Combo Treatment Best for Early Rheumatoid Arthritis

(Newswire) -- A new study out of the Netherlands suggests early rheumatoid arthritis (RA) is best treated more aggressively with a combination of proven drugs.

Researchers note treatment for rheumatoid arthritis in recent years has migrated from a simple attempt to alleviate symptoms to strategies aimed at preventing long-term damage to the joints and organs. With so many new treatments available, doctors have been unsure which are best for people newly diagnosed with the condition.

In this study, investigators compared four different strategies: standard treatment with disease-modifying antirheumatic drugs (DMARDs), sequential therapy beginning with a DMARD and adding additional DMARDs and prednisone, a combination therapy consisting of DMARDs and prednisone, and a combination therapy consisting of a DMARD and the drug infliximab.

Results show all the strategies help people with the disease, with 32 percent reaching clinical remission. Those receiving the two combination therapies fared significantly better, with less progression of the disease and greater functional improvements.

Study authors say, "During the first year of follow up, patients with newly diagnosed RA who received initial combination therapy with either prednisone or infliximab had earlier function improvement, with less progression of radiographic joint damage and no more side effects than patients who receive sequential monotherapy or step-up combination therapy."

Pain and Arthritis

Arthritis (Rheumatics, Joint Pains)

By Dr. Lillian Sanvee
Published: 31 October, 2005

What is pain? Pain is the body's warning system, alerting you that something is wrong.

The International Association for the Study of Pain defines pain as an unpleasant expression associated with actual or potential tissue damage to a person's body. Specialized nervous cells, called neurons that transport pain signals are found throughout the skin and other body tissues. The cells respond to things such as injury or tissue damage. For example, when a harmful agent such as a sharp knife comes in contact with your skin, chemical signals travel from neurons in the skin through nerves in the spinal cord to your brain, where they are interpreted as pain.

Most forms of arthritis are associated with pain that can be divided into two general categories: Acute and Chronic. Acute pain is temporary. It can last a few seconds or longer but wanes as healing occurs. Some examples of things that cause acute pain include burns, cut, and fractures. Chronic pain, such as that seen in people with osteoarthritis and rheumatoid arthritis, ranges from mild to severe and can last weeks, months and years to a lifetime.

What is arthritis?

Arthritis is an illness that causes pain, stiffness and swelling in or around joints. It is one of the causes of disability, limiting the activity of many working class people. It is a chronic disorder that affects people all over the world and fifty percent of people over 65 years old and above. Arthritis is a significant public health problem that is expected to affect about thirty percent or more of our working population by the year 2020. Arthritis is an illness that can be prevented in certain cases by risk-reduction strategies.

What are the types of Arthritis?

Two common types of arthritis are rheumatoid arthritis and osteoarthritis. These are separate diseases that affect people in different ways.

Osteoarthritis is the most common type of arthritis, affecting many older Liberians. It is also called “degenerative joint disease” and most often involves the weight-bearing joints. (Knees, hips, feet) and others like hands and spine. The knee is the most commonly affected joint. The disorder results from mechanical joint damage whether from long-term “wear and tear” or previous injury. Osteoarthritis is usually diagnosed in people older than forty. Nearly everyone seventy and older has osteoarthritis in at least one joint, but not everyone develops symptoms.

Rheumatoid arthritis involves inflammation of the joints and results from the body's abnormal attack on the joints, not from overuse of joints. It can affect someone's entire body and often causes other symptoms, in addition to joint pain. Rheumatoid arthritis is most commonly diagnosed in people between the ages of twenty-five to fifty, but can affect people of all ages, including children.

Many other types of rheumatic disorders exist. Not all of them are diagnosed in adults. Juvenile arthritis is the name given to a group of arthritis-related conditions that affect children.

How can you prevent arthritis?

You can reduce your risk of developing symptomatic osteoarthritis by maintaining a normal weight. Being overweight puts more stress on your weight-bearing joints and increases your risk for knee pain (and possibly hip and back pain).

If you are overweight, losing just ten pounds significantly reduces your risk of developing osteoarthritis in your knees. If you have wanted to take off weight for some time, do not feel that you have to take it off all at once. Just set your sights on taking off the first ten or eleven pounds and you will have accomplished a significant reduction in your health risk.

How can you get help for arthritis?

See your doctor if you suspect you have arthritis. Your doctor will find it easier to give you an accurate diagnosis if you describe your symptoms clearly. You may be asked the following:

• Where do you feel joint pain?

• How long does your joint pain or stiffness last?

• When did you first start having this type of pain?

• Have you had swelling of the joint?

• Are you having problems carrying out certain activities?

• Have you ever injured the affected joint?

• Does anyone else in your family have similar symptoms?

Your family doctor can evaluate and treat most cases of arthritis. Some patients are referred to special doctors for specialized treatment.

How can you cope with arthritis?

If you are already being treated for arthritis:

• Learn as much as you can about what type of arthritis you have and how the disease affects you. Enlist your family members or close friends in this effort so that they, too, may become informed.

• Follow your doctor's treatment recommendations. Make sure a qualified doctor who communicates well with you is treating you. Consider looking for another doctor if you are not satisfied.

• Exercise (according to your doctor's recommendation) to help you feel better, to extend your movement and to increase your strength.

• Protect your joints by using your stronger joints to carry out task, by avoiding stress on joints affected by arthritis and by using assertive devices to make daily life easier. Ask your doctor for more information.

• Your doctor cannot make the pain go away completely but can help you with ways to reduce joint pain. Ask for help with pain management if you feel your treatment is not addressing your pain well.

• Do not believe everything you hear when it comes to “miracle treatments” or “cures” for arthritis. If an advertised remedy sounds too good to be true, it probably is. Check with your doctor before spending money or potentially risking your health on it.

Important Points to remember about Arthritis?

• Arthritis is a common condition that is becoming even more frequent in our world today as the average age of the population increases.

• Arthritis is a leading cause of disability and a significant public health concern.

• There is more than one type of arthritis. Rheumatoid arthritis affects people differently from osteoarthritis.

• Arthritis can affect children and adults.

• Maintaining a normal weight or losing ten pounds if you are overweight helps reduce the risk of osteoarthritis and helps reduce joint stress if you already have arthritis.

• Other strategies for coping with arthritis include exercising appropriately, joint protection, rest and medication as recommended by your doctor; staying informed about your condition; and getting support from your family, friends and arthritis organizations when you need it.

Glucosamine - The Arthritis Cure?

Glucosamine sulphate has been around a long time now and as each year goes by more and more claims are made telling us about this miracle joint lubricant. Are all the claims true? Will it cure Arthritis? What is Glucosamine anyway? And what about Chondroitin?

Glucosamine is a naturally produced amino sugar which is found in small amounts in foods. It plays an important role in maintaining the cartilage gel-like material between our joints. The body also produces a carbohydrate called Chondroitin, which is thought to promote water retention and elasticity as well as blocking the enzymes that break down cartilage.

As we get older the body's ability to manufacture and synthesize Glucosamine and Chondroitin decreases. This probably contributes to the joint problems we have all come to associate with growing old, a fact that health food companies did not take long to latch on to.

Although studies have been carried out in numerous countries to try to prove conclusively that Glucosamine is effective in treating arthritis and joint problems there have been an equal number of questions raised about the methodology of many of these studies. One such study, in Europe, took X-rays to measure the size of the gap in the knee joint before and after taking Glucosamine. Even though the results showed that the size of the gap was significantly larger, in a group of people taking Glucosamine compared to a group taking NSAIDs, critics said that the study was not large enough to draw firm conclusions. They also claimed the X-ray evidence was too difficult to interpret.

Many Vets and pet owners have been using Glucosamine to treat joint problems in horses and dogs for a number of years now. They swear by the effectiveness of this form of treatment for their animals. While there is no placebo effect in animals it is equally difficult to find well documented, and conclusive, scientific evidence to confirm the effectiveness of Glucosamine.

While there might be limited good, accredited, scientific proof as to the effectiveness of Glucosamine there is an abundance of people as well as pet owners who swear by the effectiveness of Glucosamine. Even though Glucosamine is often used in combination with other supplements, or treatments, the general feeling among most users is that it does help. Results of empirical studies in various countries have shown that arthritis sufferers report significant improvements when taking Glucosamine supplements. The same is also true for people who have other types of joint injuries or back problems. Some countries now sanction Glucosamine as a treatment for people with mild to moderately severe osteoarthritis.

To date no study has found any serious side effects from either Glucosamine or Chondroitin when taken as a supplement in humans. However people with diabetes are advised to keep a check on their blood-sugar level. While there have been no reports of allergic reactions to Glucosamine, since it's made from shellfish shells, it may not be suitable for people with seafood allergies. It may also increase a person's daily salt intake level - something people with high blood pressure may want to watch. Chondroitin on the other hand may sometimes cause bleeding in people with bleeding disorders or taking blood-thinning drugs. Like many supplements insufficient data is available about the long term effects and hence it should be not be taken by children, or pregnant or breastfeeding mothers.

The United States Food and Drug Administration embarked on a study involving 1500 people earlier in 2005 to determine the effects of Glucosamine and Chondroitin on people with arthritic problems.

There are many claims that taking Glucosamine will slow and possibly halt osteoarthritis-related damage to joints, speed healing of strains and sprains, control back pain and help promote healthy aging. Whether this is true or not, the overall rhetorical evidence is probably stacked in favour of the use of Glucosamine as a supplement - so maybe it's worth a try - for a trial period anyway!

This information in this article should not be used to diagnose, treat, or prevent any disease. You should always consult with your health care professional especially relating to suitability of supplements or drugs and on all health matters that may require diagnosis or medical attention.

Bill Morrison has his own website http://www.help4urback.com where he describes his own personal experiences coping with lower back pain and sciatica. He also includes personal recommendations for people who suffer from sciatica or lower back pain including what books to buy, TENs machines, and what web sites to check out.

Easing the Symptoms of Rheumatoid Arthritis (RA) Naturally

Easing the Symptoms of Rheumatoid Arthritis (RA) Naturally By Stewart Hare

Rheumatoid arthritis (RA) is a chronic inflammatory disease where the synovial membranes lining in certain joints and sometimes other parts of the body are attacked by the immune system. This causes the synovial membranes lining to become inflamed, thickened and become stiff, red, swell and painful due to the excess synovial fluid produced. The underlying bones of the joints that are affected by RA are affected by the inflammation as it spreads causing them to become distorted and worn. Some individuals who are affected with RA also have other symptoms such as fatigue, weakness, fever and weight loss. The exact cause of RA is unknown but it has been linked to an over-active immune system, an under-active immune system and Epstein-Barr virus which causes glandular fever. About 1% of the population, mostly women are affected by RA; the main parts of the body affected are the hands, feet, wrists, ankles, knees and neck. Most cases of RA occur between the ages of 40-50 years old.

Studies have shown that a very low fat free vegetarian style diet with plenty of olive oil and fish oil can improves RA. Further studies show that linking a vegetarian style diet with fasting improves RA, although the exact reason why this happens is unknown. Allergies and food sensitivies especially to milk and wheat have been linked to making the symptoms of RA worst. Avoiding these foods may be beneficial; also cutting down on coffee consumption will help with RA.

The RA sufferer should, although at first painful, do gentle exercise, keep warm, avoid cold draughts, use hot/cold compresses and showers and baths to help joints affected by RA.

The following supplements may help if you are suffering from Rheumatoid arthritis (RA).

Borage oil

Devil’s claw

Evening primrose oil

Extracts of New Zealand green-lipped mussels

Fish Oil

Multivitamins and multiminerals

Vitamin B3

Vitamin E

Stewart Hare C.H.Ed Dip NutTh

Advice for a healthier natural life

website: http://www.newbeingnutrition.com

Article Source: http://EzineArticles.com/

Trial to test arthritis treatment

A NATIONAL clinical trial will be launched today to test the effectiveness of the popular arthritis treatment glucosamine.

Commissioned by the Federal Government, the $450,000 trial will test use of the dietary supplement on 340 Australians with osteoarthritis of the knee.

Glucosamine is believed to help rebuild cartilage, cushion joints, relieve pain and reduce inflammation.

However, an Australian consumer study published earlier this year found 70 per cent of glucosamine products did not contain as much of the supplement as claimed on the packaging.

Announcing the nine-month trial today, Federal Minister for Ageing, Julie Bishop, said it would finally establish the effectiveness of the treatment.

"As yet there is no cure for osteoarthritis, but any treatment that can help relieve the suffering will be welcomed," Ms Bishop said.

"Glucosamine has been used for around 20 years, and there is reasonable evidence that it can help, at least in the short term, particularly with osteoarthritis of the knee."

The trial, funded through the National Health and Medical Research Council, will be conducted by a research team from Sydney University's George Institute for International Health.

It will examine how useful the treatment is in different preparations, for different joints and at different stages of disease severity.

The trial will also look at the economic and long-term value of the supplement, which is created by extracting amino sugars from the tissues of shellfish.

The work will be conducted in general practice surgeries, with a long-term follow-up study planned, Ms Bishop said.

Most of the 1.5 million Australians affected by osteoarthritis are aged over 55.

Treatments differ for rheumatoid arthritis

Treatments differ for rheumatoid arthritis

Q: My mother has rheumatoid arthritis, which developed about a year ago. Could you tell me what treatments are used now and who to see about it?

A: The current treatment of rheumatoid arthritis is not new news at this point. During the past 15 years, the standard of care shifted from what we all were used to. Previously, a doctor would prescribe drugs like aspirin, ibuprofen, naproxen and other NSAIDS (non-steroidal anti-inflammatory drugs). If that didn't work well enough, the next step would be gold therapy, or prednisone. Finally, if the disease progressed, the doctor would turn to low doses of drugs used for cancer chemotherapy. In low doses, physicians call these "disease-modifying agents."

Rheumatoid arthritis and several other "autoimmune" diseases come from the immune system mistakenly attacking the person rather than foreign invaders. Therefore, the joints are the prime target in rheumatoid arthritis, causing deformity and loss of function. In lupus (SLE), many types of connective tissue and organs are targeted, and the joint disease doesn't cause deformity.

For many years, doctors hesitated to use the cancer treatment drugs, even though they knew that these drugs knocked the immune system down. The fear of the possible side effects kept these drugs in reserve. Then a change of heart occurred.

Years of experience with low doses of these cancer drugs had proven that low dose treatments had very little risk and did little or no serious harm compared to the terrible joint destruction that was occurring. Gradually, the thought grew that intervention should be done at the front end of the disease, rather than the later period. Once the disease destroys the joints, it's too late. Joint erosion is already visible by the fourth month of active disease on MRI.

However, not all people who present with inflammatory arthritis that might be rheumatoid arthritis have it. About half of patients have an undifferentiated illness in which half of those (or 25 percent of the total group) will go away spontaneously. In the remaining 20 percent or so who do actually have rheumatoid arthritis, approximately half will recover spontaneously as well.

So, how do doctors decide who should be treated early and aggressively? There are criteria that apply, and if a person fulfills enough of these criteria, then treatment makes sense.

The criteria are as follows:

Erosions seen on X-ray at the first doctor's visit

Joint inflammation lasting longer than six weeks

A blood test called the anti-CCP, whose result is over 92

Antibodies against rheumatoid factor

Pain felt when the doctor presses on the first knuckle in both hands

Morning stiffness lasting over an hour and arthritis affecting more than two joint groups

Programs team up to offer cheaper drugs for low-income Alabamians

MONTGOMERY — Low-income Alabamians who don't have drug coverage can apply to a new prescription partnership with 475 programs that offer free or low-cost drugs to patients of any age.

Partnership for Prescription Assistance of Alabama is part of a national effort sponsored by the pharmaceutical industry to help those who can't afford prescription medicines. The initiative is similar to Senior Rx, a state program that helps people 60 and older.

More than 400,000 Alabamians under 65 who haven't gotten help before will qualify for some type of assistance with their drugs, according to an estimate by the Pharmaceutical Research and Manufacturers of America, which is sponsoring the initiative.

More than 2,500 drugs are available free or at low-cost, said Christian Clymer, a senior directory with the pharmaceutical group.

The income eligibility cutoff varies among the programs, but most will help those at or below 200 percent of the poverty left. That mean assistance typically is available for a single person with $19,140 or below in annual income or a couple with $25,660 or below.

The Prescription Assistance Program was launched national in April, sparking 1 million to get assistance in the first six months. Thursday's launch in Alabama added 25 partners who are public or private groups in the state.

"Some of the most life-changing medications for arthritis are incredibly expensive, and they are all on there," said Sandi Falkenhagen, director of the state chapter of the Arthritis Foundation.

All applications require a valid prescription.

Consumers can access the Partnership for Prescription Assistance program by calling a toll free number — (888) 477-2669, or through the Internet at www.pparx.org.

Electrical Muscle Stimulation Helps Knee Arthritis

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Home-based electrical stimulation of thigh muscles can improve strength and physical performance in people with osteoarthritis of the knee.

Osteoarthritis results from wear and tear on the joints, rather than from an immune reaction that causes rheumatoid arthritis.

Resistive and aerobic exercise has been shown to reduce pain, severity, and disability in adults with knee osteoarthritis. However, such exercise by usually sedentary adults may cause muscle damage, especially in women. So an alternative method of increasing muscle strength would be useful.

As described in the Journal of Rheumatology, Dr. Laura Talbot from The Johns Hopkins University in Baltimore studied the use of a home-based neuromuscular electrical stimulation (NMES) system as a way to improve quadriceps strength in older adults with knee osteoarthritis. The study involved 34 patients who were given standard arthritis education either with or without NMES.

Patients assigned to NMES used a portable muscle stimulator 3 days a week for quadriceps training. Over a 12-week period, the intensity of the contractions was increased up to 30-40 percent of maximum.

During the study, the strength of knee extensions increased in the NMES patients and decreased in the other patients. Both groups improved in how fast they could walk and in the time needed to get up from a chair.

Joint pain was still similar in both groups. The research team concludes that NMES "appears to be a promising intervention" for maintaining muscle strength and increasing mobility, without making arthritis symptoms worse.

They say such therapy may be particularly useful when medication, exercise, or surgery are not options.

The Secret of a Long Life?

The Village of Long Life

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Could Hyaluronic Acid Be an Anti-Aging Remedy?
Like many of his peers who routinely live into their 90s and longer, Tadanao Takahashi, 93, is in good health. Japanese researchers think this phenomenon may be connected to the local diet. (ABCNEWS.com)

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Nov. 2 - Every morning, Hiroshi Sakamoto wakes up and farms his field, usually for about four or five hours a day.

Sakamoto, who lives in the village of Yuzuri Hara, two hours outside of Tokyo, is 86 years old. But his age by no means makes him the elder statesman of his village, nor is a daily routine like his uncommon among his peers.

More than 10 percent of the population of his village is 85 or older - 10 times the American norm. The residents of Yuzuri Hara are not only living longer, but they are also quite healthy. Rarely do they have any reason to see a doctor, and they are hardly affected by diseased like cancer, diabetes and Alzheimer's. Many have even managed to keep their skin from showing signs of aging. What makes the residents of Yuzuri Hara even more remarkable is that they are living long, healthy lives - even those who engage in unhealthy activities.

Sakamoto, for example, smokes a pack and a half of cigarettes daily and is still in reasonably good health and physically fit. Tadanao Takahashi, 93, has worked in the sun for 50 years, never once using sun block or skin cream, and yet his skin is soft and smooth.

Some medical researchers believe that Yuzuri Hara, known as "The Village of Long Life," and its residents may hold the key to anti-aging secrets: the local diet that is unique to the village. Unlike other regions of Japan that grow rice, Yuzuri Hara's hilly terrain is better suited to harvesting different carbohydrates that may prove healthier: things like satsumaimo, a type of sweet potato; satoimo, a sticky white potato; konyaku, a gelatinous root vegetable concoction; and imoji, a potato root.

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The Secret Ingredient

Dr. Toyosuke Komori, the town doctor who has studied and written books on longevity in Yuzuri Hara, believes these locally grown starches help stimulate the body's natural creation of a substance called hyaluronic acid, or HA, which aging bodies typically lose. This may ward off the aging process by helping the cells of the body thrive and retain moisture, keeping joints lubricated, protecting the retina in eyes and keeping skin smooth and elastic.

"I have never seen anyone suffer from skin cancer here," he says. "I have seen a woman in her 90s with spotless skin."

One of Japan's leading pharmaceutical companies began researching and developing a pill supplement containing hyaluronic acid. The company tested the pills on 1,000 people, and said roughly half reported smoother skin, less fatigue and better eyesight.

In the United States, hyaluronic acid has been used for years in eye surgery as a shock absorber to protect the retina, and has been proven effective in lubricating arthritic joints.

Synvisc, for example, a Food and Drug Administration-approved product used to treat osteoarthritis, works by injecting hyaluronic acid, or Hyaluronan, which acts as a shock absorber and lubricant.

Dr. Irving Raphael, a Syracuse, N.Y., orthopedist who specializes in sports medicine, explains that these injections coat the surface of the joint to decrease friction, which allows the joint to move more smoothly and cuts down pain.

"When I prescribe it," he says, "I simply tell my patients I'm going to give them a lube job."

But, he warns, before prescribing it, he always asks if the patient is allergic to chicken or eggs. That's because HA is extracted from chicken combs. The mohawk crown on a chicken's head is washed, sliced and purified.

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Western Skeptics

While hyaluronic acid has proven useful in orthopedics and opthalmology, many Western experts are skeptical that swallowing it in a pill could actually help prolong one's life.

"I cannot today imagine any possible benefit," says Dr. Endre Balazs, a leading expert on HA.

"The only way it acts, as far as I can see, as an anti-aging remedy," adds Raphael, "is because if you're not limping, and your joints feel better, you feel younger."

But HA has been shown to have wound-healing and tissue-reconstruction applications, and some cosmetic companies tout it as an effective ingredient in moisturizers that can soften facial lines, leaving skin elastic and firm. One company even claims it may be the latest development in treating hair loss.

And Komori, 80, who has adopted the local diet of very little meat and a lot of homegrown sticky starches, holds to his theory.

"I feel very strongly that if I had not come here to Yuzuri Hara, I would not have lived this long and healthy a life," he says. "I probably would have died from some adult disease."

Komori also points to statistics that since Western-style processed food infiltrated the village a few years ago, heart disease has doubled. With youngsters being seduced by these products, what the Japanese call an upside-down death pyramid has emerged, in which adults die before their elderly parents.

"Although my children ate what I had been eating while they were young and lived here," says a 91-year-old woman who has outlived two of her six children, "when they moved away they chose to eat differently."

Regular physical activity may strenghten knee cartilage

Osteoarthritis (OA) is the leading cause of disability among adults. As the population ages, increased intervention efforts are vital to controlling the individual and public health toll of this chronic, crippling joint disease. Along with early diagnosis, moderate exercise is one of the most effective ways to reduce pain and improve function in patients with OA of the knee and hip. Yet, more than 60 percent of U.S. adults with arthritis fail to meet the minimum recommendations for physical activity.

Based on the "wear and tear" nature of OA, the commonly held belief is that exercise will not strengthen joint cartilage and may even aggravate cartilage loss. Until recently, investigators were unable to put that belief to the test. Radiographs, the standard measure of OA's progression, made it impossible to assess cartilage before severe cartilage damage had occurred. Advances in magnetic resonance imaging (MRI) now make it possible to study cartilage changes earlier in the course of OA. Two researchers in Sweden, Leif Dahlberg, M.D., Ph.D., and Ewa M. Roos, P.T., Ph.D., used a novel MRI technique to determine the impact of moderate exercise on the knee cartilage of subjects at high risk for developing OA--middle-aged men and women with a history of surgery for a degenerative meniscus tear. In the November 2005 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), they share evidence to support the therapeutic value of exercise for OA patients, for improving not only joint symptoms and function, but also the quality of knee cartilage.

Working with the Department of Orthopedics at Malm� and Lund University Hospitals and the medical faculty of Lund University, Drs. Dahlberg and Roos recruited 29 men and 16 women, between the ages of 35 and 50, who had undergone meniscus repair within the past 3 to 5 years. Subjects were randomly assigned to either an exercise group or a control group. The exercise group was enrolled in a supervised program of aerobic and weight-bearing moves, for 1 hour, 3 times weekly for 4 months. At the study's onset and follow-up, subjects from both groups underwent MRI scans to evaluate knee cartilage. The technique used focused specifically on the cartilage's glycosaminoglycan (GAG) content, a key component of cartilage strength and elasticity. Subjects also answered a series of questions about their knee pain and stiffness, as well as their general activity level. Of the original 45 subjects, 30--16 in the exercise group and 14 in the control group--completed the trial and all post-trial assessments.

In the exercise group, many subjects reported gains in physical activity and functional performance tests compared with subjects in the control group. Improvements in tests of aerobic capacity and stamina affirmed the self-reported changes. What's more, MRI measures of the GAG content showed a strong correlation with the increased physical training of the subjects who had regularly participated in moderate, supervised exercise.

"This study shows compositional changes in adult joint cartilage as a result of increased exercise, which confirms the observations made in prior animal studies but has not been previously shown in humans," notes Dr. Dahlberg. "The changes imply that human cartilage responds to physiologic loading in a way similar to that exhibited by muscle and bone, and that previously established positive symptomatic effects of exercise in patients with OA may occur in parallel or even be caused by improved cartilage properties."

As Drs. Dahlberg and Roos acknowledge, the study does have limitations--its small sample size and narrow focus on meniscectomized knee joints--and makes no claims for predicting the long-term effects of exercise on cartilage. The conclusion, however, remains worthy of serious consideration: "Exercise may have important implications for disease prevention in patients at risk of developing knee OA."

Arthritis Warnings On Weather Web Site

AccuWeather.com has launched the world's first weather index to inform arthritis sufferers of the severity of weather-related arthritic pain.

Arthritis is the leading cause of disability among U.S. citizens, with a reported 44 million patients. Arthritis limits daily activities for more than 7 million people.

Changes in atmospheric pressure and temperature, among other things, can increase joint sensitivity and arthritic pain. The index, which ranges from low to severe, takes into consideration all weather factors that may affect arthritis sufferers.

To find out what the index reading is in your area, go to www.AccuWeather.com

Type in your ZIP code, and the arthritis reading will be displayed along with other AccuWeather indexes, such as pollen and air quality.

Combination Treatment Works Best for Preventing Future Complications

Oct. 28, 2005 -- Two or even three drugs are much better than one in treating the early stages of rheumatoid arthritis and preventing future complications, according to a new study.

Dutch researchers compared the four most recommended and widely used prescription drug treatments for early rheumatoid arthritis (RA). The researchers found that people treated with a combination therapy with methotrexate (sold under Rheumatex and other brand names), and corticosteroids or Remicade (infliximab) fared much better one year later than those treated with methotrexate alone.

Researchers say two new classes of drugs, known as disease-modifying antirheumatic drugs (DMARDs) and tumor necrosis factor (TNF) antagonists, have changed the way rheumatoid arthritis is treated in recent years. Used early on, studies have shown that these drugs have the potential to slow the progression of rheumatoid arthritisrheumatoid arthritis and reduce joint damage.

But the best strategy and combinations for using the drugs to prevent long-term joint damage and disability is unclear.

Rheumatoid Arthritis Treatments Face Off

In the study, researchers compared the effectiveness of the four most widely prescribed drug treatments for early rheumatoid arthritis in 508 people, mostly women, over the course of one year. Participants were ones with early RA who had the disease for two years or less and who had not had prior treatment with DMARDs. Other criteria for inclusion and exclusion of participants were based on history of medical conditions, lab tests, and substance abuse.

The participants were divided into four groups and received one of the following four treatments:

1. Standard DMARD therapy: methotrexate alone.
2. Step-up combination therapy: methotrexate alone to start followed by adding other DMARDs and prednisone.
3. Combination therapy with three drugs: methotrexate, Azulfidine, and taper high-dose prednisone.
4. Combination therapy with two drugs: methotrexate and Remicade.

At the end of the study, researchers used X-rays to measure joint damage and disease progression as well as clinical exams to evaluate symptom improvement.

Patients With Best Results

Patients With Best Results

The results showed that each treatment group showed measurable improvements, and 32% of all participants experienced a remission of their disease.

But those who received initial combination therapy with methotrexate and Remicade or prednisone had significantly less joint damage and progression of their disease than those treated with methotrexate alone or those in the step-up combination group.

"Patients in groups 3 and 4 had the benefit of a more rapid relief of symptoms and improvement of physical function," says researcher B. A. C. Dijkmans, MD, of VU Medical Center in Amsterdam, The Netherlands, in a news release. "In addition, there is the possibility that effective suppression of disease activity during the early phases of the disease may ameliorate the long-term joint damage and poor physical function and, ideally, even induce true clinical remission without the need for ongoing DMARD treatment."

The number of rheumatoid arthritis patients in these two groups without any progression of their disease was also higher than in the other two groups.

Overall, researchers say people who received initial combination rheumatoid arthritis treatment experienced no more side effects than the other groups.

Methotrexate can cause severe toxicity to the liver and bone marrow. Regular monitoring of blood counts and liver enzymes is standard during treatment. Methotrexate can also produce injury to the lungs and the GI tract. Pregnant women and those that are planning on being pregnant should not take this medication.

Remicade use has been associated with severe liver injury, decreased blood counts, and development of lymphoma (a kind of cancer). It should not be used if you are suffering from certain other medical conditions.

Both medications have immune-suppressing activity which can make a person more susceptible to infections, particularly opportunistic infections that can be fatal.

What is Arthritis? A Short Introduction

What is arthritis?
There are more than 100 types of arthritis. (The wordarthritis literally means "joint inflammation.") The most common type, osteoarthritis (OA), is a degenerative disease of the cartilage and bone that results in pain and stiffness in the affected joint. Although OA can occur in any joint, it usually affects one or more of the following areas: the hand, shoulder, neck, lower back, hip, and knee.
The other major form of arthritis, which causes inflammation in the lining of the joints and joint deformity, is rheumatoid arthritis (RA). In some instances RA may affect not only the joints, but also internal organs of the body (including the lungs, heart, and blood vessels). Although anyone can get RA, including children, the disease most often appears in middle age or later; furthermore, there are three times as many women as men with RA.
How to treat OA/RA?
The goals in treating arthritis are to reduce pain; to help restore mobility, function, strength, and flexibility; and to prevent unnecessary disability. Physical Therapist can develop a program consisting of low impact exercise (i.e. swimming, bicycling, walking), strength training and stretching for successful arthritis management. People with arthritis should see their doctor prior to increasing their level of physical activity and for information regarding other alternative treatments of arthritis, such as, medications and surgery.

Cherry products must drop medicinal claims: FDA

WASHINGTON - The U.S. Food and Drug Administration said on Monday it warned more than two dozen companies to stop selling cherry products that claim to help treat or prevent cancer, heart disease, arthritis and other diseases.

The agency sent warning letters earlier this month to 29 companies, ordering them immediately to stop making the health claims on their Web sites and product labels.

"The companies cited are marketing dried fruit, fruit juice, and juice concentrate for treating or preventing of a variety of diseases, including cancer, heart disease, and arthritis," the FDA said in a statement.

If the companies fail to take corrective measures, they may face FDA enforcement actions such as seizure of their products or criminal sanctions.

The following companies were sent the warning letters:

* Amon Orchards, Acme, Mich.

* Brownwood Acres, Eastport, Mich.

* Cherry Lands Best, Appleton, Wis.

* Cherry Republic, Glen Arbor, Mich.

* Cherry Rx, Genoa City, Wis.

* Chukar Cherry Co., Prosser, Wash.

* Coloma Frozen Foods, Coloma, Mich.

* Country Ovens, Ltd., Forestville, Wis.

* Eden Foods Inc, Clinton, Mich.

* Flavenoid Sciences, Traverse City, Mich.

* Friske Orchards, Ellsworth, Mich.

* Heritage Products International, Livonia, Mich.

* H & W Farms, Belding, Mich.

* King Orchards, Central Lake, Mich.

* Leelanau Fruit Co., Suttons Bay, Mich.

* Leland Cherry Co., Leland, Mich.

* Obstbaum Orchards, Salem, Mich.

* Orchard's Harvest, Traverse City, Mich.

* Overlake Foods Corp., Olymica, Wash.

* Payson Fruit Growers, Inc., Payson, Utah

* Rowley and Hawkins Fruit Farms, Basin City, Wash.

* Rowley's South Ridge Farms Inc., Santaquin, Utah.

* Royal Ridge Fruit & Cold Storage, Royal City, Wash.

* Seaquist Orchards, Sister Bay, Wis.

* Skyview Orchards, Ludington, Mich.

* Sunrise Dried Fruit Co., Northport, Mich.

* TPG Enterprises Inc., Othello, Wash.

* Traverse Bay Farms, Bellaire, Mich.

Chopsticks May Cause Arthritis

ISLAMABAD, October 26 (Online): Using chopsticks may cause arthritis in the hand, U.S. researchers reported on Friday.

A study of more than 2,500 residents of Beijing found that osteoarthritis was more common in the hands used to operate chopsticks -- and in the fingers specifically stressed by chopstick use.

While the effect is not big, and not likely to discourage anyone from using chopsticks, it merits further study, the researchers told a meeting of the American College of Rheumatology Orlando, Florida.

Dr. David Hunter of the Boston University School of Medicine and colleagues interviewed 2,507 60-year-old residents in randomly selected Beijing neighborhoods.

They asked them whether they were left- or right-handed, especially when eating, studied how they handled their chopsticks and took X-rays.

Each joint was checked for signs of osteoarthritis, and then the team compared how many people had arthritis in the chopstick-using hand as opposed to the other hand.

Arthritis was more likely in the chopstick-using hands -- specifically the thumb and the second and third joints on the first and third fingers.

"This study suggests that chopsticks may play a role in the development of hand osteoarthritis," Hunter said in a statement.

"While the increase in risk associated with chopstick use is small, this accounts for a large proportion of the osteoarthritis in these joint groups. We recommend further biomechanical research to evaluate the forces involved in chopstick use."

Hunter noted that other studies have shown that using the hands repetitively can stress the joints and cause arthritis.

Watch out Arthritis: A New Enemy in Sight

New esearch has uncovered a promising new drug to fight rheumatoid arthritis. The best part? It doesn't suppress the immune system.

Researchers at the University of California, San Diego, have just completed phase II trials of a new drug called dnaJP1. The drug is a peptide that comes from the naturally occurring protein, dnaJ. The protein generates inflammation in patients with rheumatoid arthritis by impairing inflammatory-control mechanisms and causing the body's T cells to attack its own tissues.

Now, researchers hope to put a stop to that process. DnaJP1 resets the body's immune system to tolerate dnaJ. By doing so, the drug transforms a damaging trigger into a new tool for controlling the disease. Taking the drug in pill form is vital because the mucosal immune system found in the gut can teach the body to see a protein as harmless. Researchers say just like food is ingested into the body and not rejected; the body does the same thing with dnaJP1.

Salvatore Albani, M.D., Ph.D, from UCSD, says, "In essence, we re-educated the immune system T-cells to be tolerant of the dnaJP1 amino acid sequence, which would usually contribute to inflammation in rheumatoid arthritis patients." He says one of the biggest benefits is that the drug does not suppress the immune system like many drugs currently used to fight the disease. He continues: "Our drug leaves the patient's natural immune responses intact. This differs profoundly from what is currently available to patients."

In the current study, dnaJP1 was found to be safe and effective in 160 patients enrolled in the trial at centers across the country. Those centers included UCSD, Stanford University, Johns Hopkins University, the Mayo Clinic, and Virginia Mason Medical Center in Seattle.

Patients receiving the drug for six months had a reduction in symptoms such as swollen joints, tenderness, pain and decreased mobility when compared to those who received a placebo. Dr. Albani says, "The first two trials of dnaJP1 have not raised any significant safety concerns and offer an improved treatment option for patients with rheumatoid arthritis."

Choosing a Trainer When You Have Arthritis

Selecting a certified personal trainer can be a challenge, especially when you're arthritic. Here's a list of questions you should ask prospective trainers, courtesy of the Arthritis Foundation:

• Are you certified by a nationally recognized organization?
• Does your background include health and wellness or sports medicine?
• What experience do you have with people with arthritis?
• Can you provide references of clients with arthritis?
• What do you charge, and what is included in that price?
• Do you network with other health professionals?

After choosing a trainer, make sure he or she is responsive, motivates you, and communicates clearly.