Women Aged Over 85 Have Higher Prevalence Of Arthritis And Joint Pain

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Main Category: Arthritis / Rheumatology
Also Included In: Seniors / Aging;  Women’s Health / Gynecology
Article Date: 21 Sep 2011 – 0:00 PDT

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Published today in the journal Age and Ageing, an investigation conducted by Newcastle University has discovered that the lifetime prevalence of arthritis is 65.4% in individuals aged 85, occurring more commonly in women. The discoveries of this investigation indicate that compared to prior research of 85 year olds, the prevalence of arthritis is greater.

Although arthritis is strongly connected with age, very few investigations have studied how the oldest individuals (those aged 85+ years) are affected by the disease, even though by 2033 these individuals will make up for 3.3 million of the population in the UK.

The investigation from an observational cohort study, looked at 1040 individuals aged 85 years old, born in 1921, from GPs in Newcastle upon Tyne and North Tyneside Primary Care Trusts. The results revealed that for ‘any arthritis’ the lifetime prevalence was high, with 673 (65.4%) of the participants having arthritis, they also discovered that the disease was more common in women than men (69.1% vs 58.8%, p=0.001).

In 534 (51.9%) of the participants, osteoarthritis was common, more in women than men (57.1% vs 42.5%). Osteoarthritis was most prevalent in the knee joint followed by the hip and hand. Several of those participating in the study identified the knee as the most painful joint, even though the foot, ankle and lower back received the highest pain score. With the exception of the shoulder and foot, for all joints women reported a higher average pain score.

In the UK, last month, approximately two-thirds of the population reported pain in their joints, with 71.7% reporting pain on most days of the month. This is slightly higher that prior population investigations including individuals aged 85 and over: United Kingdom 56.9% (women 64.5%, men 44.2%) and 53.6% (women 58.3%, men 39.6%), Netherlands 57% (women 62%, male 47%), Sweden (women 48.7%, men 12.9%)

The authors stated that:

“Establishing the impact of arthritis on disability, health and wellbeing and healthcare use, is fundamental before we can determine treatment approaches and measure their success; particularly in the presence of multimorbidity in this age group. The economic burden of musculoskeletal disease in the oldest old is potentially huge and its management presents a major challenge.”

Prof. Louise Robinson, GP and RCGP Champion for Older People’s Health and Wellbeing, explains that: “This new research, from a large cohort study of the oldest old, reveals that osteoarthritis is more common in the over 85 year olds and perhaps GPs realize. Much of the care we provide on the management of long term chronic conditions is evidence – based and as a consequence, we have quality outcome markers to adhere to; however this is not so for osteoarthritis. It would be interesting to explore how well GPs manage a condition as common as in the oldest old.”

Key Points:

  • Arthritis and join pain are highly common in individuals aged 85+
  • The most common diagnoses were knee osteoarthritis and cervical spondylosis
  • In the 11 areas investigated, pain occurred more frequently in women in all areas
  • Compared to men, women reported a higher total of painful joints
  • 13.5% of those who participated had undergone either a hip or knee replacement

Written by Grace Rattue

Copyright: Medical News Today

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American College Of Rheumatology Campaign Highlights Devastating Impact Of Rheumatic Diseases

Main Category: Arthritis / Rheumatology
Article Date: 20 Sep 2011 – 1:00 PDT

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The American College of Rheumatology launches its Simple Tasks campaign. The initiative aims to raise awareness of the severe impact of rheumatic diseases such as rheumatoid arthritis, lupus and gout on the U.S. population and to highlight the importance of rheumatologists in the diagnosis and treatment of these diseases.

Rheumatic diseases are not just aches and pains or a normal part of aging. Over seven million American women, men and children are affected by these diseases, which often strike in the prime of life and can cause inflammation and damage to joints and other organs of the body, the development of co-existing diseases, disability and even death.

“Despite millions of Americans suffering their consequences, many people still know very little about rheumatic diseases,” says David Borenstein, MD, president of the ACR. “The Simple Tasks campaign explains that straightforward everyday tasks can quickly become overwhelming, painful and impossible as a result of a rheumatic disease. We’re working to educate those who make decisions that affect rheumatology about the severity of these diseases and the importance of early and appropriate treatment by a rheumatologist.”

More specifically, the Simple Tasks campaign aims to:

  1. Educate lawmakers, administration officials, referring physicians/physician groups, and others who influence rheumatology about the value of rheumatology and the role rheumatologists play in helping the millions of Americans with rheumatic diseases

  2. Explain how treatment within the ‘window of opportunity’ the first few weeks and months after disease symptoms appear can diminish long-term complications

  3. Champion the rheumatology profession

The campaign is launching in conjunction with the ACR’s annual Advocates for Arthritis lobbying fly-in on Capitol Hill. Over the next two days rheumatologists, rheumatology health professionals and their patients will meet with key legislators and policymakers to discuss the goals of the Simple Tasks campaign and to share with Capitol Hill their experiences of living with, and treating, rheumatic diseases.

“By reaching out to these influential groups and people with a campaign based on scientific research and personal experiences of patients and rheumatologists, we can make our case that the rheumatology profession is a vital component in today’s health care landscape,” explains Eric Matteson, MD, rheumatologist at the Mayo Clinic in Rochester, Minn. and chair of the ACR’s communications and marketing committee.

“Rheumatologists are uniquely trained and are advancing the medical field – positively impacting the health and quality of life of those with rheumatic diseases as well as relieving stress on their families, caregivers, employers and society as a whole.”

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Canakinumab Relieves Symptoms In Systemic Juvenile Idiopathic Arthritis

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Main Category: Arthritis / Rheumatology
Also Included In: Pediatrics / Children’s Health
Article Date: 18 Sep 2011 – 11:00 PDT

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Canakinumab (ACZ885; Novartis) achieves major relief of symptoms in patients with systemic juvenile idiopathic arthritis (SJIA), according to encouraging results from a pivotal phase III trial with the anti-interleukin-1 beta antibody reported at the Pediatric Rheumatology European Society Congress (14-18 September, Bruges, Belgium).

The study randomised 84 patients with active SJIA (age 2-19 years) to a single subcutaneous dose of canakinumab (4mg/kg) or placebo. Most of the children treated with the antibody (83.7%) showed at least a 30% improvement in symptoms (ACR Ped30) compared to only 9.8% of those given placebo (p

Reporting the results, Nicola Ruperto, paediatric rheumatologist at the University of Tutto Gaslini, Genoa, Italy, said:

“A single dose of canakinumab has proven to have superior efficacy to placebo in children with SJIA with fever, providing rapid onset of action and robust response in the majority of patients.”

Canakinumab was generally well tolerated. Adverse events were reported in 55.8% of children treatment with canakinumab and 39.0% of the placebo group. There were no discontinuations due to adverse events in either treatment group.

“These data suggest that canakinumab could become an important treatment option for children with SJIA, which is most difficult to treat and severe form of juvenile arthritis,” suggested Pierre Quartier, co-investigator and paediatric rheumatologist at Necker-Enfants Malades Hospital, Paris, France. Children treated with the antibody showed complete control of fever, a major improvement in functional scores and ability to carry out daily activities, and had fewer inflamed joints, he noted.

Professor Quartier said that currently available treatments for SJIA only partially mitigate symptoms and do not prevent long-term damage associated with the condition, adding that prolonged use of steroids can cause slowed growth and delayed puberty.

Canakinumab is a long acting fully human anti-interleukin-1-beta antibody. It inhibits the effects of the cytokine, which plays a major role in several inflammatory conditions including SJIA. A second phase III trial is investigating whether the antibody can extend the time between disease flares and reduce or eliminate corticosteroid use in SJIA. Novartis is planning worldwide regulatory submissions in SJIA for 2012.

Written by Susan Mayor
Susan Mayor PhD, medical journalist, London, UK

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Novartis Study Showed ACZ885 Provided Substantial Symptom Relief In 84% Of Patients With The Most Serious Form Of Childhood Arthritis

Main Category: Arthritis / Rheumatology
Also Included In: Clinical Trials / Drug Trials;  Pharma Industry / Biotech Industry
Article Date: 17 Sep 2011 – 0:00 PDT

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Novartis announced positive results of the first pivotal Phase III trial of ACZ885 in patients with systemic juvenile idiopathic arthritis (SJIA), a rare and serious childhood auto-inflammatory disease[3]. The results, presented at the 2011 European Pediatric Rheumatology Congress in Bruges, Belgium, showed all primary and secondary endpoints of the study were met[2].

Most ACZ885 patients (83.7%) experienced at least a 30% improvement in symptoms vs. 9.8% for placebo (p

“SJIA is the most severe form of juvenile arthritis. Many of my patients suffer terribly from this disease, resulting in a critical need for new treatment options,” said Daniel Lovell, M.D., one of the study investigators and Professor of Pediatrics at the Cincinnati Children’s Hospital Medical Center. “This study showed ACZ885 effectively relieved the systemic and arthritic disease components evaluated in the trial, demonstrating a much-needed benefit for this patient population.”

SJIA affects less than one child per 100,000 worldwide[5]. It is called ‘systemic’ because the inflammation affects the whole body, as well as most of the joints. The condition is characterized by potentially life-long and recurrent arthritis flares, which can involve skin rash, daily spiking fever, joint pain and swelling[3,4].

In this study, patients were evaluated according to the adapted American College of Rheumatology (ACR) Pediatric criteria, which includes absence of fever. The ACR criteria are regularly used to assess the success of treatments in SJIA.

“These results are a positive development for patients suffering from this very severe auto-inflammatory condition,” said David Epstein, Head of the Pharmaceuticals Division of Novartis. “We are committed to investigate ACZ885 in a range of inflammatory diseases where interleukin-1 beta plays a key role and high unmet medical needs exist.”

The results of a second pivotal Phase III trial, aimed at determining whether ACZ885 can extend the time to next flare and reduce or eliminate corticosteroid use, will be presented later this year. Worldwide regulatory submissions for ACZ885 in SJIA are planned for 2012.

About the Study

The study was a Phase III, 4-week, randomized, double-blind, placebo-controlled study involving 84 patients between the ages of 2 and 19 years, with active SJIA[2]. Patients were treated with either a single subcutaneous (s.c.) dose of ACZ885 (4 mg/kg, up to 300 mg) or placebo[2].

The primary endpoint was the proportion of patients achieving the adapted ACR Pediatric 30 criteria, demonstrating a 30% improvement from baseline at Day 15 in at least three of the six variables[2]. The six variables were physician’s assessment of disease activity, parent’s or patient’s assessment of overall well-being, functional ability, number of joints with active arthritis, number of joints with limitation of motion and C-reactive protein, a laboratory measure of inflammation[2]. Body temperature also was measured[2].

Secondary endpoints included the proportion of patients achieving the adapted ACR Pediatric 50, 70, 90 or 100 criteria, demonstrating a 50%, 70%, 90% or 100% improvement in at least three variables from baseline at Day 15 or 29[2].

ACZ885 was generally well tolerated. During the study, 55.8% of patients experienced adverse events (AEs), including infections, with ACZ885 vs. 39% with placebo[2]. Serious adverse events (SAEs), including infections, were reported for two patients for ACZ885 vs. two for placebo[2]. These did not lead to discontinuation and were resolved without complications[2].

About ACZ885

ACZ885 is a fully human monoclonal antibody that inhibits IL-1 beta, which is an important part of the body’s immune system defenses[1]. Excessive production of IL-1 beta plays a major role in many inflammatory diseases, including SJIA[6]. ACZ885 works by neutralizing IL-1 beta for a sustained period of time, therefore inhibiting inflammation[1].

ACZ885 is currently approved in the US and other countries for a different disease state.

References

1. Ilaris [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; 2009.

2. Ruperto N, Brunner H, Horneff G, et al. Efficacy and safety of canakinumab, a long acting fully human anti-interleukin-1β antibody, in systemic juvenile idiopathic arthritis with active systemic features: results from a Phase III study. At: The 18th European Pediatric Rheumatology Congress; 2011 September 14-18; Bruges, Belgium; 2011.

3. Woo P. Systemic juvenile idiopathic arthritis: diagnosis, management, and outcome. Nat Clin Pract Rheumatol 2006; 2(1):28-34.

4. Mellins ED, Macaubas C, Grom AA. Pathogenesis of systemic juvenile idiopathic arthritis: some answers, more questions. Nat Rev Rhuematol 2011; 7(7):416-426.

5. Ramanan AV, Grom AA. Does systemic-onset juvenile idiopathic arthritis belong under juvenile idiopathic arthritis? Rheumatology (Oxford) 2005; 44(11):1350-3.

6. Church LD, Cook GP, McDermott MF. Primer: inflammasomes and interleukin 1beta in inflammatory disorders. Nat Clin Pract Rheumatol 2008; 4(1):34-42.

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Article adapted by Medical News Today from original press release.

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Novartis Pharmaceuticals Corporation (2011, September 17). Novartis Study Showed ACZ885 Provided Substantial Symptom Relief In 84% Of Patients With The Most Serious Form Of Childhood Arthritis. Medical News Today. Retrieved September 17, 2011 from
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Cam-type Deformities Linked To MRI Detected Hip Damage In Young Men

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Academic Journal
Main Category: Arthritis / Rheumatology
Also Included In: Bones / Orthopedics
Article Date: 14 Sep 2011 – 10:00 PDT

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A study published in Arthritis Rheumatism reveals that hip impingement (femoracetabular impingement) might be a risk factor for osteoarthritis (OA) of the hip. The report indicates that the presence of an underlying deformity, known as cam impingement, is connected with hip damage in young men without any symptoms of arthritis and detected using magnetic resonance imaging (MRI).

Medical evidence reveals that each year in the U.S., OA accounts for over 200,000 hip replacements and is a major cause of pain and disability. Because of boney bumps on the femoral head, cam impingement restricts full range of motion in the hip socket. The deformity causes hip pain as the bumps move inside the socket, applying extreme pressure to cartilage, which may eventually lead to osteoarthritis in the hip. Investigations have revealed that cam impingement is frequently observed in young male athletes who have been referred to orthopedic specialists after experiencing groin pain, and hip rotation is found to be diminished.

Lead author Dr. Stephan Reichenbach from the Institute of Social and Preventive Medicine at the University of Bern in Switzerland, says:

“Given that cam-type deformities are common in young asymptomatic males, we examined whether the deformities were associated with early signs of MRI detected hip damage.”

The investigators recruited 244 participants from a population-based group of male individuals enrolling in the Swiss army at one recruiting center. The average age of the 244 males was 20 years, and all reported having no hip pain. In every participant, an MRI was conducted to analyze one hip for cam-type deformities, labral lesions, signs of cartilage damage and impingement pits.

67 definitive cam-type deformities were detected in the participants, and these men also had higher body mass index and decreased internal rotation. In 85% of participants with cam-type deformities labral lesions were detected, and in only 67% of participants without the deformity. Labral avulsions were discovered in 76% with the deformity in comparison to 58% of those without. Impingement pits was found in 30% of participants with cam-type deformity compared to 12% of those without.

They report an adjusted prevalence of 24% for cam-type deformities in the investigation participants together with a high frequency of signs of joint damage. The signs of joint damage discovered in the study population could be an outcome in the sequence from normal to osteoarthritic hips, the researchers suggest.

Dr. Reichenbach concluded:

“Our study is the first population-based MRI study to confirm the role of cam-type deformities of the hip as a potential risk factor for joint damage. Longer-term studies are needed to determine if cam-type deformity increases risk of developing hip OA.”

Written by Grace Rattue

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