Arthritis & Rheumatism

There are over 100 types of arthritis and rheumatic diseases including osteoarthritis, rheumatoid arthritis, and fibromyalgia. This site provides the latest arthritic and rheumatic information including the treatment options available.



Arthritis is a common disease that affects millions of people worldwide. This can be felt in the person's joints, skin and organs inside the body. Should the person feel anything wrong, it is advisable to go straight to the doctor. Doctors have discovered that there are over 100 types of arthritis. Given the number, the doctor will not be able to know which one is affecting the person without an examination.

There are 2 common forms of arthritis. The first is rheumatoid arthritis which is considered a chronic disease. There is inflammation in the joints caused by cartilage damage. Anyone who has this will suffer long term joint damage that will lead to chronic pain and disability. Pain is usually felt when waking up in the morning and will gradually disappear during the day.

Rheumatoid arthritis is a problem that will not go away. This happens in three stages. The first is swelling. The second is the rapid division and growth of cells. The third is when these cells release enzymes that will eat the bone causing the joint to lose shape until the person will not be able to move it anymore.

Since this is systemic disease, it can spread and affect other organs in the body. The best way to prevent is from happening is detecting it early to prevent the person from being disabled. This can be treated with proper medication and therapy. There many drugs available that the patient can use. Some drugs offer pain relief to reduce the inflammation. Others can just do one function.

The second is called osteoarthritis. This happens more often than rheumatoid arthritis but unlike the first, there is no inflammation present. The cartilage in the joint is damaged and will eventually degenerate. Pain will slightly be felt when the person gets up but this will hurt later on during the day. Osteoarthritis can either be primary or secondary. When it is primary, it is often associated with age. It is similar to a car where the parts have to be replaced due to wear and tear. Doctors consider this to be normal as people grow older.

The secondary type is often associated with something else that has caused this to happen. Some of these factors are an injury that took place, heredity, obesity and bone density. Osteoarthritis can be treated with medication, exercise, weight control, joint protection, physical and occupational therapy. This is done to relieve the pain and slow the progression of the disease. Both of these are caused by different things. The common thing between these 2 types is that joint pain can happen anywhere in the body.

Given the many medications available to treat this disease, the patient has to be aware of the side effects of each before choosing which one to use. The doctor should explain these to the person in order to make the right decision.



Friday, October 19, 2007

I’ve Heard That Infections Are A Problem With The New Rheumatoid Arthritis Drugs…

Biologic therapies- silver bullets that target the immune system abnormalities in rheumatoid arthritis (RA) patients- have revolutionized the treatment of this disease. It is now possible to put patients with RA into remission. However, as with all therapies there are potential downsides. One of the risks that has been written extensively about is infections, particularly with TNF-α inhibitors. Examples of these drugs include Enbrel, Humira, and Remicade.

A recent study supports the notion that infections are not only increased in incidence but also are responsible for more hospitalizations in patients with rheumatoid arthritis. Among patients with rheumatoid arthritis, treatment with tumor necrosis factor (TNF) antagonists is associated with a "small to moderate" increase in risk of hospitalization with infection. (Askling J, et al. Ann Rheum Dis 2007;66:1339-1344). The authors state, "These findings add to the emerging evidence to suggest that anti-TNF treatment is indeed associated with an increased risk of infections," and they add, "since… closer monitoring for infections may be difficult to achieve in clinical practice, an increased awareness and increased patient information of this potential side effect of treatment may be indicated."

The investigators studied a total of 45,000 RA patients obtained from the Swedish Biologics Register and other national Swedish registers to determine the outcome, relative risks, and predictors of hospitalization with an infection in patients with rheumatoid arthritis. They found that treatment with a first TNF inhibitor was associated with a significant 43% increased risk of hospitalization with infection during the first year of treatment. Infection risk during the second year and thereafter was not significantly increased. The relative risk for infection was two times higher during treatment with a second TNF inhibitor, the researchers note. Using additional data, other risk factors identified as being significant predictors for infection with TNF inhibitor treatment were older age, higher Health Assessment Questionnaire (HAQ) score, and disease-modifying anti-rheumatic drug (DMARD) treatment other than methotrexate. When infections were assessed by type, only respiratory infection showed a slightly significant increase in relative risk in association with TNF antagonist treatment.

It is unclear so far as to whether the risk is due to one of the TNF inhibitor drugs more than another. These findings, as well as other observational trials, mirror what was seen in the clinical trials that led to approval by the FDA for the treatment of RA. Patients who are prospective candidates for this type of treatment need to be warned about this potential side effect. In addition, they should be monitored carefully. In the future, it may be possible to identify high risk patients ahead of time so that other therapies might be offered instead of anti-TNF drugs.

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