According to data presented at EULAR 2007, the Annual European Congress of Rheumatology, in Barcelona, Spain, treatment with oral steroids for a period of two years or more can reduce the risk of rheumatoid arthritis (RA) related lymphoma.

It was disclosed that benefits of steroids were experienced regardless of when in the course of the disease the steroids were first administered.

From Sciencedaily.com:

The study involved 378 patients with rheumatoid arthritis-associated lymphoma identified from the Swedish Hospital Register and the Cancer Register compared with 378 individually matched RA controls, i.e. patients with RA but without lymphoma.

Using data on steroid treatment type and duration along with inflammatory load collected from cases and controls, information on lymphoma type (where observed) was also collected. The lymphoma tissues were obtained from the pathology laboratories and were reclassified according to the most recent lymphoma classification, the World Health Organization classification.

Interestingly, researchers also compiled information on the duration of RA at initiation of steroid treatment. In this study there was no correlation observed between protective function and length of RA at onset of steroidal treatment. The protective effect was identical in those starting steroid treatment the first five years after onset of RA and in those starting later (relative risk 0.6; 0.3-0.9). Steroid treatment outcome was not associated with the presence of the Epstein-Barr virus in the lymphomas.

Study author Dr Eva Baecklund of Uppsala University Hospital, Sweden said the data reveals a new aspect of steroid treatment.

Tags: benefits of steroids, Oral Steroids, Rheumatoid arthritis, steroid

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CH-1504, considered by many as a potential oral drug for rheumatoid arthritis (RA), can motivate women to treat their condition earlier because it is less difficult than currently-available treatment options.

Chelsea Therapeutics, a pharmaceutical company specializing in treatment for rheumatoid arthritis and other immunological diseases, is currently on a developing spree to formulate an oral anti-inflammatory drug and conducting Phase I clinical trials in the UK with an aim to provide an amicable solution for this condition that is more prevalent in women and develops between ages of 35 and 50.

From News-Medical.Net:

Current treatment options for RA include over-the-counter oral nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers; oral steroids; but the gold standard for treatment is still methotrexate, a drug that been used for nearly 30 years. Newly available compounds known as biologic response modifiers, such as etanercept and infliximab are used when the disease progresses (mostly in combination with methotrexate) but have to be injected and are very expensive.

While methotrexate is often effective, long-term chronic doses of the drug can be toxic to the liver, kidneys and other organs. Short-term tolerability issues such as nausea, vomiting and diarrhea also often limit its use.

“Given the problems that many patients have tolerating methotrexate along with its long-term safety concerns, a drug candidate that is proven to be as effective or more effective than with fewer side effects would be a major breakthrough in the treatment of RA. This may prompt patients to treat their condition earlier and continue treatment longer,” says Dr. Pedder.

Dr. M. Gopal Nair, a professor and vice-chairman at the department of Biochemistry and Molecular Biology at the University of South Alabama, initially developed the CH-1504 therapy.

Tags: CH-1504, Oral Steroids, Rheumatoid arthritis, steroids

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According to a review of evidence, low doses of steroids when used in the early phase of rheumatoid arthritis could inhibit joint damage.

It was remarked by review authors led by John Kirwan of Liverpool Women’s Hospital in England that treatment involving steroid pills with standard medications in the first two years after diagnosis should be made readily available to the patients.

From Sciencedaily.com:

Concern exists about the side effects of steroid therapy, however. High doses can contribute to heart disease, osteoporosis and other complications. Questions remain about whether smaller doses lead to similar problems.

Rheumatoid arthritis is a chronic disease in which the body’s immune system attacks and destroys healthy joint tissue. The hands and feet are frequently affected, and as the disease progresses it can cause pain, swelling, deformity and disability.

The steroids studied in the review are known as glucocorticoids and include the well-known anti-inflammatory prednisone. This medication is often prescribed in the first few months after diagnosis to relieve the discomfort of RA until slower-acting drugs begin protecting the joints.

Until now, concerns about side effects caused most rheumatologists to “put people on the lowest possible dose of steroids and get them off it as soon as possible,” said Scott Zashin, M.D., of the University of Texas Southwestern Medical Center. “Now, we have to give steroids a little more respect.”

The benefits from this treatment option were statistically significant when reviewers made use of statistical methods for focusing on only the highest-quality data.

Tags: Rheumatoid arthritis, steroid, steroid therapy, steroids

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A novel way for halting and even reversing rheumatoid arthritis has been developed by a researcher from Northwestern University Feinberg School of Medicine. This invention is concerned with the development of an imitation of a suicide molecule, which floats unidentified into overactive immune cells responsible for the disease.

Harris Perlman, the lead author and an associate professor of medicine at Feinberg, said the new therapy stops the disease cold in 75 percent of the mice.

From Sciencedaily.com:

Perlman discovered that immune cells in rheumatoid arthritis are low in a critical molecule called Bim, whose job is to order the cells to self-destruct. To correct that shortage, Perlman developed an imitation of the molecule, called BH3 mimetic. When Harris injected his drug into mice with rheumatoid arthritis, it floated ghostlike into their macrophages and bam!, the misbehaving immune cells self destructed.

In his research, Harris showed the molecule could prevent the development of rheumatoid arthritis as well as trigger a remission of existing disease. After the drug was injected in animals with the disease, joint swelling was reduced and bone destruction decreased.

Current treatments for rheumatoid arthritis include low-level chemotherapy and steroids. These are not always effective, however, and they are frequently accompanied by side effects. A newer class of therapy, which is sometimes used in combination with chemotherapy and steroids, is biologic response modifiers. These are antibodies or other proteins that reduce the inflammation produced by the hyperactive immune cells. These biologics don’t work for everyone, though, and can be associated with side effects including the risk of infection.

The study was published in the February issue of Arthritis & Rheumatism.

Tags: chemotherapy, Rheumatoid arthritis, steroids

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A prospective new treatment approach has been uncovered by researchers to treat severe asthma by blocking a powerful immune system chemical that is present in large quantities in patients, according to a small study in Thorax.

Severe asthma though rare can be noticed in around one in every ten asthmatics and progressively higher doses of steroids are required to be administered in an attempt to control symptoms.

From Sciencedaily.com:

Seventeen people with severe asthma who still had symptoms, despite being treated with a range of drugs, were also given 25 mg of a drug that blocks TNF alpha production (etanercept) twice weekly, injected below the skin for 12 weeks. Fifteen completed the course.

At the end of the study period, these patients experienced a significant improvement in symptoms and lung function. Two patients were able to discontinue one of their drugs.

The treatment also curbed the inflammatory reaction in the lungs, known as bronchial hyperresponsiveness. And there were few side effects.

The authors caution that further research will be required before this approach can be recommended, but they say that it offers a potentially new avenue of treatment for severe asthma.

The research team investigated tumor necrosis factor alpha (TNF alpha) that is found in many chronic inflammatory conditions such as rheumatoid arthritis, Crohn’s disease, and psoriasis.

Tags: Asthma, Crohn's disease, psoriasis, Rheumatoid arthritis, severe asthma, steroids

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A potential oral drug for rheumatoid arthritis (RA), CH-1504, could encourage women in treating their condition earlier since it is less arduous than the presently available treatment forms.

Chelsea Therapeutics, a pharmaceutical company specializing in treatment for RA and other immunological diseases, is presently developing an oral anti-inflammatory medication and conducting Phase I clinical trials in the U.K. to offer a suitable solution for this condition that develops between the ages of 35 and 50 and is 2-3 times more prevalent in women.

From News-Medical.Net:

Current treatment options for RA include over-the-counter oral nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers; oral steroids; but the gold standard for treatment is still methotrexate, a drug that been used for nearly 30 years. Newly available compounds known as biologic response modifiers, such as etanercept and infliximab are used when the disease progresses (mostly in combination with methotrexate) but have to be injected and are very expensive.

While methotrexate is often effective, long-term chronic doses of the drug can be toxic to the liver, kidneys and other organs. Short-term tolerability issues such as nausea, vomiting and diarrhea also often limit its use.

“Given the problems that many patients have tolerating methotrexate along with its long-term safety concerns, a drug candidate that is proven to be as effective or more effective than with fewer side effects would be a major breakthrough in the treatment of RA. This may prompt patients to treat their condition earlier and continue treatment longer,” says Dr. Pedder.

CH-1504, the potential therapy, was initially developed by Dr. M. Gopal Nair, a professor and vice-chairman at the department of Biochemistry and Molecular Biology at the University of South Alabama.

Tags: CH-1504, Oral Steroids, Rheumatoid arthritis, steroids

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The risk of rheumatoid arthritis (RA) related lymphoma is significantly reduced when oral steroid treatment is continued for a period of two years or more. This finding was disclosed by data presented at EULAR 2007, the Annual European Congress of Rheumatology, in Barcelona, Spain.

It was further disclosed that this set of benefits are attainable irrespective of when the steroids were first administered in course of the disease.

From MedicalNewsToday.com:

The study involved 378 patients with rheumatoid arthritis-associated lymphoma identified from the Swedish Hospital Register and the Cancer Register compared with 378 individually matched RA controls, i.e. patients with RA but without lymphoma.

Using data on steroid treatment type and duration along with inflammatory load collected from cases and controls, information on lymphoma type (where observed) was also collected. The lymphoma tissues were obtained from the pathology laboratories and were reclassified according to the most recent lymphoma classification, the World Health Organization classification.

Interestingly, researchers also compiled information on the duration of RA at initiation of steroid treatment. In this study there was no correlation observed between protective function and length of RA at onset of steroidal treatment. The protective effect was identical in those starting steroid treatment the first five years after onset of RA and in those starting later (relative risk 0.6; 0.3-0.9). Steroid treatment outcome was not associated with the presence of the Epstein-Barr virus in the lymphomas.

These results build on those of a previously published study that reported that orally prescribed and intra-articular (administered within the joint or joint cavity) steroids protect the individual from the development of malignant (actively cancerous) lymphomas in a dose responsive manner.

Study author Dr Eva Baecklund of Uppsala University Hospital, Sweden, said that long term steroid treatment may decrease the risk of malignant lymphomas (cancer in the immune system) in patients with severe rheumatoid arthritis.

Tags: lymphoma, Rheumatoid arthritis, steroid, steroids

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A drug previously approved for the treatment of non-Hodgkin’s B cell lymphoma and rheumatoid arthritis, Rituxan, was recently identified by researchers as a useful option to treat severe ANCA-associated vasculitis as effectively as cyclophosphamide, the present standard therapy.

The news was presented on October 18 at the annual meeting of the American College of Rheumatology in Philadelphia.

From Sciencedaily.com:

“If you followed patients long enough, you found they had a higher risk of leukemias, lymphomas and solid tumors,” said Dr. Spiera, who is also an Associate Professor at Weill Cornell Medical College. “People would sometimes develop terrible infections. Women, almost reliably, would become infertile, as did many men. So, although it was a dramatically effective drug at reducing remissions in these patients, it came at a price.”

In the current study, nine centers enrolled a total of 197 patients with severe Wegener’s granulomatosis or microscopic polyangiitis, two of the more common types of ANCA-associated vasculitis. Patients were given steroids and randomized to receive either the standard treatment with cyclophosphamide or Rituxan given at a dose of 375 mg/m2 weekly for four weeks. Investigators used the standard tools to assess disease status and remission. The study was rigorously designed and was double-blinded, meaning that neither patient nor doctor knew which drug individuals were getting.

Robert Spiera, M.D., an associate attending rheumatologist at Hospital for Special Surgery in New York, said Rituxan is as effective as cyclophosphamide when it comes to promoting patients to go on remission without leading to infertility or causing secondary cancers.

Tags: cyclophosphamide, Rheumatoid arthritis, Rituxan, steroids, vasculitis

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A serious international public health concern was recently raised by researchers after results from the Global Longitudinal Study of Osteoporosis in Women (GLOW) showed that women are at an increased risk for osteoporosis-associated fractures.

It was also suggested by the study that there is a complete failure among women to perceive the implications of having important risk factors.

From Sciencedaily.com:

Improved education of both physicians and postmenopausal women about osteoporosis risk factors is urgently needed, according to the study authors. Osteoporosis causes bones to become fragile and therefore more likely to break. If left untreated, the disease can progress painlessly until a fracture occurs. Several risk factors for fractures have been identified and should be considered by physicians treating women age 55 and over:

* older age

* low weight

* parental hip fracture

* personal history of fracture (clavicle, arm, wrist, spine, rib, hip, pelvis, upper leg, lower leg, ankle) since age 45

* two or more falls in the past year

* current use of cortisone or prednisone (steroids often prescribed for a number of medical conditions)

* rheumatoid arthritis

* cigarette smoking

* consumption of three or more alcoholic beverages daily.

GLOW is supported by a grant from The Alliance for Better Bone Health (formerly sanofi-aventis and P&G Pharmaceuticals, now sanofi-aventis and Warner Chilcott) and is being directed by The Center for Outcomes Research, University of Massachusetts Medical School.

Tags: cortisone, osteoporosis, Prednisone, public health, Rheumatoid arthritis, steroids

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Patients affected by osteoarthritis can experience slowing down of the disease progression and pain getting eased with injecting gold into knees but this treatment form is not meant for every patient with rheumatoid arthritis, as per scientists.

As per the Arthritis Research Campaign, approximately 80 million people suffer from this condition and a further 350,000 people suffer from rheumatoid arthritis, which is an autoimmune joint disease where the joints in the body become inflamed.

From Bio-Medicine.Org:

Treatments include painkillers, steroids and joint replacement.

Gold has already been used in the past for rheumatoid arthritis and for other rheumatic diseases such as psoriatic arthritis, which also causes swelling and pain in and around the joints.

As many as half those patients with rheumatoid arthritis, especially those in the early stages of the condition, can benefit from gold, claim researchers at the University of Washington.

In some, it relieves joint pain and stiffness, reduces swelling and bone damage, and lowers the chance of joint deformity and disability.

It was remarked during the study that injecting gold into knees is not a same-treatment-for-all remedy as around 20-30 percent of the affected patients do not benefit from gold.

Tags: arthritis, joint replacement, osteoarthritis, Rheumatoid arthritis, steroids

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