http://www.webmd.com/rheumatoid-arthritis/news/20101029/solid-marriage-may-ease-ra-pain?src=RSS_PUBLIC
"This study suggests that the association between marital status and health status depends on the quality of the marriage..."
Isn't that a 'no-brainer'? Your grand mother could have told you that before these Johns Hopkins researchers! Although I do wonder if they are jumping to conclusions. It may just be that RA patients who are in better health have better marriages...In fact I am sure, healthy people have healthier marriages.
Sunday, December 12, 2010
Sunday, October 24, 2010
UK Scientists Developing Stem Cell Treatment To End Need For Hip, Knee Replacements
http://www.dailymail.co.uk/health/article-1321434/Stem-cell-jab-end-need-hip-replacements-repairing-damaged-joints.html
This maybe a major breakthrough for a potential treatment of Osteoarthritis. If successful, we will be able to treat Osteoarthritis with an injection of stem cells instead of joint replacement surgery.
There have been ongoing attempts to regenerate cartilage but it is difficult to recreate the natural structure of cartilage in the lab. Hopefully, embryonic stem cells will make that possible.
Meanwhile there are some voo-doo remedies sold by some famous 'arthritis experts'...and I quote one here - "At our center, we are using autologous (a patient’s own stem cells) stem cell concentrates to regionally treat osteoarthritis of the knee and hip. So far, our data looks promising." Beware of these claims. They are not standardized, not approved and not paid for by insurance. And they don't work.
This maybe a major breakthrough for a potential treatment of Osteoarthritis. If successful, we will be able to treat Osteoarthritis with an injection of stem cells instead of joint replacement surgery.
There have been ongoing attempts to regenerate cartilage but it is difficult to recreate the natural structure of cartilage in the lab. Hopefully, embryonic stem cells will make that possible.
Meanwhile there are some voo-doo remedies sold by some famous 'arthritis experts'...and I quote one here - "At our center, we are using autologous (a patient’s own stem cells) stem cell concentrates to regionally treat osteoarthritis of the knee and hip. So far, our data looks promising." Beware of these claims. They are not standardized, not approved and not paid for by insurance. And they don't work.
Tuesday, October 12, 2010
Arthritis: It's Only Going to Get Worse
http://www.hcplive.com/articles/Arthritis-Its-Only-Going-to-Get-Worse?utm_source=Listrak&utm_medium=Email&utm_term=http%3a%2f%2fwww.hcplive.com%2farticles%2fArthritis-Its-Only-Going-to-Get-Worse&utm_campaign=Rheumatology+eDigest%3a+Arthritis+-+It%27s+Only+Going+to+Get+Worse
There won't be enough Rheumatologists to take care of these patients. But if we listened to our mothers, most of the modifiable risk factors for Osteoarthritis would be taken care of: don't smoke, don't skip school, don't be lazy and don't get fat.
It is remarkable that these four life-style changes can significantly reduce the risk of the four most prevalent diseases - arthritis, diabetes, high blood pressure and coronary artery disease. It is even more remarkable that a person's level of formal education is a strong determinant of the risk of developing many diseases, including: Rheumatoid Arthritis, Osteoarthritis, Back problems, High blood pressure, Heart attack, Stroke, Diabetes, Kidney diseases and certain Cancers. Studies have shown that high school graduates have a 2-4 fold decrease in risk of having these diseases compared to those with less than 8 years of education.
One large study from the UK found that the risk of dying from a heart attack more than triples, in men with a certain type of arrhythmia, depending on their education level:
http://www.nejm.org/doi/pdf/10.1056/NEJM197807132990202
There won't be enough Rheumatologists to take care of these patients. But if we listened to our mothers, most of the modifiable risk factors for Osteoarthritis would be taken care of: don't smoke, don't skip school, don't be lazy and don't get fat.
It is remarkable that these four life-style changes can significantly reduce the risk of the four most prevalent diseases - arthritis, diabetes, high blood pressure and coronary artery disease. It is even more remarkable that a person's level of formal education is a strong determinant of the risk of developing many diseases, including: Rheumatoid Arthritis, Osteoarthritis, Back problems, High blood pressure, Heart attack, Stroke, Diabetes, Kidney diseases and certain Cancers. Studies have shown that high school graduates have a 2-4 fold decrease in risk of having these diseases compared to those with less than 8 years of education.
One large study from the UK found that the risk of dying from a heart attack more than triples, in men with a certain type of arrhythmia, depending on their education level:
http://www.nejm.org/doi/pdf/10.1056/NEJM197807132990202
Monday, October 11, 2010
Eating Broccoli Could Guard Against Arthritis
http://www.sciencedaily.com/releases/2010/09/100915084504.htm
I hope this one works! My mother will not take Glucosamine/Chondroitin because she is a vegetarian.
There are many other vegetarian items that are claimed to be good for prevention/treatment of arthritic pain.
Here is a short list:
Oranges, Blueberries, Kiwis, Apples, Cherries, Parsley, Prunes, Carrots, Beans, Tomatoes, Ginger, Turmeric.
I hope this one works! My mother will not take Glucosamine/Chondroitin because she is a vegetarian.
There are many other vegetarian items that are claimed to be good for prevention/treatment of arthritic pain.
Here is a short list:
Oranges, Blueberries, Kiwis, Apples, Cherries, Parsley, Prunes, Carrots, Beans, Tomatoes, Ginger, Turmeric.
Saturday, October 2, 2010
FDA says NO to Colchicine and Tanezumab
The implications of the FDA's two far reaching actions last week can impact every doctor and patient in the world.
First, clinical trials of a drug were halted because it was "too good". A potential drug for Osteoarthritis - Tanezumab, was stopped from development because patients were doing better than expected and as a result hurting their joints with increased activity. I can tell from my own patient's experiences that it worked well. And it is not even a narcotic.
http://www.bloomberg.com/news/2010-09-29/pfizer-arthritis-drug-cut-pain-too-well-leading-to-joint-damage-in-study.html
Second, in truly spinning the wheel backwards, FDA is removing generic colchicine from the shelves to make room for branded colchicine (Colcrys). The difference in price is 10 cents per pill vs $5 per pill. Colchicine has been around for more than a few decades, in fact more than a century in some form or another. Now a drug company decides to manufacture it as a branded drug and go through FDA's approval process. How does that make the old generic drug any more dangerous? I am asking my patients to stock up on the generic while it is still around...and I am determined not prescribe Colcrys ever.
Second, in truly spinning the wheel backwards, FDA is removing generic colchicine from the shelves to make room for branded colchicine (Colcrys). The difference in price is 10 cents per pill vs $5 per pill. Colchicine has been around for more than a few decades, in fact more than a century in some form or another. Now a drug company decides to manufacture it as a branded drug and go through FDA's approval process. How does that make the old generic drug any more dangerous? I am asking my patients to stock up on the generic while it is still around...and I am determined not prescribe Colcrys ever.
I am baffled by these two announcements. What are they trying to do? Will the FDA now remove ALL pain killers - such as Morphine for being too good , and ALL unapproved old drugs - such as Aspirin for being dangerous?
Perhaps they could have approved Tanezumab with the same warning as they have on cigarettes - "Taking Tanezumab can be injurious to your health"....
Monday, September 27, 2010
Bisphosphonates: All good things come to an end
EU agency starts safety probe of common bone drugs
Novartis Hid Bone Drug's Risks, Lawyer Tells Jury
It was too good to last. When Merck came out with Fosamax in 1995, I had just finished my training and taken up my first real job in Dallas. I remember reading the ground breaking article published in the New England Journal of Medicine in November of 1995 [N Engl J Med 1995; 333:1437-1444] and my reaction was - "this will change everything". It was the first real treatment for Osteoporosis. Osteoporosis, Bone Density Testing, Fosamax, Actonel, Boniva...have become familiar words over the last decade, thanks to the massive educational and marketing effort that followed. Osteoporosis is now a billion dollar industry, not just a 'silent epidemic'. But, drugs that make huge profits cannot last long in this market. So now more new drugs are entering the market. And they have to destroy the older generic drugs to make room for themselves. Suddenly, the bisphosphonates are not safe anymore! They are causing the "jaw-rotting disease"!!, they are causing more hip fractures!!! All non-sense. You wish that the lay press would stop exaggerating these reports.
No, the bisphosphonates will not make your jaw bone melt away. Osteonecrosis of the jaw bone is a rare complication seen predominantly in cancer patients after a tooth extraction. These are people on chemotherapy getting massive doses of bisphophonates to protect their bones from the spreading cancer. You are more likely to be hit by a UFO...
And NO, bisphosphonates do not increase the risk of hip fractures. They DECREASE the risk of hip fractures, even after long term use. The one report that was highlighted in the media was about a small series of patients who had taken Alendronate for more than 5 years, and experienced an uncommon variety of hip fracture more frequently than what is expected in the normal population. What the media failed to report was another report of a larger series of patients showing no such increase in the risk of this uncommon variety of hip fracture. And what they really failed to tell us was that these drugs clearly protect us from the common type of hip fracture.
Moral of the story: Don't get your medical information from the news man. Ask me.
Novartis Hid Bone Drug's Risks, Lawyer Tells Jury
It was too good to last. When Merck came out with Fosamax in 1995, I had just finished my training and taken up my first real job in Dallas. I remember reading the ground breaking article published in the New England Journal of Medicine in November of 1995 [N Engl J Med 1995; 333:1437-1444] and my reaction was - "this will change everything". It was the first real treatment for Osteoporosis. Osteoporosis, Bone Density Testing, Fosamax, Actonel, Boniva...have become familiar words over the last decade, thanks to the massive educational and marketing effort that followed. Osteoporosis is now a billion dollar industry, not just a 'silent epidemic'. But, drugs that make huge profits cannot last long in this market. So now more new drugs are entering the market. And they have to destroy the older generic drugs to make room for themselves. Suddenly, the bisphosphonates are not safe anymore! They are causing the "jaw-rotting disease"!!, they are causing more hip fractures!!! All non-sense. You wish that the lay press would stop exaggerating these reports.
No, the bisphosphonates will not make your jaw bone melt away. Osteonecrosis of the jaw bone is a rare complication seen predominantly in cancer patients after a tooth extraction. These are people on chemotherapy getting massive doses of bisphophonates to protect their bones from the spreading cancer. You are more likely to be hit by a UFO...
And NO, bisphosphonates do not increase the risk of hip fractures. They DECREASE the risk of hip fractures, even after long term use. The one report that was highlighted in the media was about a small series of patients who had taken Alendronate for more than 5 years, and experienced an uncommon variety of hip fracture more frequently than what is expected in the normal population. What the media failed to report was another report of a larger series of patients showing no such increase in the risk of this uncommon variety of hip fracture. And what they really failed to tell us was that these drugs clearly protect us from the common type of hip fracture.
Moral of the story: Don't get your medical information from the news man. Ask me.
Saturday, September 18, 2010
Glucosamine and Chondroitin have no effect ? Again?
Researchers Claim Arthritis Supplements Have No Effect
Another article trashing Glucosamine and Chondroitin. This time from Switzerland - the motherland of Cheese, Chocolates and Banks.
"Health authorities and health insurers should not cover the costs for these preparations, and new prescriptions to patients who have not received treatment should be discouraged," Peter Juni of the University of Bern, whose study was published in the British Medical Journal on Friday, told Reuters [BMJ 2010; 341:c4675 doi: 10.1136/bmj.c4675 (Published 16 September 2010)].
Yes, that is true and has been said before, but...ask the people who take it and benefit from it. It has changed their lives. And no side effects.
Q: So where is the disconnect?
A: When a scientific article claims something is ineffective, it is like saying - "Most humans cannot fit into a size 7 shoe" . Yes, that is true, but what they fail to elaborate is that the average human shoe size is 7 and there are plenty of people who can wear a size 7 shoe perfectly well. They may well be in the minority because majority of humans may have feet bigger or smaller than size 7. So shall we stop making size 7 shoes? That is exactly what the Swiss researchers in the article above are suggesting.
Glucosamine and Chondroitin, like many other remedies, work amazingly well for some folks and do nothing for others. All you can do is try. Take it for 2 months. If it works, keep taking it. If it doesn't work, move on.
By the way, there is one other industry that Switzerland tops the world markets in - world's two biggest pharmaceutical giants, that just happen to be Swiss also - Novartis and Roche - both very active in making arthritis drugs. Wonder if the $2 billion market of Glucosamine/Chondroitin is hurting their bottom line!
Another article trashing Glucosamine and Chondroitin. This time from Switzerland - the motherland of Cheese, Chocolates and Banks.
"Health authorities and health insurers should not cover the costs for these preparations, and new prescriptions to patients who have not received treatment should be discouraged," Peter Juni of the University of Bern, whose study was published in the British Medical Journal on Friday, told Reuters [BMJ 2010; 341:c4675 doi: 10.1136/bmj.c4675 (Published 16 September 2010)].
Yes, that is true and has been said before, but...ask the people who take it and benefit from it. It has changed their lives. And no side effects.
Q: So where is the disconnect?
A: When a scientific article claims something is ineffective, it is like saying - "Most humans cannot fit into a size 7 shoe" . Yes, that is true, but what they fail to elaborate is that the average human shoe size is 7 and there are plenty of people who can wear a size 7 shoe perfectly well. They may well be in the minority because majority of humans may have feet bigger or smaller than size 7. So shall we stop making size 7 shoes? That is exactly what the Swiss researchers in the article above are suggesting.
Glucosamine and Chondroitin, like many other remedies, work amazingly well for some folks and do nothing for others. All you can do is try. Take it for 2 months. If it works, keep taking it. If it doesn't work, move on.
By the way, there is one other industry that Switzerland tops the world markets in - world's two biggest pharmaceutical giants, that just happen to be Swiss also - Novartis and Roche - both very active in making arthritis drugs. Wonder if the $2 billion market of Glucosamine/Chondroitin is hurting their bottom line!
Wednesday, September 15, 2010
Krystexxa (pegloticase) Approved For Treatment Of Gout
Your joints may be hot, but Gout is cool! Finally, the drug industry has made inroads into the Gout market. Of all the ailments we see in Rheumatology, Gout is the easiest to treat and unfortunately the easiest to screw up. It is good to have another new drug for Gout, but don't go running to your doctor asking for this one just yet. Very very few patients will truly need Pegloticase. The rest will be over-diagnosed and over-treated, as usual. And the ones who truly need it will not, as usual.
Monday, September 13, 2010
Welcome!
When it comes to Arthritis and associated conditions there is more noise and less information on the web. And then there is the "ask your doctor" disclaimer on everything. Well here is the no noise, facts only, blog - answers from your arthritis doctor. Stay tuned...and ask me. What's on your mind? Sorry, So what's in your 'joints'?
Subscribe to:
Posts (Atom)