StemCell Therapy

The white blood cell TH17 helps the immune system fight infection by promoting inflammation. But it can be too much of a good thing: Excessive inflammation from TH17 overload has been tied to autoimmune disorders, such as inflammatory bowel disease (IBD) and arthritis.

Researchers led by Hening Lin, professor of chemistry and chemical biology in the College of Arts and Sciences and a Howard Hughes Medical Institute Investigator, have found a new way to potentially treat IBD as well as other autoimmune disorders by targeting a mechanism that regulates the signaling pathway that enables TH17 to be produced and inflammation to occur.

Their paper, A STAT3 Palmitoylation Cycle Promotes TH17 Differentiation and Colitis, published Oct. 7 in Nature. The lead author is postdoctoral researcher Mingming Zhang.

The production of TH17 is a chain reaction of sorts, built around the STAT3 protein. When the body detects infection, it secretes cytokine molecules that bind to the plasma membrane of a precursor T cell and activate the enzyme JAK2. This enzyme, in turn, is responsible for activating STAT3 by adding a phosphate group to it, a process known as phosphorylation. Once turned on, STAT3 directs the expression of the interleukin 17 gene and causes TH17 cells to develop.

At least, thats the way the process has been traditionally understood. Lins group discovered a new mechanism that regulates this pathway.

For JAK2 to phosphorate STAT3, they have to be in the same location. Previously, people didnt know theres a mechanism that promotes STAT3 going to the plasma membrane, Lin said. What we found is that there is an enzyme called DHHC7 that does that job.

The DHHC7 enzyme is a kind of matchmaker. It helps STAT3 go to the plasma membrane, where JAK2 is located, by applying a fatty acid, or lipid, to the protein. The lipids greasiness directs STAT3 to the plasma membrane so phosphorylation can take place.

However, thats only half of the process. STAT3 still needs to detach from the plasma membrane and make its way to the nucleus. Thats when another enzyme, APT2, comes in and removes the lipid modification, freeing STAT3 so it can move to the nucleus and deploy the interleukin 17 gene that will cause TH17 cells to develop.

Lins group found that inhibiting this two-part lipid modification cycle in mice prevents the STAT3 protein from making its long journey to the nucleus, thereby suppressing inflammation and, ultimately, colitis, which is a form of IBD.

Theres no effective treatment for colitis, and the exact cause is not very clear. But we do know that TH17 cells play some role in it, Lin said. We found that this cycle of putting on a lipid modification and then removing it promotes TH17 cell differentiation. And when we inhibit or delete these two enzymes, DHHC7 or APT2, we can protect the mice from getting colitis.

Other researchers have targeted JAK2 with the same goal, but that enzyme can be difficult to target specifically, and inhibiting it can create toxicity. APT2 is easier to inhibit, and disrupting it does not seem to cause any severe damage, Lin said.

After analyzing human data, Lins team determined the STAT3 signaling pathway is important in humans, too. Their new method could lead to treatment of a host of autoimmune disorders, such as Crohns disease, multiple sclerosis, rheumatoid arthritis and Type 1 diabetes. It could also help prevent the rejection of organ transplants.

Co-authors include Maurine Linder, professor and chair of the Department of Molecular Medicine in the College of Veterinary Medicine; research scientist Min Yang; research support specialist Xuan Lu; doctoral students Yilai Xu, Garrison Komaniecki and Tatsiana Kosciuk; Xiao Chen, Ph.D. 18; and researchers from Sichuan University, Nanjing University, and Nanjing Medical Univeristy.

The research was supported by the Howard Hughes Medical Institute and the National Institutes of Health.

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Researchers disrupt signaling pathway to treat colitis | Cornell Chronicle - Cornell Chronicle

Jaw cracking refers to a clicking or snapping sound in your jaw. Its also known as jaw popping.

Often, the sound occurs with jaw pain and discomfort. You might also have a hard time moving your jaw, depending on the underlying condition.

Jaw cracking usually isnt a cause for concern, though. It can even happen when you widely yawn or open your mouth.

The exception is if you recently sustained a facial injury, which can dislocate or break your jaw. In this case, youll need emergency help.

Read on to learn about the possible causes of jaw cracking and when you should see a doctor.

The potential causes of jaw cracking range in severity and type. They include:

Your temporomandibular joint (TMJ) attaches your jawbone to your skull. If theres something wrong with this joint, its called temporomandibular joint disorder (TMD).

TMD can make your jaw crack or pop. Other symptoms include:

TMD often happens without a specific cause. Occasionally, clenching your teeth due to emotional stress can play a role.

Arthritis occurs when your joints become damaged and inflamed. If it affects your TMJ, it can cause TMD and jaw cracking.

All types of arthritis can lead to TMD. Most cases are due to osteoarthritis, but it can also be caused by rheumatoid arthritis.

Arthritis also causes symptoms in other parts of your body, including:

Facial injuries can dislocate or break your jaw. A dislocation happens when your jawbone moves out of place, while a broken jaw happens when your jawbone breaks.

Common causes of facial injury include:

A dislocated or broken jaw can lead to TMD symptoms, including jaw pain and cracking.

Other symptoms of dislocation include:

If your jaw is broken, youll likely have:

Myofascial pain syndrome (MPS) causes pain in your muscles and fascia. Fascia is the sheet of connective tissue that covers every muscle.

MPS can affect any muscle, including those in your jaw, neck, and shoulder. Its the most common cause of TMJ discomfort.

You may have jaw cracking and popping, along with:

If your breathing briefly and repeatedly stops during sleep, its called obstructive sleep apnea (OSA). This happens when the airways in your throat are too narrow.

OSA increases your chances of developing TMD. The connection is unclear, but its thought that the resistance in your airways triggers a stress response. This may cause your jaw muscles to clench together.

Other symptoms include:

Malocclusion of the teeth occurs when your upper and lower jaws are misaligned. It causes your upper and lower teeth to line up incorrectly.

There are several types of malocclusions, including:

The primary symptom is teeth misalignment, but you can also experience TMD and jaw noises.

Other symptoms include:

Jaw cracking and pain might indicate an infection in your:

Depending on the infection, you may also have:

Jaw infections are often mistaken for TMD. If your doctors treatment for TMD fails to work, be sure to let them know.

If a tumor develops in the oral cavity, it can lead to oral cancer. This may cause symptoms like:

The tumor can also affect how your jawbone moves, causing jaw noises like cracking or popping.

If you have jaw cracking while eating, you might have:

Jaw cracking when you yawn might indicate:

Potential causes of jaw cracking plus ear pain include:

Jaw cracking usually isnt serious. It typically goes away in 2 or 3 weeks. However, you should see a doctor if you have:

If you were recently injured, go to the nearest emergency room. Youll need immediate medical attention.

To stop jaw cracking, youll need to treat the underlying cause.

The following home remedies can be used alone or with medical treatment:

If your jaw cracking is due to a more serious condition, you may need medical treatment. This might include:

Cracking your jaw isnt necessarily harmful. It can happen if you open your mouth wide, like during a big yawn. This is expected and normal.

However, take note if your jaw cracks when you talk or chew. It may indicate a more serious issue, especially if you also have pain.

Try eating softer foods to decrease your jaw activity. If your symptoms persist, see a doctor.

If you have jaw cracking, pay attention to your other symptoms. This can help you determine what might be causing the sound. Be sure to visit a doctor if you have persistent pain, difficulty eating or breathing, or if the jaw cracking gets worse.

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Jaw Cracking Causes, Treatments, and When to See a Doctor - Healthline

Dexamethasone is a low-cost, anti-inflammatory drug that has been shown to reduce the risk of death in patients with COVID-19. Nati Harnik/AP hide caption

Dexamethasone is a low-cost, anti-inflammatory drug that has been shown to reduce the risk of death in patients with COVID-19.

Editor's note: Since we published this story, Trump's physician said that the president has completed his treatment for COVID-19.

President Trump told Fox Business Network on Thursday that he will be taking a steroid for COVID-19 for a "little bit longer." As his physicians told reporters last weekend, Trump started taking the drug on Saturday while he was still at the Walter Reed National Military Medical Center.

The steroid, dexamethasone, is now part of the "standard of care" for COVID-19, said Dr. Celine Gounder, assistant professor of medicine and infectious diseases at New York University School of Medicine.

"It's an old drug, it's cheap," she said. "Of all the drugs we're using for COVID, it's the one that we have the most experience with."

Dexamethasone is an anti-inflammatory drug used for a range of ailments, including arthritis, kidney, blood and thyroid disorders and severe allergies. The drug is on the World Health Organization's list of essential medicines and is also used to treat certain types of cancer.

Earlier this year, a large clinical trial in the U.K. found that giving dexamethasone to patients hospitalized with COVID-19 reduced their risk of dying. Patients were given 6 milligrams of the drug for 10 days.

The study, published in The New England Journal of Medicine in July, found the drug cut mortality by a third among severely ill COVID-19 patients who were on ventilators, and by a fifth for patients receiving supplemental oxygen. It was found not to have any benefits for patients with mild illness, and there was some evidence of potential harm.

Later in the course of the disease, COVID-19 can cause the immune system to go into overdrive, damaging the lungs and other organs. That's what can happen to people who are severely ill. Dexamethasone helps these patients by tamping down the body's immune response.

The Infectious Diseases Society of America now recommends giving 6 milligrams of the drug for 10 days to critically ill COVID-19 patients on ventilators and those requiring oxygen support. But it recommends not using the drug on people with mild illness who do not require supplemental oxygen.

While this commonly used drug is generally safe, there are a range of known side effects. "By far, the most common is hyperglycemia, so that's where your blood sugars will shoot up," Gounder said.

Also quite common, especially among older patients are a range of psychiatric side effects, she added.

"Anything from feeling like you're on top of the world ... your arthritic aches and pains of age just melt away, you have lots of energy," she said. "There may be some grandiosity."

The drug can also cause agitation, insomnia and even, psychosis, Gounder said. "My own father was treated with high-dose steroids as part of his lymphoma regimen and developed acute psychosis requiring psychiatric hospitalization."

All these side effects point to the need to monitor people on these drugs carefully, she added.

If the president's doctors had prescribed him the recommended course of treatment, Trump would have finished the steroid therapy early next week. On Thursday evening, White House physician Dr. Sean Conley said Trump has completed his COVID-19 treatment.

Excerpt from:
Trump Was Treated With Steroids: How These Drugs Are Used For COVID-19 Patients - NPR

UPPER NYACK, N.Y.--(BUSINESS WIRE)--CreakyJoints Espaol, a digital patient community en Espaol for people with all forms of arthritis and part of the Global Healthy Living Foundation, today announced that the Bristol Myers Squibb Foundation has funded the RA Hispanic Outreach Program, a $1 million, two-year grant to improve relationships between Hispanic people living with rheumatoid arthritis (RA) and rheumatologists. The grant includes creation and dissemination of evidence-based education about RA, developed in patient-friendly formats and language. The project will include assembling an advisory council of Hispanic patients with RA and rheumatologists to collaboratively develop and evaluate educational materials to achieve culturally sensitive and patient friendly interventions that can become part of established care, if found effective.

The COVID-19 pandemic highlighted what we already knew to be true: Hispanics and other communities of color face structural and systemic inequities that contribute to poor access to health care. The Hispanic community faces further barriers related to a lack of understanding of the cultural traditions and attitudes that influence healthcare decision-making, said Daniel Hernandez, MD, Director of Medical Affairs and Hispanic Outreach. Through this program, well employ culturally sensitive approaches to achieve better health literacy about RA within the patient community and drive people to take a more proactive approach to managing a complex, chronic condition. We know that if we can improve communication between doctors and their patients, we can expect better health outcomes.

RA Hispanic Outreach Program Measures Engagement

Although the Hispanic population is the largest minority in the United States, composed of nearly 60 million Americans there are limited disease-specific resources for this community. According to Pew Hispanic Research, 71 percent of Hispanics obtain health information through their social networks, and 79 percent of them act on this information. Also, 41 percent reported making a medical decision regarding the treatment of an illness or medical condition due to some form of outreach.

The RA Hispanic Outreach Program to be created by CreakyJoints Espaol will develop and test patient-centered outcomes and create educational materials that are culturally appropriate and patient friendly. Materials will be developed, then disseminated digitally and in partnership with rheumatology pilot sites, Hispanic community organizations and key opinion leaders. Part of the goal is to use findings to train clinicians to deliver culturally competent care and patient education to develop stronger more-trusting relationships.

We are excited to support Global Healthy Living Foundation and their efforts to deliver accurate and culturally sensitive RA education through the RA Hispanic Outreach Program, said John Damonti, president, Bristol Myers Squibb Foundation. This program aligns perfectly with our commitment to health equity, which focuses on raising disease awareness and education, increasing health care access and improving outcomes for medically underserved populations. It will improve how Hispanic people living with RA communicate with their physicians and make decisions about their health care.

Using CreakyJoints Espaol digital channels, the organization will use online evaluation methods to develop and test patient-centered outcomes measures. The participatory nature of the study will allow the team to add patient outcome measures during the early phases of the study, thereby increasing the flexibility and comprehensiveness of the program. Online communication and participation via websites and social media with analytics will help ensure the measured outcomes are meaningful to a medically underserved community to improve health equity and outcomes.

Recognizing that social media is the most frequent source of medical information for people in the Hispanic community, the program will use novel and innovative methods to create mobile-first content designed for best use on mobile phones but also available on tablets, websites, television, podcasts, radio or print.

We created CreakyJoints Espaol to meet the needs of Hispanic communities looking for evidence-based advice about managing the different forms of arthritis. We are gratified to see engagement with our platforms grow as weve introduced programming related to Rheumatoid Arthritis Patient Guidelines, our Spanish-language COVID-19 resources, and our research, such as the our COVID-19 patient research registry, ProyectoCovid19.org and ArthritisPower, a bone, joint and skin condition patient registry, said Louis Tharp, executive director and co-founder of CreakyJoints and the Global Healthy Living Foundation. We thank the BMS Foundation for their generous award and look forward to implementing and reporting on how our interventions are positively impacting how patients in the Hispanic community are managing their RA.

About Bristol Myers Squibb Foundation

The Bristol Myers Squibb Foundation promotes health equity and seeks to improve the health outcomes of populations disproportionately affected by serious diseases by strengthening healthcare worker capacity, integrating medical care and community-based supportive services, and mobilizing communities in the fight against disease. The Bristol Myers Squibb Foundation engages partners to develop, test, sustain and spread innovative clinic-community partnerships to help patients access care and support for cancer in the U.S., China, Africa, and Brazil and for cardiovascular diseases, multiple sclerosis, and rheumatoid arthritis in the United States. For more information about Bristol Myers Squibb Foundation, visit us at BMS.com/Foundation.

About CreakyJoints Espaol

CreakyJoints Espaol offers a repository of Spanish language arthritis educational information at http://creakyjoints.org.es and engages with the Spanish-speaking arthritis community via its social media channel: @creakyjoints_esp (Instagram). CreakyJoints Espaol is conducting longitudinal research about the evolving impact of COVID-19 on people living with arthritis in English and Spanish via the Autoimmune COVID-19 Project.

About CreakyJoints

CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. We represent patients through our popular social media channels, our websites http://www.CreakyJoints.org, https://creakyjoints.org.es/, http://www.creakyjoints.org.au, and the 50-State Network, which includes more than 1,500 trained volunteer patient, caregiver and healthcare activists.

As part of the Global Healthy Living Foundation, CreakyJoints also has a patient-reported outcomes registry called ArthritisPower (ArthritisPower.org) with more than 29,000 consented patients with joint, bone, GI and inflammatory skin conditions who track their disease while volunteering to participate in longitudinal and observational research. CreakyJoints also publishes the popular Raising the Voice of Patients series, which are downloadable patient-centered educational and navigational tools for managing chronic illness. It also hosts PainSpot (PainSpot.org), a digital risk assessment tool for musculoskeletal conditions and injuries. For more information and to become a member (for free), visit http://www.CreakyJoints.org.

Find us on social media:Facebook: https://www.facebook.com/creakyjoints andhttps://www.facebook.com/GlobalHealthyLivingFoundation/ Twitter: @GHLForg, @CreakyJoints, #CreakyChatsInstagram: @creaky_joints, @creakyjoints_aus, @creakyjoints_esp

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CreakyJoints Espaol Awarded $1Million Grant to Promote Health Equity and Improve Health Outcomes Among Hispanics Living with Rheumatoid Arthritis -...

A Laois mother of four is going to run a marathon virtually from her doorstep, for a charity that is helping her teenage daughter to cope with arthritis.

On Sunday October 25, the day of the cancelled Dublin City Marathon, Melissa Fenelon, 40, will set out from her home in Ballinakill and run to Ballyroan, then Abbeyleix, back to Ballinakill, on to Durrow and finally returning to Ballinakill, the full 42.2km.

She will still get a medal posted out from the marathon organisers on completing her epic 26.2 mile race, but it is not for glory that Melissa is running.

I want to raise awareness and raise money for Arthritis Ireland, that is my number one priority, she said.

Her eldest child Kaitlin was diagnosed last year with a condition called Psoriatic Arthritis, just before her 16th birthday.

An autoimmune disease, psA sometimes develops in people who have psoriasis in their family genes, which is surprisingly as high as one in 50 people.

The body is fighting against itself. She could be fine one day then theres a change in the weather, and her knees ache and get stiff and inflamed, with chronic fatigue.Its very unpredictable. Kaitlin injects herself every second Friday and takes medication. It can flare up anywhere, her fingers, ankles, knees," she said.

Kaitlin attends Heywood Community School and is now in 5th year. Covid-19 is an extra worry.

We cocooned ourselves this year for her and she didnt stir from home, so going back to school is a worry. But her school have been fantastic, and she has a great group of friends," said Melissa.

A lot of people associate arthritis with old people, they dont think that at 17 you might have a disease that makes you feel like a 70 year old at times. People are coming up to me telling me they cant believe it, she said.

Melissa has put sponsorship cards in Hamm's shop, Mcgraths, O'Shaughnessy's bar and Drury's bar in Ballinakill and opened a Facebook fundraiser which reached over 1,600 in less than a week.

Its been absolutely phenomenal, and thats only online, not including the cards. I hoped to get 500, I cant believe it. Everyones behind me, people are brilliant. And Kaitlin is delighted, proud as punch, she said.

Full interview in next Tuesday's Leinster Express.

See her fundraiser here.

Continue reading here:
Mother of teen with arthritis to run marathon in Laois for Arthritis Ireland - Leinster Express

The father-of-three and husband to former model Christine Martin has dealt with a crippling condition for the past three years. What is it?

At 47 years old, Paddy (real name Patrick) has been living with rheumatoid arthritis.

Sharing his diagnosis with the world on social media in 2018, Paddy posted a picture of him pointing towards the bandage on his shoulder.

In the snap, he wrote: "Morning! Nursing a poorly shoulder today. I had an ultrasound steroid injection in it yesterday. The reason, arthritis? I'm 44!"

What is rheumatoid arthritis?

This inflammatory form of arthritis can affect people of any age, testified the charity Arthritis Action.

It's caused by the immune system mistakenly attacking a person's joints, causing pain, stiffness and swelling.

If the condition is promptly treated, joint damage and disability can often be prevented.

The reason why this disease develops is not yet known, but it's been found to run in families.

READ MORE:Arthritis treatment: Apply this herbal cream to significantly reduce pain

Symptoms of rheumatoid arthritis

The condition tends to affect the small joints of the fingers and toes, the wrist, elbows, shoulders and knees, the neck and jaw.

At times, the pain, stiffness and swelling of joints can seemingly move around from joint to joint.

The mornings tend to be the most painful, and symptoms tend to improve during the day.

How to get a diagnosis

Rheumatoid arthritis can be diagnosed via a combination of symptoms, blood tests and X-rays of the joints.

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Medications are available to dampen the immune response, including disease-modifying drugs (DMARDs).

Most people with this condition will be on lifelong medication; there are other treatment options too.

Physiotherapists are able to provide hands-on care and can advise you on exercises.

Podiatrists can help with insoles and foot care, while occupational therapists can offer advice on how to protect the joints.

Meanwhile, Paddy and his wife Christine have said they're "struggling" raising three autistic children.

Six-year-old twins Penelope and Leo and their three-year-old sister Felicity have the condition.

What's autism?

Autism Speaks noted the condition is "characterised by challenges with social skills, repetitive behaviours, speech and nonverbal communication".

The spectrum disorder becomes apparent in children from the age of two or three.

The charity emphasised that "professional evaluation is crucial", as many children with autism don't show all the signs.

Equally as important, many children who don't have autism may show a few of the signs.

What are the signs?

At any age, symptoms of autism can include restricted interests, difficulty understanding other people's feelings, and avoidance of eye contact.

Other signs could include resistance to minor changes in routine or surroundings.

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Paddy McGuinness health: The TV presenter opens up on his crippling condition - Express

Transparency Market Research (TMR) has published a new report titled, Small bone and joint orthopedic devices Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast, 20192027. According to the report, the global small bone and joint orthopedic devices market was valued at US$ 5,575.7 Mn in 2018 and is projected to expand at a CAGR of 6.3% from 2019 to 2027.

Overview

Orthopedic devices are implants used to restore skeletal structure and joint movement after fracture, abnormal growth of bones, soft tissue damage, or other deformities. These devices can be surgically implanted or externally attached through minimally invasive procedures and can be classified into internal and external fixation devices.

These devices are used in fractures, trauma, and to correct bone deformities. Under certain circumstances, a joint or a part of it needs to be replaced for proper functioning. These orthopedic devices are known as joint implants. Joint implants are generally used to treat deformities in long and small bone and joints. Implants such as femoral head, humeral head, reverse shoulder prosthesis, prosthesis, and others assist in restoring proper joint movement.

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Extremities orthopedic devices are made of alloys of titanium, stainless steel, polyether ether ketone (PEEK), and polymeric synthetic resorbable materials. Some companies have stopped the manufacture of metal-on-metal implants due to serious injuries and adverse reactions.

Small bone and joints may face difficulty during surgical procedures due to their anatomical complexity and disposition. Hence, various devices, such as Re-motion Total Wrist System by Small Bone Innovations (SBi), have been designed to overcome these intricate procedures. Several key players are working toward providing solutions to eradicate impairments of small bone and joint.

Unmet Needs in Emerging Countries of Asia Pacific and RoW to Provide Growth Opportunities for the Market

Asia Pacific is the fastest growing market for orthopedic devices; however, the region holds a smaller market share as compared to North America and Europe. The demographics and lifestyle changes and higher number of elderly people favor the market growth. There is a rise in per capita income and the knowhow of the medical technologies.

Asia Pacific is also a preferred option for medical tourism for patients in the U.S. where cost of medical services is high. Hence, OEMs can focus on sales, distribution, and target marketing programs in the lucrative market in Asia Pacific.

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On the other hand, the cost of operations in Asia Pacific and RoW is lower than that in organized markets such as North America and Europe due to minimal compliance requirements. Therefore, market players can focus on the lucrative market in RoW, which is unorganized and has low entry barriers.

Fracture Fixation and Replacement Systems Segment to Dominate Market

Based on product type, the global small bone and joint orthopedic devices market has been divided into fracture fixation and replacement systems, plates and screws, external fixation devices, and joint prosthesis.

Orthopedic devices for small bones and joints are used to prevent and/or cure musculoskeletal injuries and disorders of the bones and joints. These devices comprise various implants, internal fixators, and external fixators for application in shoulder, elbow, wrist, hand, ankle, and foot reconstruction or surgeries.

Recently, technologically advanced orthopedic devices have overcome the previous life threatening situations of amputations. Rise in orthopedic procedures and high incidence rates of osteoarthritis and osteoporosis contribute to the growth of the global small bone and joint orthopedic devices market.

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Foot Application Segment to be Highly Lucrative Segment

In terms of application, the global small bone and joint orthopedic devices market has been classified into foot, hand, and shoulder.

Small bone and joint orthopedic devices for foot are majorly recommended for support and alignment, correction of foot deformities, and improving the overall function of foot and ankle.

Advances in plastics and materials science have significantly improved the design and manufacture of foot orthoses in the last couple of decades.

According to a study published in the journal Injury, foot and ankle fractures account for 9% of all the fractures and around 65% of these found in females were osteoporotic. The risk of ankle fracture increases with obesity and osteoporosis.

Other indications include avascular necrosis, traumatic deformity, and arthritis. Fractures of foot and ankle include fractures in metatarsals, calcaneus bones, cuboid bone, and distal head of tibia and fibula. Severe fracture fixation could require internal fixation devices such as wires, plates, and screws or external fixation devices.

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North America to Dominate Global Market

In terms of region, the global small bone and joint orthopedic devices market has been segmented into North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. North America dominated the global small bone and joint orthopedic devices market in 2018, followed by Europe.

The dominance of these two regions was majorly attributed to growing geriatric and obese populations and introduction of technologically advanced products.

Asia Pacific is considered an emerging market for home rehabilitation products and services Rising disposable income, rapid urbanization, increase in health care infrastructure, and distribution and partnership strategies adopted by the players support market growth in the region.

Competitive Landscape

The global small bone and joint orthopedic devices market is consolidated in terms of number of players. Key players in the global market include Acumed LLC, Arthrex, Inc., Depuy Synthes, DJO Global, Smith & Nephew plc, Stryker Corporation, Tecomet, Inc., Wright Medical Group N.V., Z-Medical GmbH + Co. KG, and Zimmer Biomet Holdings, Inc., among others.

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Small Bone and Joint Orthopedic Devices Market: Increasing Prevalence of Arthritis across Globe to Spur Demand - BioSpace

A new study has revealed psoriatic arthritis may be activated by the same trigger in different patients. Researchers from the University of Oxford and the Wellcome Sanger Institute identified high levels of a specific receptor in immune cells from psoriatic arthritis patients, giving the strongest evidence yet of a single cause for the disease.

Published today (21st September) inNature Communications, this could lead to finding the exact molecular 'trigger' and gives hope for developing a targeted treatment in the future.

A third of patients with the skin condition psoriasis, will develop psoriatic arthritis, which typically causes affected joints to become swollen, stiff and painful. Psoriatic arthritis is a long-term condition that can get progressively worse over time. While some treatments are available there is currently no cure, and in severe disease the joints can become permanently damaged, needing surgery.

It was already known that the disease had a number of genetic predispositions, one of which controls how immune cells called T cells see antigen molecules from disease-causing microorganisms. However, it is not understood exactly what triggers the onset of psoriatic arthritis in patients.

Using cutting edge single cell technology, the researchers analysed thousands of individual immune cells from fluid drained from the knees of patients with psoriatic arthritis. They could see which genes were switched on in each cell and showed these T cells had an activated inflammatory profile. The researchers also amplified and sequenced the RNA from receptor genes, to identify active T cell receptors in each cell. The study showed that many T cells in the joint fluid shared an identical T cell receptor and were therefore clones of each other. These were very likely to have been triggered to reproduce themselves by a particular antigen.

Using machine learning to compare these receptors from different patients, they discovered that the expanded clones of T cells were potentially recognising something in common. These cells also shared other markers, including a receptor called CXCR3, that directed them to the inflammation site.

Dr Hussein Al-Mossawi, Honorary Research Associate at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS) at the University of Oxford, said: "Our data suggest that psoriatic arthritis doesn't just appear out of nowhere. Each receptor is like a unique lock that recognises a molecular key and we discovered, that across the patients, they are recognising a common molecule. This gives the first evidence that the T cells are seeing and reacting to the same molecule, which acts as a trigger for the disease. We don't know the exact culprit yet, but this a great step forward in understanding the disease."

The large-scale single cell data from the joints and blood of psoriatic arthritis patients were then used to investigate how the T cells could transfer from the blood to the joint to cause the damage.

Dr Sam Behjati, Group Leader and Wellcome Trust Intermediate Clinical Fellow at the Wellcome Sanger Institute commented: "Our study produced the largest single cell dataset from psoriatic arthritis patients to date. It is helping us to understand the intricate mechanisms behind psoriatic arthritis, including starting to unravel the signals that tell the T cells to cross over into the joint fluid. Imagine the cells as train passengers with a ticket that tells them at which station to get off - the single cell data is allowing us to read that destination for each cell, and understand the signals."

Professor Paul Bowness, Professor of Experimental Rheumatology at NDORMS said: "Our findings indicate that specific T cells are likely to be targeted to enter the joint, where they are triggered to expand, creating inflammation and causing psoriatic arthritis. The next stage of research will be to find the key that is unlocking the disease in patients - from the signals that direct cells to the joint, to what then triggers them to expand. If we can understand these, we could move towards creating therapies that would prevent this, potentially providing a cure."

Reference:Penkava, F, Velasco-Herrera, MDC, Young, MD, et al. Single-cell sequencing reveals a clonal expansion of pro-inflammatory synovial CD8 T cells expressing tissue homing receptors in psoriatic arthritis. Nat Commun 2020; doi:10.1038/s41467-020-18513-6

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Could Psoriatic Arthritis Be Activated by the Same Receptor in Different Patients? - Technology Networks

Arthritis is the most common joint disorder in the United States, and knees are often the first joints affected by the condition.

One study found that in people above age 60, more than 10 percent of men and 13 percent of women had symptoms of arthritis in their knees.

OTC and prescription pain medication can offer relief, but are frequently associated with side effects. These side effects include kidney damage and heart problems.

Almost 20 percent of Americans report some degree of knee pain, according to figures published in 2006 by the Centers for Disease Control and Prevention (CDC). Pain can range from mild stiffness to levels that are nearly disabling.

Recent studies have found that turmeric, a flavorful spice popular in India, may help relieve joint pain. The spice is popular in Ayurvedic medicine, but is mainly used in food in the United States and not as a medication.

Experts say that there is increasingly clear evidence that the active ingredient in turmeric may have health benefits.

It is widely believed that curcumin, which is the active ingredient in turmeric, has anti-inflammatory and antioxidant properties. And for this reason, its frequently used as a supplement by many people to help with joint symptoms, Dr. Nagendra Gupta, FACP, CPE, an internist at Texas Health Arlington Memorial Hospital, told Healthline.

A study published in the medical journal Trials compared the effectiveness of turmeric to that of an anti-inflammatory drug called diclofenac.

The randomized trial gave 139 patients with knee pain either a 500-milligram (mg) capsule of curcumin three times a day or a 50-mg diclofenac pill twice daily. Scientists found that both groups experienced significant pain relief.

Curcumin has similar efficacy to diclofenac but demonstrated better tolerance among patients with knee OA. Curcumin can be an alternative treatment option in the patients with knee OA who are intolerant to the side effects of non-steroidal anti-inflammatory drugs, the study authors wrote.

In another study, published this week in the Annals of Internal Medicine, researchers at the University of Australia in Tasmania assigned 70 participants, over age 40, with knee osteoarthritis (OA) and swelling diagnosed by ultrasound, to receive either 1000 mg per day of turmeric or a placebo.

After 12 weeks, the randomly controlled placebo trial found that an extract of turmeric was more effective than a placebo in reducing knee pain in people with knee osteoarthritis.

Those taking turmeric reported significantly less knee pain at the end of the study, according to the standardized questionnaire.

Researchers emphasized that more research is needed, and the only limiting factor of their study was the small number of participants.

This research also received funding from Natural Remedies PVT Ltd, a company that offers Ayurvedic medicines and herbs.

While this may indicate a conflict of interest, previous research also supports this spices effectiveness for pain relief.

Turmeric (Curcuma Longa) is a frequently used spice in South Asian foods like curries, and it can add a warm orange or yellow color to meats and rice dishes. It also has a long history of use in Ayurvedic medicine.

The active ingredient in turmeric is curcumin, and research finds that it has a surprisingly wide range of beneficial properties.

Curcumin, unlike some NSAIDs, has also been determined to be nontoxic. NSAIDs, such as ibuprofen, taken in excess can cause symptoms that include convulsions, coma, and acute renal (kidney) failure.

Experts say that given turmerics known health benefits, including it in meals is best.

Eating turmeric with fats or oils can improve absorption.

Turmeric however, specifically the phytonutrient curcumin, has so many health benefits, so definitely incorporating turmeric into meals would be ideal as part of an overall healthy lifestyle plan, said Reema Kanda, RD, a clinical dietitian at Hoag Orthopedic Institute.

Incorporating turmeric into meals that contain fats and oils or black pepper will enhance absorption.

Kanda emphasized that the quality of the turmeric powder can also affect bioavailability. She also said, You want to be sure the turmeric powder is free of contaminants that are often found when making powders.

She added that many studies have utilized turmeric extracts over turmeric powder, which has higher amounts of curcumin. Because of that, the studies recommended extracts for therapeutic use for health benefits such as improving in joint pain.

Theres strong evidence that eating the Mediterranean diet may provide significant knee pain relief in people with OA.

Researchers reviewing three different studies found that people with symptoms of arthritis had an improved quality of life after starting the Mediterranean diet.

According to the study, the Mediterranean diet may benefit OA because of its anti-inflammatory properties, tendency to reverse metabolic syndrome (a risk factor of diabetes), and reduce obesity.

Researchers say the diet is also rich in polyphenols (plant compounds), which can prevent inflammation and cartilage destruction, and this could also be why it shows benefit.

While there is no specific diet that works as a cure for arthritis, various studies have shown that a Mediterranean diet can help fight the inflammation associated with arthritis and slow the disease progression, said Gupta.

As always, getting the right dosage is key to staying healthy. While turmeric may help joint pain, more is not always better.

Consuming large amounts of turmeric can have side effects.

Subjects in a 2006 small dose-response study reported a range of adverse reactions from using 500 mg to 12,000 mg of curcumin daily, although the researchers found overall participants tolerated the high levels of the spice.

Of 24 participants, seven reported side effects that included headache, diarrhea, and skin rash. All but one of the people with side effects were taking over 4,000 mg of turmeric.

Turmeric is also high in oxalate, a chemical that in large doses can combine with calcium to create kidney stones.

According to the Food and Drug Administration (FDA), curcumin, the active ingredient in turmeric, is generally recognized as safe. However, the FDA has previously warned that turmeric from Bangladesh contained excessive levels of lead, which can adversely affect health.

Studies have shown that turmeric can have strong anticoagulant effects, which could affect how blood-thinning drugs work in the body.

If you want to try using turmeric to treat joint pain, its always a good idea to speak with your doctor first to make sure it wont interact with medications youre already taking.

Joint pain, especially in the knee, due to arthritis affects about 1 in 10 older Americans.

Research finds that an ingredient in the spice turmeric can significantly reduce knee pain in people with osteoarthritis but it wont improve swelling or change cartilage.

Although considered safe by the FDA, there is strong evidence that turmeric can interact with blood-thinning drugs, and the agency has warned that turmeric imported from Bangladesh has shown high levels of lead.

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Want to Take Turmeric for Arthritis Pain? Here's What to Know - Healthline

Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue.

Osteoarthritis, on the other hand, is usually the result of external lifestyle factors, such as injury and obesity.

Although, as the NHS points out, osteoarthritis can be associated with the joints severely damaged by rheumatoid arthritis.

Unfortunately, there is no cure for both forms of arthritis but making healthy lifestyle changes has been shown to provide some symptom relief.

READ MORE:Arthritis pain - the best vegetable to lower your risk of joint pain and inflammation

Further research supports the effective anti-inflammatory and immune-balancing properties.

Boswellias ability to alleviate osteoarthritis pain and inflammation appears to be even more promising.

One study published in the journal Phytomedicine found that all 30 people with osteoarthritis knee pain who received boswellia reported a decrease in knee pain.

They also reported an increase in knee flexion and how far they could walk.

If you have arthritis, it is vital that you take steps to lose weight if you are overweight.

Why? "Too much weight places excess pressure on the joints in your hips, knees, ankles and feet, leading to increased pain and mobility problems," explains the NHS.

As the health body points out, exercise may seem counterintuitive if you are in pain but it can aid weight loss while bringing direct benefits for managing arthritis.

Regular exercise can also:

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Rheumatoid arthritis treatment: The herbal extract shown to reduce joint swelling - Express

While the short-term risks of hydroxychloroquine treatment were minimal, long-term use was associated with excess cardiovascular mortality in rheumatoid arthritis (RA), according to study results published in Lancet Rheumatology. Researchers noted that combining hydroxychloroquine with azithromycin further increased risk for heart failure and cardiovascular mortality, even in the short term.

Hydroxychloroquine is frequently used as a first-line treatment agent in patients with autoimmune conditions, including RA. The potential efficacy of hydroxychloroquine as an antiviral agent against coronavirus disease 2019 (COVID-19) has led to widespread publicity, much of which focuses heavily on its side effects. The present study assessed the safety profile of hydroxychloroquine alone and in combination with azithromycin in patients with RA.

The multinational, retrospective cohort study enrolled adult patients with RA who were new users of hydroxychloroquine or sulfasalazine. Health records and claims data were obtained from 14 databases in Germany, Japan, the Netherlands, Spain, the United Kingdom, and the United States. The study period was from 2000 to 2020.

Study participants were followed up for the development of 16 severe adverse events of interest over the short (30 days) and long term (>30 days). Patients being initiated with hydroxychloroquine were compared with those being initiated with sulfasalazine. A self-controlled case series was also conducted to assess the safety of hydroxychloroquine in the general population, including patients without RA. Case series participants were identified from the same 14 databases. Finally, severe adverse events were assessed in patients receiving hydroxychloroquine plus azithromycin vs those receiving hydroxychloroquine plus amoxicillin. Propensity score matching and calibration were performed in all patient-to-patient comparisons to minimize confounding. Cox proportional hazard models were used to estimate the hazard ratios (HRs) for severe adverse outcomes among patients receiving hydroxychloroquine vs comparator drugs.

The study cohort included 956,374 patients receiving hydroxychloroquine, 310,350 receiving sulfasalazine, 323,122 receiving hydroxychloroquine plus azithromycin, and 351,956 receiving hydroxychloroquine plus amoxicillin. No excess risk for any of the 16 adverse events was observed with hydroxychloroquine vs sulfasalazine over 30 days of follow-up. The same trends were observed in the self-controlled case series. However, longer use of hydroxychloroquine vs sulfasalazine was associated with increased cardiovascular mortality (HR, 1.65; 95% CI, 1.12-2.44).

Compared to hydroxychloroquine plus amoxicillin, hydroxychloroquine plus azithromycin was associated with significantly increased risk for cardiovascular mortality (HR, 2.19; 95% CI, 1.22-3.95), chest pain or angina (HR, 1.15; 95% CI, 1.05-1.26), and heart failure (HR, 1.22; 95% CI, 1.02-1.45) in the short term.

While hydroxychloroquine presented no significantly increased risk for severe adverse events with short-term use, long-term use was associated with excess cardiovascular mortality. The addition of azithromycin appeared to increase the risk for heart failure and cardiovascular mortality, even in the short term.

We call for careful consideration of the benefit-risk trade-off when counselling those on hydroxychloroquine treatment, the researchers concluded.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors disclosures.

Lane JCE, Weaver J, Kostka K, et al. Risk of hydroxychloroquine alone and in combination with azithromycin in the treatment of rheumatoid arthritis: a multinational, retrospective study. Published online August 21, 2020. Lancet Rheumatol. doi:10.1016/S2665-9913(20)30276-9

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Treatment With Hydroxychloroquine Plus Azithromycin Linked to Cardiovascular Mortality in Rheumatoid Arthritis - Rheumatology Advisor

VIENNA, Va.--(BUSINESS WIRE)--CEL-SCI Corporation (NYSE American: CVM) today announced that the European Patent Office has issued CEL-SCI patent: European Patent 2989121 to be published on October 7, 2020, and titled Method of Preparation and Composition of Peptide Constructs for Treatment of Rheumatoid Arthritis for the Companys LEAPS platform technology. CEL-SCIs LEAPS technology relates to peptide constructs which may be useful in the treatment or prevention of autoimmune diseases, particularly rheumatoid arthritis, asthma, allergies, and host versus graft (or graft versus host) rejection.

The basic goal of this technology is to 'modulate' the immune system of a patient with Rheumatoid Arthritis, and other autoimmune diseases, away from the body attacking itself to a more normal immune response where the body does not attack itself. This should result in a decrease or elimination of the symptoms of the disease. We are in the process of completing pre-IND studies for CEL-4000, being developed against Rheumatoid Arthritis, and hope to start human studies with CEL-4000 next year. LEAPS is also currently being tested at the University of Georgia vaccine center against COVID-19, said Dr. Daniel Zimmerman, Senior Vice President of Research, Cellular Immunology.

The LEAPS platform technology is being developed as a potential therapeutic vaccine for rheumatoid arthritis under phase I and phase II SBIR grants of over $1.7 million from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) of the U.S. National Institutes of Health (NIH) which was used in part to fund IND enabling studies in non-human primates.

In animal challenge tests conducted in arthritic diseased animals using CEL-4000 as a therapeutic treatment in collaboration with our Rush Universities Medical center collaborators and co-inventors on this patent, LEAPS platform technology has been shown to direct the immune response preferentially to a cellular (e.g. T-cell) response, reducing pro inflammatory cytokines (IFN and IL17A) and enhancing production of anti-inflammatory cytokines (IL4 and IL10). Additional studies in other disease models have shown either cellular, humoral (antibody) or mixed pathway immune responses depending on the disease model and the desired type of protection.

LEAPS is a patented, T-cell modulation, peptide epitope delivery technology that enables CEL-SCI to design and synthesize proprietary peptide immunogens. LEAPS compounds consist of a small T-cell binding peptide ligand linked with a disease-associated peptide antigen. Usually given after the disease process is initiated and underway. That is not being used as a preventative agent or conventional preventative vaccine.

The LEAPS conjugates can potentially be utilized to treat diseases for which antigenic epitope sequences have already been identified, such as: a number of infectious diseases, some cancers, autoimmune diseases (e.g., rheumatoid arthritis), allergic asthma and allergy, and select CNS diseases (e.g., Alzheimer's).

About CEL-SCI Corporation

CEL-SCI believes that boosting a patients immune system while it is still intact should provide the greatest possible impact on survival. Therefore, in the Phase 3 study CEL-SCI treated patients who are newly diagnosed with advanced primary squamous cell carcinoma of the head and neck with the investigational product Multikine* first, BEFORE they received surgery, radiation and/or chemotherapy. This approach is unique. Most other cancer immunotherapies are administered only after conventional therapies have been tried and/or failed. Multikine (Leukocyte Interleukin, Injection), has received Orphan Drug designation from the FDA for neoadjuvant therapy in patients with squamous cell carcinoma (cancer) of the head and neck.

CEL-SCI believes that this Phase 3 study is the largest Phase 3 study in the world for the treatment of head and neck cancer. Per the studys protocol, newly diagnosed patients with advanced primary squamous cell carcinoma of the head and neck were treated with the Multikine treatment regimen first - for 3 weeks prior to receiving the Standard of Care (SOC), which involves surgery, radiation or concurrent radiochemotherapy. Multikine is designed to help the immune system see the tumor at a time when the immune system is still relatively intact and thereby thought to better be able to mount an attack on the tumor. The aim of treatment with Multikine is to boost the bodys immune system prior to SOC to attack the cancer. The Phase 3 study is fully enrolled with 928 patients and the last patient was treated in September 2016. To prove an overall survival benefit, the study requires CEL-SCI to wait until 298 events have occurred among the two main comparator groups. This study milestone occurred in late April 2020. The study is currently in the database lock and analysis phase.

The Companys LEAPS technology is being developed for rheumatoid arthritis and as a potential treatment of COVID-19 in hospitalized and at-high-risk patients. The Company has operations in Vienna, Virginia, and near/in Baltimore, Maryland.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, including statements with respect to Multikine and the Phase 3 clinical trial of Multikine in patients with advanced primary squamous cell carcinoma of the head and neck. When used in this press release, the words "intends," "believes," "anticipated," "plans" and "expects," and similar expressions, are intended to identify forward-looking statements. Such statements are subject to risks and uncertainties that could cause actual results to differ materially from those projected. Factors that could cause or contribute to such differences include an inability to duplicate the clinical results demonstrated in clinical trials or nonclinical studies, timely development of any potential products that can be shown to be safe and effective, receiving necessary regulatory approvals, difficulties in manufacturing any of the Company's potential products, inability to raise the necessary capital and the risk factors set forth from time to time in CEL-SCIs filings with the Securities and Exchange Commission, including but not limited to its amended report on Form 10-K/A for the year ended September 30, 2019. The Company undertakes no obligation to publicly release the result of any revision to these forward-looking statements which may be made to reflect the events or circumstances after the date hereof or to reflect the occurrence of unanticipated events.

* Multikine (Leukocyte Interleukin, Injection) is the trademark that CEL-SCI has registered for this investigational therapy, and this proprietary name is subject to FDA review in connection with the Company's future anticipated regulatory submission for approval. Multikine has not been licensed or approved for sale, barter or exchange by the FDA or any other regulatory agency. Similarly, its safety or efficacy has not been established for any use. Moreover, no definitive conclusions can be drawn from the early-phase, clinical-trials data involving the investigational therapy Multikine. Further research is required, and early-phase clinical trial results must be confirmed in the Phase 3 clinical trial of this investigational therapy that is in progress.

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CEL-SCI Awarded European Patent for LEAPS Vaccine in Treatment of Rheumatoid Arthritis - Business Wire

There is some renewed hope for rheumatoid arthritis drugs, like Eli Lilly & Co.s and Incyte Corp.s Olumiant and Roche Holding AGs Actemra, as possible COVID-19 treatments after a series of clinical setbacks this summer seemed to close the door on the categorys potential.

Lillys LLY, -1.93% stock was up 1.1%, shares of Incyte INCY, -1.61% were down 4.2%, and Roches ROG, -1.48% stock had gained 1.8% in trading on Friday afternoon.

The industry has done what it should, to really test those [hypotheses], said Patrik Jonsson, president of Lilly Bio-Medicines. You never know what the outcome will be...I think that will probably continue to be the progress made and also sometimes disappointment.

Lilly and Incyte said Monday that giving Olumiant to hospitalized COVID-19 patients in combination with Gilead Sciences Inc.s GILD, -1.29% remdesivir helped them recover faster. The Food and Drug Administration in May granted an emergency use authorization to remdesivir as a treatment for COVID-19 during the pandemic.

Then, on Friday, Roche said a late-stage trial that primarily enrolled people of color found that hospitalized COVID-19 patients who took Actemra were less likely to go on ventilators than those receiving placebo an intriguing finding given that Black and Hispanic Americans are disproportionately more likely to contract and die from COVID-19.

We wanted to start a clinical trial with Actemra because it was being investigated in a general population for the treatment of COVID-19 pneumonia, said Dr. Jamie Freedman, head of U.S. medical affairs for Roches Genentech business. We decided we should [enroll a] trial with African-Americans and other minority patients.

The interest in testing rheumatoid arthritis drugs as COVID-19 treatments began back in February, when The Lancet published a list of already approved drugs that could benefit COVID-19 patients, including Olumiant. In March, researchers in China shared findings from a single-arm study that tested Actemra as a treatment for 21 severely ill COVID-19 patients.

One of the non-arthritis indications for Actemra is for cytokine release syndrome in leukemia patients undergoing gene therapy. Cytokine release is a type of an immune response seen in some severely ill COVID-19 patients. Given the lack of proven treatment options during the pandemic, doctors began to prescribe Actemra to their COVID-19 patients extensively off-label, Freedman said.

All of these factors set off a flurry of global trials, initiated by the drug makers, governments, and public health bodies, evaluating Actemra, Kevzara, and Olumiant as coronavirus therapies.

But then this summer, Actemra and Kevzara, another FDA-approved rheumatoid arthritis treatment, both failed Phase 3 clinical trials testing the therapies in severely ill COVID-19 patients. Roche said in July that there was no difference in the number of patients who died by week four among those taking Actemra or placebo, while Sanofi SNY, -3.03% and Regeneron Pharmaceuticals Inc. REGN, +0.08%, which market Kevzara, said Sept. 1 they would no longer pursue coronavirus-related clinical development for the drug.

The snapshot of data that Lilly released this week about Olumiant is the first finding that the company has released about using the drug as a treatment for COVID-19 treatment. This data may also indicate that rheumatoid arthritis drugs like Olumiant and Actemra, which are also being tested with remdesivr, with data expected to be shared sometime this year, may work better in combination than as standalone therapies for COVID-19 patients.

Olumiant could serve as an important additional treatment option as the medical community continues to learn how to best manage patients hospitalized with COVID-19, Mizuho Groups Vamil Divan told investors in a Sept. 14 note.

Lilly and Roche separately said they both expect to publish this weeks findings in peer-reviewed medical journals.

So far this year, Lillys stock has rallied 16.6%, shares of Incyte are down 1.4%, and Roches stock is up 16.4%. The S&P 500 x SPX, -1.15% is up 3.9% year-to-date.

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Initial data from a pair of clinical trials may revive interest in arthritis drugs as COVID-19 treatments - MarketWatch

Biting into my first apple after so many years was brilliant.

To eat something so crunchy without experiencing the unfathomable pain I had previously is something most people take for granted.

Just over a year earlier Id had a complete jaw replacement after several years of suffering from arthritis. Contrary to popular belief, it is not simply an old persons disease.

I was eight years old when I first remember waking up with stiffness, but I didnt understand why. My parents and I thought these were simply growing pains, but by the age of 10, I was struggling to function and my fingers rapidly became more inflamed and swollen.

Only just into double digits, and I was diagnosed with Juvenile Polyarticular Rheumatoid Arthritis (JPRA). I went from this bubbly, confident girl to one who had to learn to cope with all this change.

My condition is characterised by chronic inflammation to the joints caused by the immune system mistakenly attacking the cells lining them when you are still growing up.

My JPRA was particularly aggressive when I was young, and it caused lots of damage to my joints. I had to wear a neck brace and sleep in custom-made leg and arm splints.

I ended up missing quite a bit of school, which hugely impacted my confidence and my academic performance. My life became more about getting through each day instead of playing outside and being carefree like all the other children.

I had to stop all the hobbies I enjoyed: gymnastics, ballet, athletics, competitive swimming. I wasnt allowed to do PE; I had to sit and watch the others,which was devastating.

My whole world changed overnight. I felt quite alone and confused as I really didnt understand the fight that was going on in my body. Because I wasnt visibly ill, some of the children in my year started to bully, tease and make fun of me.

As I got older, my joints could not deal with the normal stresses and strains of life and eventually it became clear that Id have to undergo surgery. I really wanted to continue with life as normal, so I put on a brave face and didnt divulge much information with my friends; nothing about my finger operations at 15, wrist replacement at 17, or wrist fusions in my early 20s.

When I left schoolat 18, I started training to become a nursery nurse. I figured that if I worked the way normal people did then my illness could stay hidden. I did this for more than 30 years.

I really was the master of disguise, playing down every surgery and telling very few people about them. At times I wonder how I managed at all. But having my two sons in my early 20s gave me all the strength I needed. Being a mum was all I ever wanted in life.

Then 2018 came and the jaw pain Id been experiencing suddenly got very intense to the point where I could no longer eat or sleep.For a year I endured the worst agony Ive ever felt in my entire life.

I was on 3,600mg of painkillers every day and woke up each morning with dread at what I would have to face.

I waited for a gruelling year for surgery to completely replace my jaw, which is unfortunately common.

In the months leading up to my operation, my jaw had basically collapsed due to the deterioration of my joints, so I had to have a series of steroid injections as well as surgical wash outs to get rid of some of the bone debris.

I also had to have a muscle graft from my stomach to my jaw joint at one side to hold it up and screws into the other collapsing side to allow me to open my mouthenough for liquids and purees.

Talking was difficult due to the severe pain.

The operation was 8.5 hours long. Doctors replaced my jaw joint with a 3D printed model made ofsurgical steel and plastic, and 25 screws were drilled into my face.

I was in floods of tears when I came round tears of relief and of hope for the future. I knew it was a turning point in my life. The pain immediately afterwards was different and, although I had to get through the long recovery of 18 months, I could feel that things were going to improve and I was starting to see the light at the end of the tunnel.

My recovery is still ongoing and I still get a burning sensation every time I chew, as well as intermittent nerve pain but its like night and day compared to what it was before the operation. I feel like smiling again.

Im 41 years old now and,unfortunately, I know that more surgery will be inevitable as my underdeveloped joints just dont stand everyday life like other peoples do. But it doesnt scare or worry me.

Surgery is tough but I accepted it as an inherent part of my life a long time ago. Instead, what really scares me is not being able to do simple things the other day I was trying to cut some vegetables, but my fingers ached too much. I just broke down in tears because all I wanted to do was make dinner for my sons and I hated having to ask for help.

Arthritis is a lifelong illness and you never get away from the pain and the challenges it throws at you.

As Covid-19 impacts hundreds of operations, those with arthritis need clear communication about when they will be treated.

I know what its like to live with chronic pain for so long, nows the time to finally give arthritis the attention it deserves.

Joanna is supporting Versus ArthritisImpossible to Ignore campaign.

My Life Through a Lens is an exciting series on Metro.co.uk that looks at one incredible photo, and shares the story that lies behind it. If you have an experience you would like to share, please email kathryn.snowdon@metro.co.uk with MLTAL as the subject.

MORE: I abseiled into a 400C flaming pit otherwise known as the Door to Hell

MORE: As a wheelchair user, I never imagined Id be cycling alongside other commuters

MORE: I took pictures of my NHS colleagues as we worked through the first peak together

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I had a whole jaw replacement because of arthritis - Metro.co.uk

Eli Lilly and Co. has played a key role in developing important medicines since its founding in 1876. Some of those drugs include penicillin, Prozac, Zyprexa and Humulin. Wochit

Eli Lilly and Company officials are asking the federal government to grant emergency approval to use a drug approved for rheumatoid arthritis to treat COVID-19, after a study showed it hastened recovery when used with another therapy.

The trial looked at the impact of adding baricitinib, marketed as Olumiant, to treatment with remdesivir, an antiviral. Patients who received both drugs recovered one day sooner than those who received remdesivir alone, the study of more than 1,000 hospitalized patients found.

Its quite a big outcome, said Patrik Jonsson, Lilly senior vice president and president of Lilly Bio-Medicines.

Those who received baricitinib along with remdesivir also required less clinical support while they were in the hospital and had better outcomes overall, Jonsson said.

While 24 hours may not seem like a dramatic difference, if hospitals are experiencing a surge in patients it can ease the strain on resources.

Eli Lilly officials said that while the results from the trial have not yet been peer-reviewed, they will be doing further analyses and expect to have more results soon.

Unlike remdesivir, which is an infusion, baricitinib is taken by mouth. Currently it is approved to treat rheumatoid arthritis. Jonsson said that if it was also approved for use in COVID-19, Lilly would be able to produce sufficient amounts for both conditions.

We are very confident that we are in a good position when it comes to supply, he said.

Rheumatoid arthritis patients take a 2-mg dose. Lilly plans to ask the FDA to approve a 4-mg dose for COVID-19. The drug currently comes with warnings about a risk of developing blood clots or infections.

Baricitinib is thought to help coronavirus patients by acting as an anti-inflammatory, Jonsson said. It is thought that the drug may lessen the effects of the so-called cytokine storm that the bodys own immune system may produce in response to the virus. It may also interfere with the viruss ability to reproduce, lowering the viral load.

Contact IndyStar reporter Shari Rudavsky at shari.rudavsky@indystar.com. Follow her on Facebook and on Twitter: @srudavsky.

Read or Share this story: https://www.indystar.com/story/news/health/2020/09/16/lilly-study-shows-rheumatoid-arthritis-drug-helps-treat-coronavirus/5803136002/

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Lilly study shows its drug for rheumatoid arthritis helps in coronavirus treatment - IndyStar

Dr Shashank Akerkar, consultant, rheumatology clarifies several doubts and misconceptions pertaining to hydroxychloroquine (HCQ) and highlights the safety and efficacy profile of HCQ. He mentions that in general, practicing rheumatologists prescribe HCQ without ordering a baseline ECG unless the patient has a history of cardiac disease. If the right dosage of HCQ is used for the right patient with no prior cardiac complication, it is not likely to cause cardiac adverse effects.

What is the role of HCQ in the management of COVID-19? Can it in any way cure the disease?

COVID-19 has multiple pathological features and therefore its management requires multiple drug therapies. Hydroxychloroquine (HCQ) alone cannot cure COVID-19 but it has been used in combination with other drugs for this purpose.

However, HCQ is not approved by the Drugs Controller General of India (DCGI) for the management of COVID-19. The Indian Council of Medical Research (ICMR), has recommended it as a prophylaxis (prevention) for COVID-19 (March 23, 2020) and for the treatment of mild and moderate cases of COVID-19 (June 13, 2020 ICMR management protocol).

In many studies, it has been found to decrease morbidity and mortality in COVID-19 patients. For example, in one retrospective observational study that included 3,451 patients from 33 hospitals in Italy, use of HCQ was associated with a 30 per cent lower risk of death in COVID-19 hospitalised patients.

In India, HCQ has shown promising outcomes as a prophylaxis for COVID-19 amongst healthcare workers. In a nation-wide case-control ICMR study with 751 health care workers, the intake of six or more doses of HCQ was linked to a >80 per cent reduction in the risk of COVID-19 infection.

For the last five decades, HCQ has been widely used for the management of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). In in-vitro studies, HCQ has been found to possess antiviral activity against many viruses such as the rabies virus, poliovirus, HIV, hepatitis A virus, chikungunya virus, dengue virus, Zika virus and even SARS-CoV-2.

What are some of the common misconceptions about HCQ that have emerged since the COVID-19 pandemic?

During the pandemic, the use of HCQ has been linked to excessive cardiovascular adverse effects like QTc prolongation, arrhythmia and cardiovascular (CV) mortality. None of this has been conclusively proven through research.

In fact, for decades HCQ has been prescribed for those with RA and SLE, and CV adverse effects have been rare in these patients. A study with 1,537 RA patients on HCQ therapy, found no significant correlation between HCQ use and QT interval prolongation.

QTc prolongation is rarely seen with HCQ use and it is often a self-limiting event. QTc prolongation mostly occurs in the presence of several risk factors, such as high drug concentration and simultaneous exposure to QTc-prolonging drugs like azithromycin. It is possible that the QTc prolongation and arrhythmia observed in COVID-19 patients are cardiac manifestations of COVID-19 disease. Clinical evidence shows that patients with a severe case of COVID-19 are in an arrhythmogenic state with myocardial injury, hypoxia, renal insufficiency, and electrolyte disturbance. Use of antiviral drugs and azithromycin in COVID-19 patients has also been also linked to QTc prolongation.

In general, practicing rheumatologists prescribe HCQ without ordering a baseline ECG unless the patient has a history of cardiac disease. If the right dosage of HCQ is used for the right patient with no prior cardiac complication, it is not likely to cause cardiac adverse effects. However, an ECG (with estimation of QT interval) may be done before prescribing HCQ. The Indian Heart Rhythm Society recommends a baseline ECG to estimate the QTc interval in individuals receiving HCQ treatment. Thus, the rare CV risk linked to HCQ can be assessed proactively, which is why I believe the overall fear about serious CV adverse effects is unfounded and often exaggerated.

Of late, have you encountered any constraints when prescribing HCQ to patients?

There are no constraints in prescribing HCQ for patients with RA, SLE and type-2 diabetes. It has been approved by regulatory authorities such as the DCGI and US FDA for RA and SLE, and in addition to these indications, DCGI has approved it for the management of type 2 diabetes. HCQ has been used in these patients for a long period of time and it has a favourable safety profile.

Why do you believe that the controversy over HCQ is a myth?

Early in March, the WHO initiated a multinational trial of four untested drugs for COVID-19. HCQ was also a part of the trial. Then in May, Mehra et al published one multinational real-world analysis in The Lancet, in which they reported that HCQ treatment (alone or in combination with a macrolide) had no benefit on the in-hospital outcomes in patients with COVID-19. Instead, they concluded that HCQS increases mortality in patients with COVID-19, which led to the stopping of the WHO trial mentioned earlier.

Later on, Australian researchers found discrepancies in the mortality data for HCQ users. In response to this, The Lancet t published an expression of concern and retracted the article that had halted the HCQ trial. The members of the WHO trial committee recommend that there was no reason to modify the trial based on available mortality data. And on June 3, the WHO resumed the trial including the HCQs arm in patients with COVID-19. Most of the HCQS trials which were stopped earlier were also restarted.

What will be the consequences if HCQ is banned for use in COVID-19?

The COVID-19 pandemic is unprecedented and such a health crisis arises once in a century. The morbidity and mortality of COVID-19 is comparatively high. To control a viral pandemic of this kind, the following measures are generally required.

1) preventive healthcare measures e.g. social distancing, hand hygiene and wearing masks etc.

2) vaccination of the general population, when a vaccine is available

3) use of antiviral drugs

4) use of immunomodulatory drugs

5) repurposing of existing drugs when specific treatment is not available.

A vaccine that prevents COVID-19 would ideally have been the best measure. But it takes a long time to develop and test effective vaccines against RNA viruses with rapidly mutating strains. Similarly, it is extremely difficult to develop a specific antiviral drug in a short period of time.

Considering the high morbidity and mortality of COVID-19, newer antiviral drugs such as remdesivir, lopinavir/ritonavir have been repurposed to manage COVID-19 and existing drugs such as HCQ, azithromycin, other antiviral drugs, and dexamethasone have also been repurposed for the treatment of COVID-19. HCQ has been found effective for the treatment and prevention of COVID-19 disease.

No serious untoward effects have been observed with HCQ use for the last five decades that can cause the regulatory authorities to think about banning HCQ. Such a possibility is extremely remote as millions of RA and SLE patients are being successfully treated with HCQ without serious safety concerns.

(Note: These are not recommendations, to be considered as an opinion.)

Read more from the original source:
FAQs on HCQ use in rheumatoid arthritis and other conditions - Express Healthcare

One-and-a-half million people in the United States suffer from rheumatoid arthritis (RA). In fact, The Arthritis Foundation estimates that three times as many women as men have the disease and it affects individuals of all ages, but primarily women ages 30 to 60.

Commonly affecting the hands and feet of the body, RA is considered an autoimmune disease, where the body attacks joints, leading to inflammation and pain as well as a loss of motion. With a diagnosis comes a rapidly-changing lifestyle, often causing activities and hobbies that were once loved and now off-limits.

Through stories on the National Rheumatoid Arthritis Society website, many individuals have shared that arthritis has caused a dramatic lifestyle change thats often accompanied by depression and anxiety. But that doesnt have to be the case.

With patients young and old experiencing the debilitating effects of rheumatoid arthritis, individuals like Pearl Schomburg are advocating for doctors to mention the effects of cannabis in office. Pearl explained to Newshub, Cannabis balm was the first thing I discovered and was shocked by how well it worked.

RELATED: Theres No Known Cure For Arthritis, But Marijuana Works Wonders

The Arthritis Foundation recently shared information about CBD and marijuana on their website to educate patients around its use. Recognizing the potential to treat both inflammation and pain, they advise to always discuss CBD and cannabis with your care team and make sure to contact the manufacturer to see proof of a third-party analysis for purity.

Photo by rawpixel.com

In a 2018 study published in the journal CannabisandCannabinoid Research, researchers found that terpenoids, which exist in cannabis, offer anti-inflammatory properties, but didnt offer as much relief as purified CBD. Often used in chronic inflammation and for pain, purified CBD offered better relief in the study over other mixtures, including CBD.

Psoriasis, a condition where cells build on top of the skin and cause pain and redness, is often coupled with RA and offers treatment that can be very expensive. John S. from Minneapolis explained that his medicine came in the form of a shot billed to insurance at $60,000 each year creating a debilitating pattern of relying on pharmaceutical medicine that is often inaccessible. Would he explore CBD and cannabis? He explained, Its been on my mind; a year ago, I wouldnt have even thought about integrating CBD, now Im looking at reviews online. In fact, MedicalNewsToday cited 2016 research that suggested that cannabinoids offered benefits to individuals with psoriasis.

With the market ever-changing, not only are tinctures available, but patches as well. In 2016, a study found that placing CBD on the body in a topical fashion offered some relief for pain and inflammation over other methods. CBD comes in many forms, including:

As the cost of medicine continues to rise, CBD and cannabis offer a more affordable solution to many experiencing the effects of RA, inflammation and psoriasis.

RELATED: Young People Experience Arthritis Too And Cannabis Can Help

House of Cannabis, a new pot shop in Twisp, WA, is seeing a steady increase (about 52%) of customers coming in aged 50 and older. Mainly focused on pain relief, House of Cannabis has been both startled and empowered by the number of older adults coming in for the first time.

Arthritis is probably the most common issue people are dealing with in their hands, back and legs, shared Cindy Knutson, the retailers general manager and state-certified medical cannabis consultant. Were seeing a shift in mindsets and the market, Knutson continued, notating that adults who typically wouldnt have spoken about cannabis or CBD are now sharing with their friends.

Original post:
Whats Next For Rheumatoid Arthritis And Cannabis? - The Fresh Toast

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Part 01: Executive Summary

Part 02: Scope of the Report

Part 03: Research Methodology

Part 04: Market Landscape

Part 05: Pipeline Analysis

Part 06: Market Sizing

Part 07: Five Forces Analysis

Part 08: Market Segmentation

Part 09: Customer Landscape

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Psoriatic Arthritis Treatment Market revenue to expand at significant CAGR through 2027 - The Daily Chronicle

Rheumatoid Arthritis Drugs Market Scenario 2020-2028:This detailed market study covers Rheumatoid Arthritis Drugs Market growth potentials which can assist the stakeholders to understand key trends and prospects in the Rheumatoid Arthritis Drugs market identifying the growth opportunities and competitive scenarios. The report also focuses on data from different primary and secondary sources and is analyzed using various tools. It helps to gain insights into the markets growth potential, which can help investors identify scope and opportunities. The analysis also provides details of each segment in the global Rheumatoid Arthritis Drugs market

Rheumatoid Arthritis Drugs

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Company profiled in this report based on Business overview, Financial data, Product landscape, Strategic outlook & SWOT analysis: AbbVie Inc., Amgen Inc., Bayer AG, Boehringer Ingelheim GmbH, Bristol-Myers Squibb Company

According to the report, the Rheumatoid Arthritis Drugs market report points out national and global business prospects and competitive conditions for Rheumatoid Arthritis Drugs. Market size estimation and forecasts were given based on a detailed research methodology tailored to the conditions of the demand for Rheumatoid Arthritis Drugs. The Rheumatoid Arthritis Drugs market has been segmented as By Type of Molecule (Pharmaceuticals, Biopharmaceuticals), By Drug Class (Non-steroidal Anti-inflammatory Drugs (NSAIDs), Corticosteroids, Analgesics) . Historical background for the demand of Rheumatoid Arthritis Drugs has been studied according to organic and inorganic innovations in order to provide accurate estimates of the market size. Primary factors influencing the growth of the demand Rheumatoid Arthritis Drugs have also been established with potential gravity.

Regional segmentation and analysis to understand growth patterns: The market has been segmented in major regions to understand the global development and demand patterns of this market. By region, the Rheumatoid Arthritis Drugs market has been segmented in North America, Europe, Asia Pacific, Middle East & Africa, and South America. The North America and Western Europe regions are estimated to register a stable demand during the forecast period with market recovery from recent slowdowns.

North America region includes the US, Canada, and Mexico. The US is estimated to dominate this market with a sizeable share followed by Canada, and Mexico. The industrial sector is a major contributor to the US and Canada economies overall. Hence, the supply of advanced materials in production activities is critical to the overall growth of industries in this region.

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Europe region is dominated by Germany, the UK, France, Italy, and Spain. These countries also have a strong influence on the industrial sector resulting in sizeable demand for the Rheumatoid Arthritis Drugs market. Asia Pacific is estimated to register the highest CAGR by region during the forecast period. The presence of some of the high growth economies such as China and India is expected to propel the demand in this region. Besides, this region has witnessed strategic investments by major companies to increase their market presence. The Middle East and Eastern Europe are estimated to be other key regions for the Rheumatoid Arthritis Drugs market with a strong market potential during the forecast period. The rest of the World consisting of South America and Africa are estimated to be emerging markets during the forecast period.

This report provides: 1) An overview of the global market for Rheumatoid Arthritis Drugs market and related technologies.2) Analysis of global market trends, yearly estimates, and annual growth rate projections for compounds (CAGRs).3) Identification of new market opportunities and targeted consumer marketing strategies for the global Rheumatoid Arthritis Drugs market.4) Analysis of R&D and demand for new technologies and new applications5) Extensive company profiles of key players in the industry.

The researchers have studied the market in-depth and have developed important segments such as product type, application, and region. Each and every segment and its sub-segments are analyzed based on their market share, growth prospects, and CAGR. Each market segment offers in-depth, both qualitative and quantitative information on market outlook.

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Objectives of this report: To estimate the market size for the Rheumatoid Arthritis Drugs market on a regional and global basis. To identify major segments in the Rheumatoid Arthritis Drugs market and evaluate their market shares and demand. To provide a competitive scenario for the Rheumatoid Arthritis Drugs market with major developments observed by key companies in the historic years. To evaluate key factors governing the dynamics of the Rheumatoid Arthritis Drugs market with their potential gravity during the forecast period.

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Rheumatoid Arthritis Drugs Market: Prospective Growth Trends & Incremental Opportunity Assessment till 2028 - The Daily Chronicle

Market Study Report LLC presents an extensive report on Rheumatoid Arthritis Therapeutics market that offers qualitative information about prevailing trends and a detailed analysis of the growth trajectory of this industry. It also includes a study of the historical data and detailed statistics that will help determine the future scope of the industry in terms of commercialization opportunities.

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The Rheumatoid Arthritis Therapeutics research report provides a detailed assessment of this business sphere. This report also estimates the market share and growth rate attained over the forecast period. The report unravels all the key aspects of Rheumatoid Arthritis Therapeutics market including revenue forecasts, industry size, and sales amassed with respected to each industry segment. The key growth drivers and the restraints of this industry vertical have also been elucidated in the report.

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Rheumatoid Arthritis Therapeutics Market Presents an Overall Analysis, Trends and Forecast to 2025 - The Daily Chronicle