StemCell Therapy

According to the NHS, the severity of osteoarthritis symptoms can vary greatly from person to person, and between different affected joints.

"For some people, the symptoms can be mild and may come and go. Other people can experience more continuous and severe problems which make it difficult to carry out everyday activities," explains the health body.

Unfortunately, there's no cure for osteoarthritis, but the condition does not necessarily get any worse over time.

Simple lifestyle tweaks can greatly alleviate joint complaints and help you maintain quality of life.

READ MORE:Paddy McGuinness health: Top Gear host explains condition that leaves him 'knackered'

They found that in five trials, daily administration of capsaicin gel was significantly more effective for pain reduction than placebo.

In the study that spanned over a period of 12-weeks, there was over a 50 percent reduction in pain with capsaicin gel use.

According to the Arthritis Foundation (AF), applied as a topical cream, gel or patch, capsaicin activates specific nerve receptors causing local heat, stinging and/or itching sensations.

"Prolonged activation of these receptors causes them to lose their ability to function properly (and process pain signals) for extended periods of time," explains the AF.

It is worth noting that capsaicin must be used regularly to keep the nerve receptors from working properly and processing pain signals, it adds.

Exercise is one of the most important treatments for people with osteoarthritis, whatever your age or level of fitness.

As the NHS points out, exercise may seem counterintuitive if you are suffering from osteoarthritis pain and stiffness, but the reverse is true.

"Regular exercise that keeps you active, builds up muscle and strengthens the joints usually helps to improve symptoms," says the health body.

Exercise is also good for losing weight, improving your posture and relieving stress, all of which will ease symptoms, notes the health site.

One of the most effective exercises for controlling weight is aerobic exercise.

"Aerobic exercise also reduces fatigue and builds stamina, while helping control weight by increasing the number of calories the body uses," explains the AF.

Examples of this type of exercise includes walking, jogging, bicycling, swimming or using the elliptical machine.

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Arthritis treatment: The topical gel shown to ease joint pain by nearly fifty percent - Express

Researchers writing in Arthritis and Rheumatology report that high levels of anti-citrullinated protein antibodies (anti-CCP2) appear to be markers for future cardiovascular events in rheumatoid arthritis patients.

The study is based on an analysis of 2,814 rheumatoid arthritis patients who, over the course of 13 years, experienced 375 cardiovascular-related incidents, including acute coronary syndrome, stroke and cardiovascular-related deaths.

It is known that rheumatoid arthritis patients are at increased risk of cardiovascular disease due to a combination of traditional risk factors and, perhaps a shared etiology between rheumatoid arthritis and cardiovascular disease, wrote the authors who were led by Helga Westerlind, Ph.D., of the Karolinska Institute in Sweden. Previously, she and other researchers have reported that a correlation exists between accrued rheumatoid arthritis disease activity and high levels of anti-citrullinated protein antibodies (ACPA) and an increased risk of acute coronary syndromes, such as stroke, cardiovascular mortality, which was confirmed in this study.

In the new study, Dr. Westerlind and colleagues examined the presence and levels of anti-CCP2, specific ACPAs and their combinations, rheumatoid factor isotypes, and risk for acute coronary syndrome, stroke and cardiovascular-related death in this group of rheumatoid arthritis patients.

They found that elevated levels of anti-CCP2 were associated with acute coronary syndrome (1.46 hazard ratio (95% confidence interval), stroke (1.47 HR), cardiovascular-related death (P value 0.024) and major adverse cardiovascular events (MACE) (1.34 HR). Associations were also documented for the number of ACPA sub-specificities; IgM rheumatoid factor with all cardiovascular endpoints except for acute coronary syndrome; and, IgA rheumatoid factor was found to be exclusively associated with cardiovascular disease-related death.

From a clinical perspective, our data implies that patients with seronegative RA are at a lower risk of CV events, while patients with high anti-CCP2 levels or presence of IgA or IgG RF at diagnosis are at higher risk and might benefit from closer monitoring from a cardio preventative perspective. In this regard, specific ACPA sub-specificities offer no further predictive capacity.

To conclude, in patients with RA, ACPA and rheumatoid factor are linked to risks for several types of CV endpoints, and to CV and overall mortality, independently of smoking. These associations do not seem to be driven by any specific (pattern of) ACPAs, suggesting that for CV co-morbidity in RA, autoAb load may be more important than individual ACPAs. For RF the CV risks seem to vary across RF isotypes, the authors wrote.

REFERENCE

Helga Westerlind, Johan Rnnelid, Monika Hansson, Lars Alfredsson, et al. "Anticitrullinated protein antibody specificities, rheumatoid factor isotypes and incident cardiovascular events in patients with rheumatoid arthritis," Arthritis and Rheumatology.First published:31 May 2020 https://doi.org/10.1002/art.41381

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Rheumatoid Arthritis and Cardiovascular Disease Share Etiology - Rheumatology Network

Glucocorticoids are the most frequently used class of drugs for rheumatoid arthritis (RA) because they are effective at relieving symptoms, and widely available at low cost. While this drug class has clear benefits for rheumatoid arthritis, it comes at a price in terms of a wide array of potential side-effects. Test your knowledge on the use of corticosteroids in rheumatoid arthritis with this quiz.

Which of the following statements align with the 2015 American College of Rheumatology guidelines regarding the use of corticosteroids in patients with rheumatoid arthritis?

a) For the treatment of early rheumatoid consider add low-dose glucocorticoids (10 mg/day of prednisone or equivalent) in patients with moderate or high disease activity when starting disease-modifying antirheumatic drugs (DMARDs) or where DMARD or biologics have failed to control disease activity.

b) Short courses of low dose corticosteroids (10 mg/day of prednisone or equivalent) may be used first line in patients with early RA with only mild symptoms.

c) Consider using short-term glucocorticoids (up to 3 months) for disease flares.

d) For patients with advanced disease higher doses of corticosteroids may be needed to control flares

e) The risk/benet ratio of glucocorticoid therapy is unfavorable for most patients with rheumatoid arthritis

f) Glucocorticoids should be used at the lowest possible dose and for the shortest possible duration

g) The target should ideally be low disease activity or remission.

See the next page for the answer.

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Quiz: Best Practices for Corticosteroid Use in Active Rheumatoid Arthritis - Rheumatology Network

TEL AVIV, Israel, June 04, 2020 (GLOBE NEWSWIRE) -- VBL Therapeutics (Nasdaq: VBLT), (the Company) today announced new data implicating the potential of its proprietary anti-MOSPD2 antibodies for treatment of rheumatoid arthritis (RA). VBL's study entitled MOSPD2: A novel therapeutic target for the treatment of rheumatoid arthritis, is being presented today at the European League Against Rheumatism (EULAR) 2020 E-Congress.

VBL's new data highlight several key findings:

"These encouraging results may open new possibilities for treatment of anti-MOSPD2 antibodies for RA," said Eyal Breitbart, Ph.D., VP Research and Operations of VBL Therapeutics."We continue to see a clear pattern across multiple indications by inhibiting monocyte migration, our proprietary antibodies lead to meaningful and durable benefit in various models of chronic inflammatory diseases.

The new results add to a growing body of data demonstrated activity of VBL's antibodies in models of multiple sclerosis, nonalcoholic steatohepatitis and colitis. VBL continues to advance lead candidate VB-601 towards a first-in-man study, which is expected to begin in 2021.

For a link to VBL's presentation at the EULAR conference, see: Poster Presentation

About VBL's VB-600 PlatformVBL is conducting two parallel drug development programs that are exploring the potential of MOSPD2 (motile sperm domain-containing protein 2), a protein that VBL has identified as a key regulator of cell motility, as a therapeutic target for inflammatory diseases and cancer. Our VB-600 platform comprises classical anti-MOSPD2 monoclonal antibodies for inflammatory indications, as well as bi-specific antibody candidates for oncology.

About VBLVascular Biogenics Ltd., operating as VBL Therapeutics, is a clinical stage biopharmaceutical company focused on the discovery, development and commercialization of first-in-class treatments for cancer. VBLs lead oncology product candidate, ofranergene obadenovec (VB-111), is a first-in-class, targeted anti-cancer gene-therapy agent that is being developed to treat a wide range of solid tumors. It is conveniently administered as an IV infusion once every two months. It has been observed to be well-tolerated in >300 cancer patients and demonstrated activity signals in a VBL-sponsored all comers phase 1 trial as well as in three VBL-sponsored tumor-specific phase 2 studies. Ofranergene obadenovec is currently being studied in a VBL-sponsored phase 3 potential registration trial for platinum-resistant ovarian cancer.

Forward Looking StatementsThis press release contains forward-looking statements. All statements other than statements of historical fact are forward-looking statements, which are often indicated by terms such as anticipate, believe, could, estimate, expect, goal, intend, look forward to, may, plan, potential, predict, project, should, will, would and similar expressions. These forward-looking statements may include, but are not limited to, statements regarding our programs, including MOSPD2, including their clinical development, therapeutic potential and clinical results. These forward-looking statements are not promises or guarantees and involve substantial risks and uncertainties. Among the factors that could cause actual results to differ materially from those described or projected herein include uncertainties associated generally with research and development, clinical trials and related regulatory reviews and approvals, the risk that historical clinical trial results may not be predictive of future trial results, the impact of the COVID-19 pandemic on our business, operations, clinical trials, supply chain, strategy, goals and anticipated timelines and clinical results, that our financial resources do not last for as long as anticipated, and that we may not realize the expected benefits of our intellectual property protection. A further list and description of these risks, uncertainties and other risks can be found in our regulatory filings with theU.S. Securities and Exchange Commission, including in our annual report on Form 20-F for the year endedDecember 31, 2019, and subsequent filings with theSEC. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof.VBL Therapeuticsundertakes no obligation to update or revise the information contained in this press release, whether as a result of new information, future events or circumstances or otherwise.

INVESTOR CONTACT:Michael RiceLifeSci Advisors, LLC(646) 597-6979

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VBL Presents New Data on the Potential of its Novel anti-MOSPD2 Monoclonal Antibodies for Rheumatoid Arthritis at the EULAR 2020 Congress -...

Public Health Column: May is Arthritis Awareness Month

Arthritis is one of the most widespread health conditions in the United States. According to the Centers for Disease Control and Prevention, nearly one in every four adults live with the pain of arthritis (1.*)

To recognize this toll on Americans health, the CDC and the Arthritis Foundation observe Arthritis Awareness Month every May. Paul Pettit, Public Health director of Genesee and Orleans counties, proclaims the importance of the month.

It is imperative to recognize arthritis awareness month as many of our local community members are faced with this debilitating health condition," Pettit said. "Although there is no cure for arthritis, there are many effective treatments available and lifestyle changes that can benefit the quality of life for people suffering with this disease. We want our community to know that help and specialists are available so that no one has to suffer.

Arthritis is the name of a disease that covers a wide variety of conditions, such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, fibromyalgia, and gout. Common symptoms of arthritis include swelling, pain, stiffness and decreased range of motion.

Symptoms may come and go and can range from mild to severe. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray.

Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints.

The arthritis rate in Genesee, Orleans and Wyoming counties in 2016 (crude rate, percentage of people with this health condition per reported region/county), and in New York State are (2.**):

During the coronavirus pandemic, we understand that older ndividuals and people with autoimmune diseases, like rheumatoid arthritis or lupus, may be more likely to get seriously sick if they do become infected with the virus, so it is important to take appropriate precautions, Pettit said.

It is important that healthy individuals continue taking their medications as prescribed by their physician and to practice social distancing,wearing a face mask or cloth face shield, and to wash hands frequently for 20 seconds.

*Centers for Disease Control and Prevention -- Arthritis Awareness Month. Reviewed May 2017. Accessed May 27, 2020.

**New York State Department of Health. Behavioral Risk Factor Surveillance System (BRFSS) Health Indicators by County. Accessed May 27, 2020.

Engaging in physical activity and maintaining a healthy weight can help manage arthritis symptoms.

Physical activity can reduce arthritis pain, improve function and mood, and delay the onset of disability. All adults should get two hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity, such as brisk walking, per week and do muscle-strengthening activities two or more days a week.

You can achieve these goals by taking brisk walks for 30 minutes a day, five days a week. You can also break it up into 10 minute sessions and spread it out during the day walk the dog 10 minutes in the morning, take a 10-minute walk to the post office, coffee shop, or grocery store in the afternoon, and then take a 10-minute walk after dinner.

Make sure to talk to your doctor about new or worsening arthritis symptoms. You may be referred to a doctor who specializes in arthritis and related conditions such as a rheumatologist or orthopedist. For more information on arthritis, clickhere.

For information about Health Department services contact the Genesee County Health Department at: 344-2580, ext. 5555, or visit their website.

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arthritis awareness month - The Batavian

AbbVie has submitted an application to the Food and Drug Administration (FDA) for review of upadacitinib in the treatment of active psoriatic arthritis (PsA) in adults.

The application is supported by data from two phase 3 studies (SELECT-PsA 1 and SELECT-PsA 2) that assessed the efficacy and safety of upadacitinib (15mg and 30mg) in more than 2000 adults with active PsA. SELECT-PsA 1 compared upadacitinib with placebo and adalimumab; SELECT-PsA 2 compared upadacitinib with placebo. The primary end point for both studies was the proportion of patients who achieved an American College of Rheumatology (ACR) 20 response at week 12.

Results from SELECT-PsA 1 showed that upadacitinib 15mg and 30mg achieved noninferiority at week 12 compared with adalimumab, with the 30mg dose showing superiority. Both doses of upadacitinib achieved statistically significant ACR20, ACR50, and ACR70 responses at week 12 compared with placebo, along with significant improvements for key secondary end points, including the Health Assessment Questionnaire Disability Index (HAQ-DI), Psoriasis Area Severity Index (PASI 75), and Minimal disease activity (MDA).

Additionally, findings from SELECT-PsA 2 demonstrated both doses of upadacitinib achieved statistically significant ACR 20, ACR50, and ACR70 responses at week 12 compared with placebo. Both doses of upadacitinib also achieved statistically significant responses for PASI 75 and MDA compared with placebo.

With regard to safety, upadacitinib demonstrated a profile consistent with that seen in previous clinical studies.

Upadacitinib, a selective and reversible Janus Kinase (JAK) inhibitor, is currently marketed under the brand name Rinvoq and is indicated for the treatment of moderately to severely active rheumatoid arthritis in adults who have had an inadequate response or intolerance to methotrexate.

For more information visit abbvie.com.

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Upadacitinib Application for Active Psoriatic Arthritis Submitted for Review - Monthly Prescribing Reference

Rheumatologist visits within 6 weeks of symptom onset was associated with greater likelihood of sustained disease-modifying antirheumatic drug (DMARD)-free remission in patients with early rheumatoid arthritis (RA), according to study results published in Lancet Rheumatology.

This observational study enrolled patients with RA from 2 existing cohort studies, including the Leiden Early Arthritis Clinic (EAC) and the French Etude et Suivi des Polyarthrites Indifferencies Recentes (ESPOIR). Patients with available symptom onset and remission data were eligible for inclusion in the study. In the present analysis, patients were categorized into 3 groups based on time between symptom onset and first encounter with a rheumatologist: within 6 weeks; within 7 to 12 weeks; and after 12 weeks. The primary outcome was sustained DMARD-free remission, identified from EAC and ESPOIR records. Radiographic progression was also assessed. Multivariable Cox regression was used to assess the relationship between time-to-referral and DMARD-free remission. Models were adjusted for relevant demographic and clinical characteristics, including age, sex, erythrocyte sedimentation rate, swollen joint count, and anti-citrullinated protein antibodies.

The present analysis included 1025 patients from the EAC and 514 patients from the ESPOIR. Mean follow-up time was 7.1 years (interquartile range [IQR], 3.9-12.2 years) and 10.0 years (IQR, 9.0-10.0 years) in the EAC and ESPOIR, respectively. After 7 years of follow-up in the EAC, DMARD-free remission was achieved by 30 (24%) of 127 patients with a time to encounter of 6 weeks, 45 (20%) of 223 patients with a time of 7 to 12 weeks, and 100 (15%) of 675 patients with a time of >12 weeks. After 10 years of follow-up in the ESPOIR, sustained DMARD-free remission was achieved by 3 (27%) of 11 patients with a time to encounter of 6 weeks, 11 (11%) of 100 patients with a time of 7 to 12 weeks, and 41 (10%) of 403 patients with a time of >12 weeks.

According to Cox regression models for the EAC cohort, patients who encountered a rheumatologist within 6 weeks of symptom onset were significantly more likely to achieve sustained DMARD-free remission than patients with a time of 7 to 12 weeks (hazard ratio [HR], 1.59; 95% CI, 1.02-2.49; P =.042) and >12 weeks (HR, 1.54; 95% CI, 1.04-2.29; P =.032). Similar trends were observed in the ESPOIR cohort, though results were not statistically significant. Results from pooled analyses showed that , there was a greater likelihood of achieving DMARD-free sustained remission with a time to encounter of 6 weeks than a time of 7 to 12 weeks (HR, 1.69; 95% CI, 1.10-2.57; P =.016) and >12 weeks (HR, 1.67; 95% CI, 1.08-2.58; P =.020). In both the EAC and ESPOIR cohorts, patients who visited a rheumatologist within 6 weeks had similar radiographic progression compared with patients in the other time-to-encounter strata.

These data suggest that early referral to a rheumatologist was associated with achieving sustained DMARD-free remission; however, early referral did not significantly affect radiographic progression.

As study limitations, investigators noted that symptom onset was patient-reported rather than defined by a validated symptom scale. As such, significant heterogeneity may likely exist in the definition of symptom onset.

[A]chieving a time to encounter within 6 weeks, although challenging, might become of increasing importance, the investigators wrote.

Reference

Niemantsverdriet E, Dougados M, Combe B, van der Helm-van Mil AHM. Referring early arthritis patients within 6 weeks versus 12 weeks after symptom onset: an observational cohort study [published online April 28, 2020]. Lancet Rheumatol. doi:10.1016/S2665-9913(20)30061-8

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Earlier Time-to-Referral Predicts Increased Likelihood of Achieving DMARD-Free Remission in Rheumatoid Arthritis - Rheumatology Advisor

INCHEON, South Korea--(BUSINESS WIRE)--At the European E-Congress of Rheumatology 2020 (The European League Against Rheumatism (EULAR) 2020 E-Congress), Celltrion Healthcare today showcased three sets of data relating to a subcutaneous formulation of infliximab, Remsima SC.

The first study demonstrated no impact of body mass index (BMI) on clinical response to CT-P13 SC in patients with active rheumatoid arthritis (RA).1 The post-hoc study investigated the impact of BMI on clinical response to CT-P13 SC in part 2 of a phase I/III randomised controlled trial (RCT) in 165 patients throughout a 1-year treatment period.1 Patients were categorized into 3 groups; under/normal weight (<25kg/m2), overweight (25kg/m2, <30kg/m2), and obesity (30kg/m2) based on the WHO BMI classification. The three groups received at least one full dose of CT-P13 SC (after IV induction) in the initial treatment stage before week 30. The data show that the mean change from baseline of DAS28 (CRP) (-3.3, -3.1, -3.3 at week 54), duration of low disease activity (LDA) up to Week 54 (26.2, 29.2, 27.9 weeks), and the good or moderate EULAR responder rates (84.1%, 80.3%, 90.2% at week 54) were all comparable among all groups and there were no statistically significant differences.1

Rene Westhovens, rheumatologist and one of the lead investigators of the trial, Emeritus Professor at the KU Leuven, Belgium said, The post-hoc results showed that there was no impact of BMI on the clinical responses of CT-P13 SC 120 mg biweekly in RA patients. Therefore, Remsima SC could be a promising therapeutic option regardless of BMI in RA patients.

The second study presented contained 1-year data from a multicenter, randomised, controlled, pivotal trial evaluating correlation between the magnitude of anti-drug antibody (ADA) positivity and clinical outcomes in RA patients. The results indicated that clinical analysis of both ADA positivity and titer are clinically meaningful in the prediction of pharmacokinetic (PK) profile and clinical response. CT-P13 SC administration did not result in a greater incidence of ADA compared to CT-P13 IV and there were no clinical differences between the formulations.2

A third study presented at EULAR, assessing budget impact analysis (BIA) data, indicated that the introduction of CT-P13 SC could lead to substantial cost savings for healthcare systems. The analysis compared a market scenario where a proportion of patients were treated with CT-P13 SC, to an alternative scenario where CT-P13 SC was not available and all patients were treated with IV formulations.3

The data show that introduction of CT-P13 SC resulted in potential cost savings of 39.6 million in the UK over a 5-year period, equating to 4,466 additional patients who could be treated with the SC formulation. In a second scenario which took into account IV dose-escalation up to 5mg/kg to reflect the real-world setting, the savings increased to 279.6 million over a 5-year period, equating to 30,839 additional patients able to be treated with CT-P13 SC.3

Self-injection will significantly reduce the burden on healthcare delivery allowing resource to be spent elsewhere, said Dr. Martin Perry at Royal Alexandra Hospital, United Kingdom. With the pressure of meeting patient need and the increasing burden on healthcare systems, there is a greater demand than ever to deliver new and innovative treatment options that enable patients to live more independently, reduce the time spent in hospitals and in turn, lessen the pressures put on healthcare systems.

Remsima SC has the potential to offer patients a more convenient method of administration, whilst retaining the same clinical benefits found in the IV formulation of Remsima, said Mr. Hyoung-Ki Kim, Vice Chairman at Celltrion Healthcare. This should not only bring improvements to quality of life for patients, but also to healthcare systems who we anticipate could experience both time and cost savings by enabling home administration of Remsima SC.

-- ENDS --

Notes to Editors

About CT-P13 (biosimilar infliximab)4,5,6

CT-P13 is developed and manufactured by Celltrion, Inc. and was the worlds first monoclonal antibody biosimilar approved by the European Commission (EC). It is indicated for the treatment of eight autoimmune diseases including RA and inflammatory bowel disease (IBD). It was approved by the EC under the trade name Remsima in September 2013 and launched in major EU countries in early 2015. The U.S. Food and Drug Administration approved CT-P13 in April 2016 under the trade name Inflectra. CT-P13 is approved in more than 94 countries (as of June 2020) including the US, Canada, Japan and throughout Europe.

CT-P13 IV is usually given as 3mg per kg/body weight in RA and as 5mg per kg/body weight for the other indications. Infliximab IV is given as an infusion over two hours. All patients are monitored for any reactions during the infusion and for at least one to two hours afterwards. Celltrion has also developed a subcutaneous (SC) formulation of infliximab that has three administration options; via a pre-filled pen (auto injector), pre-filled syringe or pre-filled syringe with needle safeguard. The SC formulation has the potential to enhance treatment options for the use of infliximab biosimilar by providing high consistency in drug exposure and a convenient method of administration.

CT-P13 SC has received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) and EU marketing authorisation for the treatment of people with RA. Celltrion has submitted a further variation to the marketing authorisation of CT-P13 SC to extend the indication to other disease areas including inflammatory bowel disease. In the United States, CT-P13 SC will be reviewed through the new drug pathway with the expectation of receiving US Food and Drug Administration (FDA) approval by 2022.

About Celltrion Healthcare

Celltrion Healthcare is committed to delivering innovative and affordable medications to promote patients access to advanced therapies. Its products are manufactured at state-of-the-art mammalian cell culture facilities, designed and built to comply with the US FDA cGMP and the EU GMP guidelines. Celltrion Healthcare endeavours to offer high-quality cost-effective solutions through an extensive global network that spans more than 110 different countries. For more information please visit: https://www.celltrionhealthcare.com/en-us

References

1 Yoo DH, Westhovens R et al. Impacts of Body Mass Index on Clinical Response of Novel Subcutaneous Infliximab (CT-P13 SC) in Patients with Active Rheumatoid Arthritis: 1-Year Results from a Part 2 of Phase I/III Randomized Controlled Trial. Poster. Presented at EULAR 2020 E-Congress.

2 Westhovens R, Yoo DH et al. Clinical Evaluation of the Immunogenicity to CT-P13 for Subcutaneous Use in Patients with Active Rheumatoid arthritis: 1-Year Clinical Results from a Multicenter, Randomized Controlled Pivotal Trial. Poster. Presented at EULAR 2020 E-Congress.

3 Perry M and Chung SI. Budget Impact Analysis of Introducing subcutaneous infliximab CT-P13 SC from the UK payer perspective. Poster. Presented at EULAR 2020 E-Congress.

4 Yoo DH, Jaworski J, Matyska-Piekarska E et al. A Novel Formulation of CT-P13 (Infliximab Biosimilar) for Subcutaneous Administration: One Year Results from Part One of a Phase I/III Randomised Controlled Trial in Patients with Rheumatoid Arthritis. Poster (FRI0128) Presented at EULAR 2019.

5 Westhovens R, Wiland P, Zawadzki M et al. A Novel Formulation of CT-P13 (Infliximab Biosimilar) for Subcutaneous Administration: 30-week Results from Part Two of a Phase I/III Randomised Controlled Trial in Patients with Rheumatoid Arthritis. Poster (SAT0170) Presented at EULAR 2019.

6 European Medicines Agency Summary of Product Characteristics (SmPC). CT-P13. Available at http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002576/WC500150871.pdf [Last accessed May 2020].

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Celltrion Healthcare showcases positive 1-year data and budget impact analysis for novel subcutaneous formulation of infliximab in patients with...

A team led by researchers atBaylor College of Medicinein collaboration with Medterra CBD conducted the first scientific studies to assess the potential therapeutic effects of cannabidiol (CBD) for arthritic pain in dogs, and the results could lead the way to studying its effect in humans.

Researchers focused first on these animals because their condition closely mimics the characteristics of human arthritis, the leading cause of pain and disability in the U.S. for which there is no effective treatment.

Published in the journalPAIN, the study first showed both in laboratory tests and mouse models that CBD, a non-addictive product derived from hemp (cannabis), can significantly reduce the production of inflammatory molecules and immune cells associated with arthritis.

Subsequently, the study showed that in dogs diagnosed with the condition, CBD treatment significantly improved quality of life as documented by both owner and veterinarian assessments. This work supports future scientific evaluation of CBD for human arthritis.

CBD is rapidly increasing in popularity due to its anecdotal health benefits for a variety of conditions, from reducing anxiety to helping with movement disorders, said corresponding author Dr. Matthew Halpert, research faculty in the Department ofPathology and Immunologyat Baylor. In 2019, Medterra CBD approached Baylor to conduct independent scientific studies to determine the biological capabilities of several of its products.

In the current study, Halpert and his colleagues first measured the effect of CBD on immune responses associated with arthritis, both in human and murine cells grown in the lab and in mouse models. Using Medterra tinctures, they found that CBD treatment resulted in reduced production of both inflammatory molecules and immune cells linked to arthritis.

The researchers also determined that the effect was quicker and more effective when CBD was delivered encapsulated in liposomes than when it was administered naked. Liposomes are artificially formed tiny spherical sacs that are used to deliver drugs and other substances into tissues at higher rates of absorption.

Halpert and colleagues next assessed the effect of naked and liposome-encapsulated CBD on the quality of life of dogs diagnosed with arthritis.

We studied dogs because experimental evidence shows that spontaneous models of arthritis, particularly in domesticated canine models, are more appropriate for assessing human arthritis pain treatments than other animal models. The biological characteristics of arthritis in dogs closely resemble those of the human condition, Halpert said.

Arthritis is a common condition in dogs. According to theAmerican Kennel Club, it affects one out of five dogs in the United States.

The 20 client-owned dogs enrolled in the study were seen at Sunset Animal Hospital in Houston. The dog owners were randomly provided with identical unidentified medication bottles that contained CBD, liposomal CBD, or a placebo. Neither the owners nor the veterinarian knew which treatment each dog received.

After four weeks of daily treatment, owners and veterinarians reported on the condition of the dogs, whether they observed changes in the animals level of pain, such as changes related to running or gait. The dogs cell blood count and blood indicators of liver and kidney function also were evaluated before and after the four weeks of treatment.

We found encouraging results, Halpert said. Nine of the 10 dogs on CBD showed benefits, which remained for two weeks after the treatment stopped. We did not detect alterations in the blood markers we measured, suggesting that, under the conditions of our study, the treatment seems to be safe.

The findings support conducting studies to evaluate CBD for the treatment of human arthritis.

Other contributors to this work include Chris D. Verrico, Shonda Wesson, Vanaja Konduri, Colby Hofferek, Jonathan Vazquez-Perez, Emek Blair, Kenneth Dunner Jr, Pedram Salimpour, William K. Decker. The authors are associated with Baylor College of Medicine, Sunset Animal Hospital, Valimenta Labs, University of Texas MD Anderson Cancer Center and Boston University School of Medicine.

This study was funded in part by a sponsored research agreement between Medterra CBD Inc and Baylor College of Medicine. This project also was supported in part by the Cytometry and Cell Sorting Core at Baylor College of Medicine with funding from the NIH (grants AI036211, CA125123 and RR024574).

Decker, Halpert and Konduri declare their ownership stakes in Diakonos Research, Ltd, an unrelated immuno-oncology company. Additionally, Halpert is a paid scientific advisor for Medterra CBD.

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Baylor Researchers find that CBD improves arthritis symptoms in dogs - El Paso Herald-Post

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Unioto graduate Maria DiFrango plans on going to Ohio University in the fall to study music education. (Photo: Robert McGraw/Gazette)

CHILLICOTHE Growing up, one Union-Scioto Local Schools student loved playing music. But a diagnosis during her junior year of high school nearly put her passions at risk.

Maria DiFrango, a senior at Unioto High School, has been involved in the school's music and band programs since the sixth grade. But during the summer before her junior year of high school, DiFrango's hands started to hurt. Then, it became difficult to play and practice. Soon after, DiFrango was diagnosed with rheumatoid arthritis and lupus.

"For me, this means that my joints and hands hurt," she said. "That makes it hard to do the things I like to do."

DiFrango's love of music began at a young age. She remembers always singing in the shower and practicing instruments as a child. When her older brother began playing percussion in school, DiFrango knew she wanted to follow suit.

In sixth grade, she joined the school band. Since then she's gone on to participate in marching band, music programs outside of her school and at church.

But towards the end of DiFrango's sophomore year, she began to notice that her hands, fingers and knuckles would ache. Up until then, she showed no symptoms ofrheumatoid arthritis. Although lupus runs in her family, DiFrango never suspected that she had it. At times, DiFrango's pain and stiffness were so bad that she couldn't even open doors.

That summer, her family took her to a physician where she underwent tests. Although there is no test for lupus, DiFrango met all of the criteria to be diagnosed. She was given medication for both conditions in hopes that her pain would be alleviated, allowing her to continue performing music.

As DiFrango waited to see if the medicine was the right fit for her, she began learning her own boundaries will playing instruments to ensure she didn't overexert herself. Yet she remained determined to prove she would still be a successful musician.

Most of her inspiration came from the fact that in the drumline of the school's marching band, DiFrango is surrounded by male classmates. Feeling like she already had to prove herself, DiFrango pushed herself each time she performed. Furthermore, as the field commander for the marching band, DiFrango felt a responsibility to students who look up to her.

"As a leader, I can't set the example that giving up is an option," she said.

And she didn't.

DiFrango continued to play and perform and has since been generally pain free. One of the hardest things about her diagnosis is the fact that the medication DiFrango takes weakens her immune system. So when the flu shutdown most school districts this fall, and with the coronavirus pandemic, it's been a scary time for DiFrango.

Despite it, she has continued to perform music at her home. DiFrango has completed eight months of preparation on pieces to perform at three different college auditions. She ultimately decided to attend Ohio University where she earned a $7,300 talent scholarship to study music education. While at college, DiFrango plans to join as many musical groups as she can.

"Band has always been a part of my life. It has given me a sense of family," she said. "While I am passionate about music, teaching is my joy and to teach, you have to do."

Have a story tip or comment?Contact Toria at tbarnhart@gannett.com or 740-349-1106. Follow her on Twitter @ToriaBarnhart.

Read or Share this story: https://www.chillicothegazette.com/story/news/2020/06/01/unioto-senior-continues-performing-despite-arthritis-lupus-diagnosis/5274114002/

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Unioto senior living with arthritis, lupus doesn't waiver on her passion to perform music - Chillicothe Gazette

Grinne OLeary, CEO of Arthritis Ireland

ARTHRITIS Ireland is encouraging Carlovians to raise funds by running, jogging, walking or cycling 30km over the 30 days of June to support people living with arthritis.

The 30 in 30 challenge will help raise vital funds to enable the charity deliver services to people with arthritis.

Nearly one-million people are living with the condition in Ireland, including 1,200 children. Many of those with arthritis have been severely impacted by the pandemic because they are immuno-suppressed or aged over 70.Arthritis Ireland chief executive Grinne OLeary said: Were working incredibly hard to meet the needs of people with arthritis at this challenging time. Our self-management classes and exercise programmes are now online and were developing further initiatives to support people where theyre at. Our helpline and online forums have been valuable sources of trusted information for people.

Fundraising income at the charity has been significantly impacted by the pandemic, she said. The extraordinary generosity of the public enables us deliver services for people with arthritis all over the country. Weve had to cancel or postpone our scheduled fundraising activity, so 30 in 30 is a safe, healthy and fun way to support our work at this challenging time.

Participants can choose to walk, run or cycle 30km in 30 days this June. You can choose to do a single kilometre a day, break it into bigger chunks or take on the full 30km in one go.

This is an entirely flexible challenge that will suit people of all fitness levels. Take part in your own time, anywhere across the country, near your home or in your local park. Our only ask is to make sure to do it safely and in line with the latest government advice, added Grinne.

Kaitlin Fenelon from Laois is one of those taking part in 30 in 30. Kaitlin says that after she was diagnosed with arthritis, she was very confused.

I didnt know how to handle my pain and it had a huge impact on my mental health, she said. I attended a self-management course organised by Arthritis Ireland and cant describe how much it helped me. I want to fundraise so that they have the resources to organise more courses and help more people that are as confused as I was.

To find out more and to register for 30 in 30, visit the Arthritis Ireland website at http://www.arthritisireland.ie.

Read the original post:
30km in 30 days for Arthritis Ireland | Carlow Nationalist - The Nationalist

Researchers from the Baylor College of Medicine, within the Texas Medical Center, published a study this week on the therapeutic potential of CBD for dogs experiencing pain from arthritis. The condition frequently affects canines, and there are few treatment options.

The research, which was published in the peer-reviewed journal Pain, started with human and murine (rodent) cells, and with mouse models. It was through this early research, Matthew Halpert, lead researcher on the study, told Cannabis Wire, that CBD first showed great promise in reducing the production of the types of inflammatory molecules and immune cells linked to arthritis, and the subsequent pain.

Researchers used CBD from Medterra, a company that produces hemp-derived CBD products, and with which Halpert is affiliated. (Cannabis Wire recently published a story about the rising involvement of the cannabis industry in research, and we asked the lead researcher about this balance, which he answers below.)

Next, researchers identified 20 dogs at Sunset Animal Hospital in Houston that would participate in the study. Dogs, which included larger breeds like Golden Retrievers and German Shepherds, were either given a high CBD dose (50 mg), a liposomal CBD dose of 20 mg (which means that liposomal sacs are used in an effort to increase absorption rates), or a placebo.

Researchers found that the owners of nine out of the ten dogs who received CBD reported some kind of improvement. In some cases, it was dramatic, Halpert said.

The Food and Drug Administration is currently crafting rules for CBD products, and has opened their public comment window indefinitely, which Cannabis Wire covered. The FDA also regulates drugs for animals.

It should be noted that CBD products have spiked in popularity among pet owners in recent years. But in November, the FDA emphasized its concerns regarding these products in a pre-Thanksgiving update regarding CBD product regulation.

Concerns regarding CBD products with unproven medical claims and of unknown quality equally apply to CBD products marketed for animals, the FDA noted, urging pet owners to talk to their vets about appropriate treatment options for their pets.

Still, Medterra CEO Jay Hartenbach told Cannabis Wire that these results have already been shared with the FDA. Knowing that this data was going to go to the FDA, it was very important for us to study both the efficacy and side effect profile of the CBD treatment. We know the FDA is very interested in gathering as much safety data as possible with ingestible CBD.

Cannabis Wire had a conversation with Halpert to better understand this research, what the implications are for dogsand possibly humanswhen it comes to CBD, and whats next for his research.

(This interview has been lightly edited for clarity.)

Alyson Martin, Cannabis Wire: What inspired this research on CBD and arthritis in dogs?

Matthew Halpert, lead researcher: This was kind of a collaborative effort between myself, at Baylor, and Medterra. And to give some background as to why Im even working with Medterra: I will tell you that before I joined them, started helping them, a couple other CBD companies actually had approached me and talked about working with me. In reality, you learn very quickly that a lot of whats out there is just trying to jump off a fad and make a quick buck. They dont care about the science or they dont care about what is reality. And so I did not do anything with them. And then when I was talking to the higher ups at Medterra, it became very apparent very quickly that they were very interested in the science, what the science had to say: How can we be not only scientifically accurate, but actually advance the science, etc?

So this fit my wheelhouse. Im just a pure academic researcher, an immunologist by trade. So that led to numerous different model systems experimenting going on in the lab where we were really looking at science. It was pretty evident from us and from other labs that CBD has this reasonably genuine anti-inflammatory role and can reduce a lot of the signaling molecules commonly associated with inflammation. And so a lot of what we were seeing in the lab and in, lets call them preliminary studies, we were seeing a reduction in inflammatory signals commonly associated with several actual diseases such as arthritis. So, you know, obviously thered be a lot of interest and movement to say, well, what about the people? Well, you cant just experiment on people. We can do that, but youre talking about clinical trials, FDA, IRB, a pretty big undertaking.

And I happened to have a perfect combination of events, where I happen to have a veterinary colleague at Sunset Animal Hospital, which weve worked with before, who had already expressed interest in CBD, and if it might be effective for dogs. And right around this time, Medterra was entertaining a couple of large pet companies, brands. These were people in the pet space who were very interested in what the science had to say about CBD in the pet space. So, we started putting things together, and Medterra said, If youve already got the connections, can we go ahead and actually fund an actual study in dogs to see if theres any benefit here?

So I worked with the vets, and we put a plan together. Heres what theyre comfortable with doing, heres what it would cost, and next thing you know, weve got a small canine placebo, double blind, clinical trial sort of going. So the study came about as a result of this desire on all sides to put the science first, and see whats actually here, and if theres any weight to these claims.

Alyson Martin, Cannabis Wire: What were the biggest surprises that emerged from this research?

Matthew Halpert, lead researcher: I honestly was surprised at how well it worked, if Im being just blunt. Its one thing to see something in a petri dish in a lab. I mean, its not invalid, but its just one small step at the beginning of a process. To suddenly go into a study, though, like this, where I have no control? I took off the labels and replaced them with A, B, C, or D. And I gave them to the vet. And I said, you dont know what each bottle has. The owners dont know. And were going to do this pretty extensive scoring system from the vet, from the owners. Were going to look at the blood. Were going to look at things like liver, kidney function. The reality is: I have no control here. I dont know what to expect. And I warned Medterra, just so you know, its a one-month study. I dont know what the data are going to be.

These dogs have pre-diagnosed, chronic arthritis. This is an ongoing condition that has drastically affected their lives, their ability to move, and jump, and things like that. So, I said, Im not sure if were going to see anything in a month. And then within one month, which clinically speaking, is very, very short, almost every dog in the appropriate CBD groups saw some sort of benefit. It wasnt a minor benefit. Some of these scores, symptoms were reduced by as much as 50 percent in just one month. That to me, being in the science space, things dont usually jump that large that quickly. And then the dogs in the placebo group, and the low-dose CBD group, they basically saw nothing. No improvement.

And they didnt know they were in the placebo group, right? This tells me, by and large, they werent trying to just give fake answers. They gave genuine answers and they said, no, whatever you gave us did not help my dog. And then youve got 10 dogs in the better groups and theyre all like, yeah, this is fabulous. I got a bunch of notes that I cant publish because theyre not scientific. Oh, my God, Im so happy. Oh, is the first time he jumped up on the couch in two years. Im just likeIm a little bit floored. Oh my gosh. I mean, its just that that actually surprised me more than anything, that it had actually worked that well that quickly.

Alyson Martin, Cannabis Wire: Is there any follow-up CBD research planned? The research said that This study supports the safety and therapeutic potential of hemp-derived CBD for relieving arthritic pain and suggests follow-up investigation.

Matthew Halpert, lead researcher: The short answer is yes, this is not the end. I can confidently say that. Without [Medterra CEO] Jay Hartenbach on the line, I dont know what he or Medterra would permit me to say at this time. All I can tell you is that weve talked to the veterinary group about expanding the dog studies, taking it to the next step. That is an active thing, in process, but I dont want to pre-scoop ourselves on that.

(Cannabis Wire reached out to Hartenbach to ask the same question, and Hartenbach said: We are now studying the combination of CBD with other ingredients to improve efficacy and the ability of CBD to penetrate the skin via different delivery methods. All of this work will continue to be completed with Dr. Halperts team at the Baylor College of Medicine. This has been a great partnership for us and we look forward to continuing it in the years to come.)

Alyson Martin, Cannabis Wire: How would you characterize interest from the private sector on the results of this research?

Matthew Halpert, lead researcher: In the vet and human space, when it comes to arthritis and osteoarthritis, theres almost no treatment for it, period. Its just a real tough disease. We dont exactly know the root cause of this, its fairly debilitating, it leads to all kinds of joint issues.

Yes, theres interest. Of course, theres the concern, the wariness if theres THC in it, or if people dont understand the difference.

A lot of people in the private space also dont know what theyre talking about. So they think that it makes no sense or has no backing. So that unfortunately slows a lot of the process down, because you end up with a lot of poorly regulated, inaccurate claims and products out there which sort of muddy the waters. As slow as the FDA is, as much as I feel like Im banging my head against the wall in working with them, theres a reason they exist. If theyre not going to regulate this product space, were unfortunately going to have to deal with a lot of muck out there until things get cleaned up.

So, theres interest, but I feel when I talk to people, people dont know where to go or who to trust.

Alyson Martin, Cannabis Wire: Cannabis Wire recently published a piece about cannabis industry involvement in and funding of research. Can you characterize the conversations you had internally and externally about the involvement of Medterra in this research? What percentage of this research did Medterra fund?

Matthew Halpert, lead researcher: This was Medterras pet CBD product. From Baylors perspective, Im not allowed to rah rah and endorse a product from any company.

Medterra provided the product and Medterra provided 90% of the funding that went into this study. A little was covered by some other stuff at Baylor.

I was very clear with Medterra up front: they dont control this. Neither of us. They dont control the data. The rule is the data are what they are. You may like them. You may not. But were not going to get this position where were going to hide data or were going to manipulate data, risk our integrity and whatever. And Baylor is on top of that, because Baylor doesnt want to get stuck in some quagmire where they look like they can be bought off.

I would say this shouldnt be solely Medterra. I do think the cannabis community should fund actual, real research and let the data drive the direction.

And if real research out of real institutions published in real journals vetted by real scientists who are not being bought off, says, hey, look, repeated studies have shown that cannabis could be a very effective quick treatment for ulcerative colitis or osteoarthritis, then great. I think that is something we need to be pursuing.

If you dont have studies out there, and Im talking all the way through human level clinical trials, it ends up fading into the background and just becomes another supplement in the supplement aisle at CVS. So the question is: what does the cannabis industry really hope for here? Do they want this to just become a kind of background thing that people are like, eh, its just kind of anecdotal? Or, do they want it to be: this has now been tested on 10,000 different people and clearly it has cured cancer, or whatever it is. I do think thats the direction the industry should go.

Alyson Martin, Cannabis Wire: What does it mean that youre a paid scientific adviser for Medterra? Do you have to balance any priorities?

Matthew Halpert, lead researcher: Ive been working with Medterra now for about a year and a half. And so we got working on some smaller experiments at Baylor, and this led to a sponsored research agreement with Baylor. So Medterra and Baylor sort of tied the knot. And Medterra said, look, were going to send you product and money and we want you to do the research and just give us the data. And we want that because we want to lead science.

Medterra asked if I could be one of their advisors to help make sure theyre not doing stuff thats scientifically stupid. And I checked with Baylor and they said its fine, you can do that. Its just a requirement that I disclose that.

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Baylor University Study Finds Therapeutic Potential in CBD for Arthritic Dogs - Cannabis Wire

The new market report on Arthritis Therapeutics is a comprehensive study providing analysis on factors trend and drivers contributing to growth of the Arthritis Therapeutics. The report is prepared with reference to historic data .Estimation of contribution of segment is expressed in terms of volume and revenue for the forecast period. Market analysis and future prospect is segmented in various sections. Each sections focus on distinct features of the products that are anticipated to shape the market over the forecast period.

Some of the common segments mentioned in the report include market overview, tends, drivers, opportunities, restraints, regional segment, end-use application, and competitive landscape. The global revenues in Arthritis Therapeutics market are projected to scale at a CAGR of xx.yy% between 2020 and 2027.

Many stakeholders are consistently adopting new methodologies to boost growth of the market. Few investors are investing on research and development of new products, on the other hand, various companies are innovating the existing products.

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In the wake of lockdown across various regions due to outbreak of COVID-19 pandemic, vendors in Arthritis Therapeutics are focusing to enhance their customer reach using e-commerce channels.

Some of the insights and market estimations that make this study unique in approach and effective in guiding stakeholders in understanding the growth dynamics. The study provides:

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Key end-users covered in the study include:

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Global Arthritis Therapeutics Market to Witness Stunted Growth amid global COVID-19 outbreak - The Cloud Tribune

Arthritis Ireland asks people in Louth to raise funds and support those with arthritis by undertaking 30km in 30 days

Arthritis Ireland is encouraging people in Louth to raise funds by running, jogging, walking or cycling 30km over the 30 days of June to support people living with arthritis.

The 30 in 30 challenge will help raise vital funds to enable the charity deliver services to people with arthritis.

Nearly one million people are living with the condition in Ireland, including 1,200 children. Many of those with arthritis have been severely impacted by the Covid-19 pandemic, for example, due to being immunosuppressed or aged over 70.

According to Arthritis Ireland chief executive, Grinne OLeary, Were working incredibly hard to meet the needs of people with arthritis at this challenging time. Our self-management classes and exercise programmes are now online, and were developing further initiatives to support people where theyre at. Our helpline and online fora have been valuable sources of trusted information for people.

Fundraising income at the charity has been significantly impacted by the pandemic, said OLeary. The extraordinary generosity of the public enables us deliver services for people with arthritis all over the country. Weve had to cancel or postpone our scheduled fundraising activity, so 30 in 30 is a safe, healthy and fun way to support our work at this challenging time.

Participants can choose to walk, run or cycle 30km in 30 days this June. You can choose to do 1km a day, break it into bigger chunks, or take on the full 30km in one go.

This is an entirely flexible challenge that will suit people of all fitness levels. Take part in your own time, anywhere across the country, near your home or in your local park. Our only ask is to make sure to do it safely and in line with the latest government advice, added OLeary.

Kaitlin Fenelon from Laois is one of those taking part in 30 in 30. Kaitlin says that after she was diagnosed with arthritis, she was very confused.

I didnt know how to handle my pain, and it had a huge impact on my mental health, she said. I attended a self-management course organised by Arthritis Ireland and cant describe how much it helped me. I want to fundraise so that they have the resources to organise more courses and help more people that are as confused as I was.

To find out more and to register for 30 in 30 visit the Arthritis Ireland website atwww.arthritisireland.ie.

Link:
Arthritis Ireland asks people in Louth to raise funds to service people with the disease - LMFM

With the outbreak of COVID-19 in worldwide and stipulated lockdown, the healthcare sector is witnessing an unprecedented slowdown as per EY-FICCI study titled, COVID-19 impact assessment for healthcare sector and key financial measures recommendations for the sector. The study is predicated on an assessment of healthcare players within the country to assess the economic impact of the COVID-19 pandemic and provides recommendations on the fiscal stimulus measures it needs within the coming months.

Arthritis is a problem associated with joints, in which a person suffers from red, hot, swollen and functionally impaired joints. Rheumatoid arthritis is a type of arthritis that is caused due to loss of tissue lining. A new research report by Persistence Market Research focuses on the various treatment options for rheumatoid arthritis and presents a forecast for this market for next few years.

The report is titledRheumatoid Arthritis Treatment Market: Global Industry Analysis 2012 2016 and Forecast 2017 2025and reveals the findings of this exhaustive research program. According to the report insights, the globalrheumatoid arthritis marketheld a market value of over US$ 23,900 Mn in 2017, which is expected to reach a valuation in excess of US$ 37,800 Mn by the end of 2025, growing at a CAGR of 5.9%.

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The growth of the rheumatoid arthritis market is driven by macro-economic factors like the increase in aging population of many countries, which subsequently increases the number of patients suffering from rheumatoid arthritis. The prevalence of this disease is also seen to be high in women; one in every 12 women develops rheumatoid arthritis during her lifetime.

There is also a rise in awareness about the disease in many developed regions. This has increased the rate of disease treatment rather than symptoms treatment. As people are more aware about rheumatoid arthritis they get more inclined towards treating the disease, thereby boosting the sales of drugs in the rheumatoid arthritis treatment market.

These factors are expected to mark the advent of a bunch of new products that will hit the market within the next eight years.

North Americas Dominance to be Overshadowed by APACs Faster Growth Rate

The North America rheumatoid arthritis market held the highest market value in the past and is also expected to continue leading the global market in future, with a market value of over US$ 16,000 Mn estimated by the end of 2025. However, Asia Pacific is an emerging leader in the competition and is expected to grow at the highest rate of 7.9% during the forecast period 2017-2025.

Middle East and Africa is also expected to show huge scope for development in the global market. Rheumatoid arthritis is one of the leading causes of disability in the Middle East and Africa. A study reveals that prevalence of the disease is reported to be at 0.3% in Egypt and 0.4% in Lesotho. Considering the poor yet fastest growing economy of Africa, generic players have massive scope for growth in the region.

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This research report comprises a detailed presentation of all the companies leading in the global market. These companies are considered to hold a higher customer base than any other companies in the industry. The drugs manufactured by these companies are widely used in the global market and there are several other products in the pipeline. Some of these companies mentioned in the report are Sanofi SA, Pfizer Inc., Hoffman-La Roche AG, Johnson & Johnson, AbbVie Inc., Eli Lilly & Company, Amgen Inc. and Sobi Inc.

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COVID-19 Impact on Rheumatoid Arthritis Treatment Market Marked US$ 30000 Mn in forecast Years 2025 - Cole of Duty

About 1.5 million Americans have RA, according to the Arthritis Foundation. Arthritis most commonly affects older people, but RA can start at any age. It affects both women and men, but its three times more likely to develop in women.

Unlike the most common type of arthritis, osteoarthritis, RA symptoms include fatigue, fever and a loss of appetite in addition to painful, stiff joints. If people experience pain in a joint on one side of the body, it is likely to also affect the same joint on the other side of the body.

There is no cure for RA, and its a progressive disease meaning it gets worse over time. Severe forms of the disease can be disabling and disfigure joints. People cannot die from rheumatoid arthritis, but it can cause complications that may be life-threatening.

Treatments can help people with the disease lead productive lives, and early diagnosis helps control joint damage before it becomes severe.

Expand

Typically, the first sign of rheumatoid arthritis is stiffness, followed by pain and tenderness in the joints. These symptoms can worsen slowly over weeks or months. Most often, symptoms start in smaller joints such as fingers and toes, and then move to other joints.

The number of joints affected varies, but RA most often attacks five or more joints. It may start as swelling that comes and goes, lasting for a few days or weeks at a time, but it gradually gets worse.

Symptoms may also worsen and occur in intense attacks called flares when triggered by stress, suddenly stopping medications or too much activity, according to National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Common RA symptoms include:

Because RA is an autoimmune disease, it can affect the entire body and attack the eyes, heart, glands, nails and nerves.

Expand

RA is caused when the immune system attacks healthy joint tissues. Researchers dont know what causes the immune system to attack the synovium, the lining of the joints. But this process causes inflammation that can destroy bone and cartilage, stretching and weakening tendons and ligaments.

This leads to pain and loss of joint shape and alignment.

While researchers dont know the exact cause, several risk factors can make someone more likely to get RA. Women are more likely to get RA, but according to the Centers for Disease Control and Prevention, women who breastfed their infants have a decreased risk.

Factors that increase risk include:

AgeWhile RA can affect people of all ages, the risk of developing it increases with age, especially for adults in their 60s.

Female SexWomen are 2-3 times more likely to have RA than men.

SmokingPeople who smoke are more likely to develop RA, and smoking makes symptoms worse. Children exposed to secondhand smoke have double the risk of developing RA.

Live BirthThe risk of RA may be greater in women who have never given birth.

Environmental exposuresExposure to toxic substances such as chemicals, asbestos or silica may increase the risk of developing rheumatoid arthritis.

ObesityBeing overweight increases the risk of RA, especially in women 55 or younger.

Research suggests that people born with specific genes called HLA (human leukocyte antigen) class II genotypes are more likely to develop RA. These genes can also make symptoms worse. In people who are obese or who smoke, the risk is highest.

People with relatives who have RA are also at increased risk of developing the disease.

People with rheumatoid arthritis are at risk of developing other health problems. In addition to physical issues, people with RA can also have difficulty keeping or finding employment because of physical limitations such as pain and fatigue.

People with RA have an increased risk of other health problems, such as:

There are three main types of RA. While symptom severity in each type may be different, the treatments are the same.

About 80 percent of people with RA have this type of disease, according to the Illinois Bone & Joint Institute. This means blood tests showed a protein called rheumatoid factor (RF) and antibodies called anti-citrullinated protein antibodies (ACPAs). This type of RA can have more severe symptoms than seronegative RA.

People with this type of RA dont test positive for antibodies or proteins, but they still have RA symptoms. They are also less likely to have complications such as lung issues, heart problems and inflamed blood vessels.

Juvenile idiopathic arthritis affects children ages 17 years old and younger and may sometimes be called juvenile rheumatoid arthritis. It has many of the same symptoms as adult RA but can also cause difficulty gaining weight and growing. Unlike adult RA which is a lifelong condition, children can outgrow JIA.

Doctors that specialize in diagnosing RA and other types of arthritis are called rheumatologists. If your primary care provider suspects you might have RA or another type of arthritis, he or she may refer you to a rheumatologist for testing.

A rheumatologist will diagnose RA based on several tests. These include blood tests, imaging tests such as X-rays and MRIs and a physical examination.

Blood tests search for a protein called rheumatoid factor (RF) and antibodies called anticitrullinated protein antibodies (anti-CCP). Other tests such as the erythrocyte sedimentation rate (ESR) test and C-reactive protein test can find high levels of inflammation present in people with RA.

These tests also help doctors distinguish RA from other types of arthritis such as gout, osteoarthritis, lupus and psoriatic arthritis.

RA has four stages that progress in severity. The stage of disease can influence treatment.

Stage 1Early stage RA with some swelling and stiffness in joints.

Stage 2Moderate stage RA with cartilage damage. Difficulty moving joints occurs more often.

Stage 3Severe disease that destroys bone and cartilage. Increased pain, swelling, decrease in mobility and loss of muscle strength. Joints may begin to deform.

Stage 4End stage RA where joints stop functioning. Symptoms include severe pain, swelling, stiffness and loss of mobility.

People with RA and OA have pain in the joints and difficulty moving around, but there are a few differences in severity of symptoms and how they manifest.

Characteristics of RA and OA

Treatment options for RA include medication, occupational therapy and surgery. In addition, lifestyle changes and assistive devices are things people with RA can do to manage symptoms at home.

Doctors will prescribe treatments depending on the stage of disease, severity of symptoms and degree of inflammation.

Several types of medications treat RA, and a doctor considers how long a patient has had the disease and the severity of symptoms when choosing a medication. Sometimes, people may have more than one prescription.

Over-the-counter NSAIDs such as ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve) can relieve pain and inflammation. Stronger NSAIDs are available by prescription.

These medications, such as prednisone, reduce pain and inflammation. They can also slow joint damage. These medications are usually prescribed for acute symptoms and patients gradually stop them.

DMARDs can slow the progression of RA and save tissues and joints from permanent damage. Common DMARDs include methotrexate and hydroxychloroquine, also known as Plaquenil.

These drugs, also known as biologic response modifiers, are a newer class of DMARD. They target parts of the immune system to control joint and tissue damage. Drugs in this class include Humira (adalimumab), Enbrel (etanercept), Remicade (infliximab), Actemra (tocilizumab) and Xeljanz (tofacitinib).

Occupational therapists can help people with RA learn to better manage their symptoms. Patients can learn how to do daily chores with less pain, how to protect their joints and how to use assistive devices to make daily tasks easier. Evidence from studies shows that occupational therapy helps people with RA do daily chores without pain and better protect their joints, according to a Cochrane review.

In cases of severe RA disease, surgery may be able to help regain some mobility and decrease pain.

In arthroplasty, the affected joint is replaced or reconstructed. This surgery can restore joint function, fix a deformity, relieve pain and stiffness, and improve mobility.

In this procedure, surgeons remove damaged or inflamed tissue without replacing or reconstructing a joint. It can restore joint function and relieve pain.

This type of surgery is also called nerve decompression surgery. It helps relieve pain caused by impinged nerves. This restores strength to the affected joints affected by RA, including elbows, feet, toes and wrists.

A synovectomy is surgery to remove the diseased synovial lining in a joint. It reduces swelling, alleviates pain, and can help prevent or slow down damage to the joint.

Hand and wrist surgery can repair damaged tendons and ligaments in the hands. It helps restore movement to the joints in the hands, wrists and fingers.

In addition to medication and surgery, patients may want to ask their doctor about simple therapies they can do at home, such as exercise and diet.

Low impact exercises can strengthen muscles and improve flexibility. These include walking, water aerobics, swimming and yoga.

According to a 2012 review published in Open Access Journal of Sports Medicine by Shirley Telles and Nilkamal Singh, yoga has shown some promise in reducing pain, improving function and providing mental health benefits.

A small 2019 study by researcher Surabhi Gautam and colleagues published in Restorative Neurology and Neuroscience found that yoga eased physical symptoms and improved mental health.

Evidence suggests that eating a healthy diet with anti-inflammatory foods can ease RA symptoms. There isnt a specific regimen to follow, but a 2018 review recommended the Mediterranean diet and fish oil for people with RA, Today reported.

In general, keeping a healthy weight and getting the proper nutrition helps manage inflammation that can worsen RA.

Foods that may manage RA symptoms include:

People with RA often suffer from fatigue and pain that can get worse during flare-ups. Make sure to get plenty of rest.

Heating pads or warm showers and cold packs can help ease inflammation, pain and stiffness.

Assistive devices such as canes, splints and braces can ease strain on joints and keep them in proper alignment. Household aids such as handrails or grab bars can help people stay safe and prevent injury.

Occupational therapists can help people learn how to use assistive devices.

RA symptoms can affect all aspects of a persons life, including work, social and leisure activities. The CDC has recommendations for improving quality of life for people with RA.

Aim to stay active for 30 minutes a day, five days a week. These 30-minute sessions can be done all at once or broken up into 10-minute sessions throughout the day.

Walking, swimming, yoga or bicycling can be effective exercises to improve cardiovascular health, flexibility and muscle strength in people with RA. Always check with your doctor before starting an exercise routine.

If exercising alone seems daunting, join a group fitness class or activity session at a local community center or other facility. These classes can teach people how to exercise effectively and safely. Plus, meeting with others can help improve mood.

Physical therapists may also be able to teach a person with RA how to properly exercise to help reduce pain and increase mobility.

People with RA who take a self-management class can learn more about arthritis, learn tips for living with the disease and learn how to control symptoms. Examples of CDC-recommended programs include Arthritis Self-Management Program (ASMP) and Chronic Disease Self-Management Program (CDSMP).

Learn more about CDC-recognized programs proven to teach people with RA and arthritis how to manage their conditions.

Smoking increases the severity of RA symptoms and can cause other medical problems. Ask your doctor for help in quitting or visit the CDCs How to Quit Smoking page.

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Rheumatoid Arthritis | Early Signs, Causes and Treatment - DrugWatch.com

It has been estimated that over 50,000 Americans are diagnosed with some form of arthritis every year. Arthritis comes with pain that may vary in frequency but commonly goes unresolved for years or even a lifetime. Treatment for chronic pain, such as arthritis, begins with addressing overall healthincluding sleep, diet and mood. While just one component of treatment, eating the best foods for arthritis can play a role in easing pain and preventing some conditions often related to the presence of arthritis.

Related:How to Keep Your Joints Healthy

After an arthritis diagnosis, taking a look at what you eat is a common starting point. There are two main benefits to improved nutrition: easing pain by adding foods that relieve arthritis and removing foods that make arthritis worse and reaching a healthy body mass index (BMI).It is important to note that an arthritis-friendly diet shouldnt replace medications, other therapies or recommendations from your rheumatologist.

The medicines that you take [for arthritis] work better in a normal BMI; studies have shown when you are at a higher BMI, the medicines dont work as well, explains M. Elaine Husni MD, MPH, vice chair of the Department of Immunologic and Rheumatic Disease and director of the Arthritis Center at Cleveland Clinic. In that case, diet becomes important not only for nutritional value but also for your treatment outcome. You will reduce a lot of comorbidities or complications of the disease.

Even someone who had the cleanest diet before an arthritis diagnosis may find adding certain foods can help alleviate pain and symptoms. Marcy OKoon, senior director of consumer health at the Arthritis Foundation, explains that while food cannot cause or cure arthritis, it can hurt or help it.

Overcoming Family History Just because your parent has arthritis doesnt mean you will. You may be more prone to arthritis, but researchers are still studying the role of genetics as a determining factor.

Osteoarthritis is the most common form of arthritis, affecting the joints as the cartilage wears down between the bones. In this case, the CDC notes that obesity can put extra pressure on joints, increasing swelling that already is a common cause of osteoarthritis.

As with all types of arthritis, doctors stress eating a healthy diet with as little processed food as possible. What we generally recommend in any case is to have a nutrient dense diet, Dr. Husni says. That means everything you put in your body we want to make sure is healthy and packed full of nutrients; we dont really want you filling with empty calories.

The best foods for easing arthritis symptoms are actually foods that are good for everyone; however, from an arthritis standpoint, OKoon recommends learning which foods are pro-inflammatory and which are anti-inflammatoryand steering away from foods that make arthritis worse. For example, processed salty and crunchy snacksparticularly those containing glutenare going to increase inflammation. Nutrient-dense foods such as blueberries contain antioxidants that lessen inflammationand can help reduce the swelling that all types of arthritis cause.

When looking for a specific type of diet, the Mediterranean diet is often cited as a great starting point because it focuses on plant-based, minimally processed foods. Eating more whole foods can also help with weight management, which is often a focus of arthritis treatment that helps medications work better.

Related:What Does Arthritis Feel Like?

Rheumatoid arthritis (RA) is an autoimmune form of arthritis thataffects over a million Americans. It triggers inflammatory chemicals that attack and damage the bodys own joints and tissues, rather than a viral or bacterial invader, OKoon says.

Obesity is actually a risk factor for RA, but there are other health issues that can be attributed to the disease. For example, those with RA have a higher risk of developing heart disease and diabetes, so nutrition in this case would be a vital part of managing life with arthritis.

Just as with osteoarthritis, you should be eating foods that are nutrient rich and reducing processed foods in your diet. Dr. Husni stresses the importance of getting nutrients from your food versus supplements; taking a turmeric pill to get more omega-3 fatty acids isnt the same as eating a piece of fresh salmon. Getting your nutrients in their most natural form is always best. That means changing how you eat fruits and vegetableslike consuming them raw vs. cookedcan help your body get more nutrients.

Related: Rheumatoid Arthritis and Diet

Psoriatic arthritis (PsA) is an inflammatory disease that attacks where tendons and ligaments connect to the bone,causing inflammation in the joints. For the same reasons, eating a healthful dietwhich is also low calorie if weight loss is neededis a smart part of an overall management plan, OKoon adds.

Just as with RA there is a risk of heart disease with PsA, however, the risk nearly doubles if you have a PsA diagnosis. Again, this is why people with PsA should follow the same guidelines for other types of arthritis. In this case, eating foods that are heart healthysuch as berries, nuts and leafy, green vegetablesshould be a focus.

Related:Know the 5 Types of Psoriatic Arthritis

Make sure you actually like whatever healthy foods you choose so your changes can be long-term and sustainable. Additionally, recognizing that other lifestyle factors go hand-in-hand with a healthy diet is important; what you eat is just a piece of the larger puzzle.

If you are on the best diet but smoke a pack of cigarettes per day, your diet wont matter, notes Husni. Stress, sleep, etc. is all intertwined; you have to be mindful of the other lifestyle factors that go along with having a good diet.

If your doctor has spoken to you about ways to ease arthritis pain with some dietary changes, here are some of the best foods to add into your meals that can help keep inflammation down, manage weight and provide you with essential vitamins and minerals for a strong body (and bones).

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5 Foods That Lower Inflammation:

5 Foods High in Omega-3 Fatty Acids:

5 Nutrient-Dense Fruits and Vegetables:

5 Staples of the Mediterranean Diet:

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20 Best Foods to Ease Arthritis Pain and Reduce Inflammation - Parade

Rheumatoid arthritis and diabetes may be closely related, according to researchers writing in the June issue of Arthritis and Rheumatology.

Led by Ronan H. Mullan, MBCHB, Ph.D., of Trinity Centre for Health Science, Ireland, researchers conducted a study of 92 rheumatoid arthritis and osteoarthritis patients finding that insulin resistance was independently associated with a high body mass index (61 patients) and swollen joint count in 28 joints (61 patients).

Both type 2 diabetes mellitus and chronic inflammatory diseases, including rheumatoid arthritis, are characterized by increased insulin resistance, a phenomenon that is thought to be a contributor to adverse cardiovascular outcomes in rheumatoid arthritis through nontraditional mechanisms, the authors wrote.

The findings are based on an assessment of disease activity in rheumatoid arthritis patients. They were assessed for cardiovascular risk factors, including insulin resistance and body mass index.

The study included 92 patients of which 66% were female and 72% were positive for rheumatoid factor. At baseline, the mean values for swollen joint count in 28 joints (SJC28), tender joint count in 28 joints (TJC28), and Disease Activity Score in 28 joints (DAS28) were 3.7 4.4, 3.6 5.2, and 3.5 1.5, respectively. The mean BMI was 28 7 kg/m with 70% of patients having a BMI higher than >25 kg/m. Insulin resistence was present in 26% of patients and 5% of patients had diabetes. They patients were being treated with DMARDs (80%), biologics (29%), and steroids (19%).

The patients, including a second group with osteoarthritis, underwent synovial tissue testing for glucose transporter 1 (GLUT 1) and GLUT4 activity. GLUT-1 expression was greater in the synovium of rheumatoid arthritis (RA) patients (n = 26) as compared to patients with osteoarthritis (n = 16). RA patients showed increased expression in the lining, sublining, and vascular regions. But, decreased GLUT4 expression was found in the RA lining layer in 21 patients as compared to only eight osteoarthritis patients.

When GLUT-1 protein expression decreased, pAMPK protein expression in synovial fluid increased in in four patients who were treated with metformin, which increased glycolytic activity and decreased oxidative phosphorylation in rheumatoid arthritis synovial fibroblasts in seven patients. RA patients who were taking metformin or aminoimidazole carboxamide ribonucleotide, demonstrated a reduced spontaneous production of interleukin6 (IL 6), IL 8, and monocyte chemotactic protein 1 in synovial explants and fibroblasts.

The results of the present study highlight a relationship between insulin resistance and disease activity in rheumatoid arthritis. Furthermore, we demonstrated downregulation of inflammatory responses in ex vivo rheumatoid arthritis synovial explant cultures and rheumatoid arthritis synovial fibroblasts cell cultures by metformin, as well as evidence to suggest that alteration in glucose pathways may ameliorate disease activity in rheumatoid arthritis, they wrote.

REFERNCE:Lorna Gallagher Sian Cregan Monika Biniecka Clare Cunningham Douglas J. Veale David J. Kane Ursula Fearon Ronan H. Mullan. "InsulinResistant Pathways Are Associated With Disease Activity in Rheumatoid Arthritis and Are Subject to Disease Modification Through Metabolic Reprogramming: A Potential Novel Therapeutic Approach," Arthritis and Rheumatology. Frst published:16 December 2019 https://doi.org/10.1002/art.41190

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Study Demonstrates Link Between Rheumatoid Arthritis and Insulin Resistance - Rheumatology Network

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

First results from a database of adults and children with rheumatic and musculoskeletal diseases who have contracted COVID-19 will be unveiled at the upcoming virtual European League Against Rheumatism (EULAR) 2020 Congress.

Loreto Carmona

The database, which is updated weekly, will enable clinicians to compare treatment and disease outcomes in patients and to analyze predictive factors for poor prognoses, said Loreto Carmona, MD, PhD, from the Musculoskeletal Health Institute in Madrid, who is chair of the EULAR abstract selection committee.

As of May26, a total of 985 patients from 28 participating countries had been entered in the EULAR COVID-19 database, which was launched as part of the Global Rheumatology Alliance. Patient data are categorized by factors such as top rheumatology diagnosis, comorbidities, top-five COVID-19 symptoms, and disease-modifying anti-rheumatic drug (DMARD) therapy at time of virus infection. Anonymized data will be shared with an international register based in the United States.

In addition to the "many questions" about which immunomodulatory drugs can make patients with rheumatic and musculoskeletal diseases more vulnerable to the virus, rheumatologists and patients also want to know if any standard therapies can prevent the cytokine storms that are a severe complication of the disease, Carmona explained.

"There are also questions about whether some of our treatments are actually masking the disease, or if we might have complications or different safety events because of that," she told Medscape Medical News.

"This crisis is going scarily fast," Carmona pointed out. "Some of the answers are not really complete and we are still waiting for some good clinical trials, but we suspect that some of the DMARD medications are actually playing a good part in this disease."

"There are real implications for our patients," said John Isaacs, MBBS, PhD, from Newcastle University in Newcastle Upon Tyne, United Kingdom, who is chair of the EULAR scientific program committee. "We can't make assumptions we have to do trials but the answers to these questions will determine the lifestyles of our patients and the decisions they make."

John Isaacs

"COVID-19 is a very interesting situation for all sorts of reasons, and not least because a lot of the drugs we use in rheumatology are being investigated as potential treatments for severe COVID," he told Medscape Medical News.

"That means our community has had quite a lot of input into COVID, and patients want to know if they are at risk for it or, conversely, if they may be safeguarded because of some treatment they're receiving," he said.

The many sessions scheduled for the original meeting remain dedicated to research on treatment options for rheumatoid arthritis, lupus, scleroderma, and other rheumatic and musculoskeletal diseases, but much of the focus has naturally shifted to COVID-19, the organizers said.

As it has in typical years, the meeting will be dominated by research on rheumatoid arthritis, especially into potential new targets. Several noteworthy abstracts will home in on thrombosis risk related to inflammatory arthritis treatments, Isaacs reported.

Another abstract will focus on opioid analgesic consumption in patients also taking TNF inhibitors. This will be interesting because "I know there's some concern about the amount of opioid use in people with arthritis right now," he added.

European League Against Rheumatism (EULAR) 2020 Congress.

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Rheumatology Drugs Explored for COVID-19 in the Spotlight - Medscape

While not as complete as in-person visits, I do love telehealth appointments because the provider has to listen to me before talking, and I absolutely take advantage of the time to share. I also feel more prepared, because I haven't had to leave the house and wait in a chair, said Charis Hill, 33, a disability and chronic disease patient advocate and activist, in a recent Twitter chat co-sponsored by CreakyJoints and Everyday Health. Hill, who lives in Sacramento, California, has ankylosingspondylitis,a form of chronic arthritis that causes inflammation where tendons, ligaments, and bones meet.

RELATED: Your COVID-19 Summer Safety Guide

When you live with rheumatoid arthritis (RA), it is important to stay in touch with your doctors and remain on your medications and treatment protocols. But with the shelter-in-place mandate, that can seem difficult. A telemedicine visit (consulting with your healthcare provider using a smartphone, tablet, computer or other technology), while not perfect, is a very good alternative. Indeed, telemedicine has exploded in just four short months because of pandemic constraints. For example, according to Brandon Welch, PhD, the founder of Doxy.me, the telemedicine portallogged 5.9 million minutes and 236,000 calls in January 2020. By April, those figures had jumped to 315.4 million minutes and 18.9 million calls.

RELATED:Rheumatoid Arthritis: Determining When You Need to See a Doctor and Get Treatment

The consensus seems to be that telemedicine is helpful during a challenging time, but that it has some significant limitations. Vinicius Domingues, MD, a rheumatologist and a medical adviser to CreakyJoints, says that when the patient is doing well, telehealth is as effective as live. The doctor can review medications and lab results and make sure patients understand their particular protocol. However, when there is an issue, it's very hard not to be able to perform a proper physical exam, feeling the joints for swelling and warmth, to see better if there's a rash. Plus, I cant give injections over video, obviously. Thankfully we have telemedicine, because otherwise it would be challenging during these times, but it's not a complete replacement for a full visit, he says.

RELATED: Telemedicine for Physical Therapy: It Works!

Chris Phillips, MD,the chair of the American College of Rheumatologysinsurance subcommittee and a member of the ACRs committee on rheumatologic care, understands that people with RA are anxious about COVID-19. A lot of them are older or immune suppressed, so they're worried about getting sick. They're worried about coming into the office to see us and getting exposed to patients who are sick, he says. More important, he has seen a few cases where patients, concerned that their immunosuppressant medications make them more vulnerable to getting the virus, just stop taking their meds, with disastrous results.

This is dangerous, Dr. Phillips says. If you go off the medicine without checking with your doctor, you run the risk of having a significant flare of underlying disease, which you then may or may not get back under control successfully when you go back on treatment. For most patients we're recommending they continue that treatment but be extra cautious about sticking to safety guidelines. I think now more than ever, it's important that we be in communication either in person or by phone or telehealth with people who have those concerns.

RELATED: Why You Shouldnt Miss Your Ob-Gyn Visit Because of the Pandemic

According to Dr. Domingues, your doctor should review all your symptoms that have arisen since you were last seen, your lab tests, and discuss your medications. Obviously, I dont have the ability to perform a full physical exam, but I can see a swollen knee via telemedicine and make the determination that the patient needs to come in for a shot, he says.

RELATED: How to Have an Effective Appointment With Your Rheumatologist

Lets say you need an injection, infusion or joint manipulation. How can you see your doctor in person safely? Most offices are following these Centers for Disease Control (CDC) precautions, says Domingues:

It looks like telemedicine is here to stay, but in what form and to what extent after the pandemic is over is still unclear. Phillips says, It depends on whether some of the regulatory changes are left in place or not. For the foreseeable future, enjoy not having to drive and then read endless out-of-date magazines in a waiting room!

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Rheumatoid Arthritis: What Telemedicine Can Do for You During the Pandemic - Everyday Health