which drug to prescribe. This is because devices used to self-administer subcutaneous injections have improved considerably and few people experience problems handling the injection devices. Subcutaneous injections can also be administered at home by a nurse or a family member.

The Committee also considered whether abatacept could be a cost-effective treatment option for people for whom treatment with a TNF inhibitor was contraindicated. However, the available evidence did not support the view that using abatacept in these circumstances would be a cost-effective use of NHS resources.

Sir Andrew Dillon, NICE Chief Executive, said: “We recognise that rheumatoid arthritis can be an extremely debilitating condition, and that patients need a range of options if their disease does not respond adequately to first-line treatment. We currently recommend seven biological treatments, including abatacept, for use at various points in the pathway, once conventional DMARDs have been tried. Unfortunately, the evidence available to the committee did not support the use of abatacept as a second-line treatment option.”

The manufacturer and other consultees, including the public, have until 20 April 2011 to comment on this draft guidance, and can do so via the NICE website. Any feedback received during this consultation will be considered by the committee and, following their next meeting, the next version of draft guidance will be issued.


Final guidance for this use of abatacept for rheumatoid arthritis is expected to be published later this year. Until then, NHS bodies should make decisions locally on the funding of specific treatments. NICE has not yet issued final guidance to the NHS.

Notes

More information on this appraisal can be found here.

Other treatments for rheumatoid arthritis recommended by NICE:

TA130 – Adalimumab, etanercept and infliximab

TA186 – Certolizumab pegol

TA195 – Adalimumab, etanercept, infliximab, rituximab and abatacept

TA198 – Tocilizumab

About the appraisal

Abatacept (Orencia, Bristol-Myers Squibb) is a selective T-cell co-stimulation modulator that blocks a co-stimulatory signal required to activate T-cells.

Abatacept is administered as a 30-minute intravenous infusion. After an initial infusion (week 0), a patient receives an infusion at week 2, week 4 and every 4 weeks thereafter. Abatacept is available in 250-mg vials at a cost of £242.17 per vial (excluding VAT; ‘British national formulary’ [BNF] edition 61). A patient requires fourteen infusions in the first year, and 13 infusions in subsequent years. The dose of abatacept depends on body weight: people weighing less than 60 kg, 60-100 kg and over 100 kg require 500 mg, 750 mg and 1000 mg respectively. The annual drug costs associated with abatacept vary according to body weight and the number of infusions required. For a person weighing between 60 and 100 kg, the annual drug cost is £10,171.14 in the first year and £9444.63 in subsequent years. Costs may vary in different settings because of negotiated procurement discounts.

Source:

NICE



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Arthritis / Rheumatology headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Benefits Of Exercise For Arthritis Suffers

Main Category: Arthritis / Rheumatology
Also Included In: Sports Medicine / Fitness
Article Date: 28 Mar 2011 – 12:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article



Patient / Public:5 stars

5 (1 votes)

Healthcare Prof:not yet rated

An estimated 50 million adults in the United States suffer from arthritis. According to the Centers for Disease Control, one of the best ways to combat the onset of arthritis as well as to control pain and improve function is through exercise.

“People who have arthritis are often scared to exercise because they think they will hurt themselves, but the condition will only get worse if people don’t get moving,” said Valerie Walkowiak, medical integration coordinator at the Loyola Center for Fitness. “The best way to start is to talk to your doctor about exercising and then work with a therapist or personal trainer to establish guidelines. Be proactive and take it one step at a time.”

Some of the benefits of exercise for arthritis sufferers include:

1. Preserving and restoring range of motion and flexibility around each affected joint

2. Increasing muscle strength and endurance to enhance joint stability

3. Increasing aerobic conditioning to improve psychological state and decrease risks of disease

According to Walkowiak the best exercise routine will depend on what type of arthritis has been diagnosed.

The most common form of arthritis is osteoarthritis, when cartilage begins to break down leaving the joint with no cushion between bones. Rheumatoid arthritis, inflammation in the joint causing it to lose shape and alignment, also affects many Americans. Though the specifics will depend on the person, all exercise programs should include stretching, muscle strengthening and low-impact aerobic exercise.

“For all arthritis suffers the most beneficial exercise will be stretching to increase range of motion around an affected joint,” said Walkowiak. “The type of stretching one should do depends on which joint is affected.”

Muscle strength training also is important for improving daily function. Be careful when starting a weight-training routine. Use light resistance with minimal repetitions. Lift weights 2-3 times a week with a day of rest between to allow for muscle recovery. One should not experience pain when performing exercises.

“Arthritis affects people in all age groups and fitness levels. The activities that an individual will be able to perform will depend on their current fitness level,” said Walkowiak.

Low-impact aerobic exercise is safe for people with arthritis and is beneficial in helping with pain control and improve daily function.

“Start slow with 10-15 minutes of aerobic exercise every other day to see how it impacts your body. As your body adapts to the new routine, gradually increase duration to 30-45 minutes,” said Walkowiak.

Some low-impact exercise ideas include:

– Aquatic exercise

– Walking

– Stationary bikes

– Gardening (depending on affected joint)

– Lap swimming

– Yoga

– Tai-Chi

– Low-impact aerobic classes

Walkowiak suggests always listening to your body and not pushing yourself too far, which can lead to injury.

Here are a few more tips to keep in mind when starting an exercise routine:

1. Get professional advice and set guidelines before starting a program

2. Listen to your body. Pain is not a part of being fit

3. Don’t exercise during an arthritis flareup

4. Start slow and progress as you go

5. Always warm up properly before you begin including stretching and walking for a few minutes

“If we don’t keep our bodies healthy and active we can lose function as we age. We all want to be independent and able to care for ourselves and by being proactive now we can make that a reality for a long time,” said Walkowiak.

Source:

Loyola University Health System



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Arthritis / Rheumatology headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Artimplant: Artelon(R) CMC Soft Cleared For Marketing In Europe

Main Category: Bones / Orthopedics
Also Included In: Arthritis / Rheumatology;  Regulatory Affairs / Drug Approvals
Article Date: 28 Mar 2011 – 5:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article



Patient / Public:not yet rated

Healthcare Prof:not yet rated

In collaboration with Small Bone Innovations (SBi), Artimplant has developed a new product in the Artelon® Spacer range with a similar user-friendly textile design to Artelon® Tissue Reinforcement (ATR). The product, Artelon® CMC Soft, has been granted CE-approval by the certification body Lloyd’s and has thus been granted clearance for marketing in Europe.

The major difference between the old Artelon® CMC Spacer and the new Artelon® CMC Soft is that the size can be adjusted and can thus be adapted to the requirements of each individual patient. Artimplant estimates that Artelon® CMC Soft will gradually replace existing Spacer products for thumb base osteoarthritis in the CMC-joint.

Source:

Artimplant



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Bones / Orthopedics headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Rheumatology Program Expands At NewYork-Presbyterian/Columbia

Main Category: Arthritis / Rheumatology
Article Date: 24 Mar 2011 – 12:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article



Patient / Public:not yet rated

Healthcare Prof:not yet rated

The rheumatology program at NewYork-Presbyterian Hospital/Columbia University Medical Center is expanding with the addition of one of the nation’s leading rheumatologists, the creation of a new integrated Arthritis Center, and plans for additional disease-specific centers.

Dr. Joan Bathon has been appointed director of the Division of Rheumatology at NewYork-Presbyterian Hospital/Columbia University Medical Center and professor of medicine at Columbia University College of Physicians and Surgeons. Previously, she was deputy director of the Division of Rheumatology and director of the Arthritis Center at Johns Hopkins.

Also joining NewYork-Presbyterian/Columbia from Johns Hopkins are Drs. Jon T. Giles and Dimitrios Pappas — both leading experts in rheumatoid arthritis.

The new Arthritis Center at NewYork-Presbyterian/Columbia will specialize in inflammatory arthritis such as rheumatoid arthritis and spondyloarthritis, crystal arthritis such as gout, as well as degenerative arthritis or osteoarthritis. One of the centerpieces of its clinical offerings will be a state-of-the-art injection clinic that employs ultrasound technology to identify the specific structures behind a patient’s pain, allowing for more targeted treatments.

Multidisciplinary collaborations with other medical specialties — including cardiology, nephrology, obstetrics and orthopedic surgery — will be the key to the success of the Division of Rheumatology’s new integrated programs. “Rheumatoid conditions affect numerous areas in a patient’s body, making a multidisciplinary approach central to effective treatment, as well as to research into future therapies,” says Dr. Bathon.

For patients with lupus, Dr. Bathon and her team will work closely with nephrology and obstetrics since the disease is associated with increased risk for renal disease and pregnancy loss. For patients with arthritis, which is associated with risk for cardiovascular disease, Dr. Bathon envisions the establishment of a Cardiovascular Risk Management Clinic with cardiology to prevent and manage heart disease, and to serve as a hub for research efforts.

An authority on the arthritis-related cardiovascular risk, Dr. Bathon is pursuing NIH-funded studies into genetics biomarkers, proteomics biomarkers, and PET and CT heart imaging. She is also looking at how a class of rheumatoid arthritis drugs called TNF blockers affects heart structure and function.

“I was delighted to recruit Dr. Bathon as chief of Rheumatology. We fully embrace her vision to create disease-specific programs in which patients with arthritis, lupus or other rheumatoid conditions can receive state-of-the-art, coordinated care from a multidisciplinary team of specialists,” says Dr. Donald W. Landry, chairman of the Department of Medicine and the Samuel Bard Professor of Medicine at Columbia University College of Physicians and Surgeons, and physician-in-chief at NewYork-Presbyterian Hospital/Columbia University Medical Center. “Patients can also look forward to new treatments and prevention strategies made possible through innovative research by Dr. Bathon and her team.”

Dr. Joan Bathon received her M.D. and completed an internship and residency at the University of Maryland in Baltimore. She completed a fellowship in rheumatology at Johns Hopkins in Baltimore. In 1983, she joined the faculty of West Virginia University in Morgantown, W.V. In 1986, she joined the faculty of Johns Hopkins. In 1998, she was appointed director of the Johns Hopkins Arthritis Center, and in 2007, she was named deputy director of their Division of Rheumatology. In 2010, she was named editor-in-chief of the journal Arthritis and Rheumatism.

Source:

Columbia University Medical Center

NewYork-Presbyterian Hospital



Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Arthritis / Rheumatology headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.