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The "Pain Management Drugs Market - Forecasts from 2019 to 2024" report has been added to ResearchAndMarkets.com's offering.

The pain management drugs market was valued at US$101.189 billion in 2018 and is anticipated to grow at a CAGR of 5.61% to reach a market size of US$140.371 billion by 2024.

The growing geriatric population suffering from pain related to joints and chronic diseases are driving the growth of the global pain management market in the forecast period. Other factors include the prevalence of chronic diseases, rising healthcare expenditures, an increase in the number of accidents and increasing surgical procedures. However, the availability of substitutes such as pain relief devices is hampering the growth of the global pain management drugs market in the forecast period.

Geographically, North America is expected to hold a significant market share owing to the highest health expenditure of the United States in addition to effective disease management owing to the prevalence of chronic diseases in this region.

Report Scope

This report is an exhaustive study that aims to present the key market trends through various chapters focusing on different aspects of the market. The study provides a detailed market overview through the market dynamics sections which detail key market, drivers, restraints, and opportunities in the current market. The report analyzes key opportunity regional markets, and the current technology penetration through lifecycle analysis. The report also analyzes the market through comprehensive market segmentation by drug type, by indication, and by geography.

The pain management drugs market has been segmented based on drug type, indication, and geography. Based on drug type, the market has been segmented into nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, acetaminophen, antidepressants, and anticonvulsant drugs. On the basis of indication, the market has been segmented into cancer, rheumatoid arthritis, chronic back pain, post-operative pain, and others.

Regional analysis has been provided with detailed analysis and forecast for the period 2018 to 2024. The global market has been broken down into North America, South America, Europe, Middle East and Africa (MEA), and the Asia Pacific regions. The report also analyzes 15 major countries across these regions with thorough analysis and forecast along with prevailing market trends and opportunities which each of these countries present for the manufacturers.

Major players in the pain management drugs market have been covered along with their relative competitive position and strategies. The report also mentions recent deals and investments of different market players over the last year. The company profiles section details the business overview, financial performance for the past three years, key products and services being offered along with the recent developments of these important players in the pain management drugs market.

Key Topics Covered

1. INTRODUCTION

2. RESEARCH METHODOLOGY

2.1. Research Design

2.2. Secondary Sources

3. EXECUTIVE SUMMARY

4. MARKET DYNAMICS

4.1. Market Segmentation

4.2. Market Drivers

4.3. Market Restraints

4.4. Market Opportunities

4.5. Porter's Five Forces Analysis

4.5.1. Bargaining Power of Suppliers

4.5.2. Bargaining Power of Buyers

4.5.3. Threat of New Entrants

4.5.4. Threat of Substitutes

4.5.5. Competitive Rivalry in the Industry

4.6. Life Cycle Analysis - Regional Snapshot

4.7. Market Attractiveness

5. PAIN MANAGEMENT DRUGS MARKET BY DRUG TYPE

5.1. Nonsteroidal anti-inflammatory drugs (NSAIDs)

5.2. Corticosteroids

5.3. Acetaminophen

5.4. Antidepressants

5.5. Anticonvulsant drugs

6. PAIN MANAGEMENT DRUGS MARKET BY INDICATION

6.1. Cancer

6.2. Rheumatoid Arthritis

6.3. Chronic Back Pain

6.4. Post-Operative Pain

6.5. Others

7. PAIN MANAGEMENT DRUGS MARKET BY GEOGRAPHY

7.1. North America

7.1.1. USA

7.1.2. Canada

7.1.3. Mexico

7.2. South America

7.2.1. Brazil

7.2.2. Argentina

7.2.3. Others

7.3. Europe

7.3.1. Germany

7.3.2. United Kingdom

7.3.3. France

7.3.4. Spain

7.3.5. Others

7.4. Middle East and Africa

7.4.1. Saudi Arabia

7.4.2. Israel

7.4.3. Others

7.5. Asia Pacific

7.5.1. China

7.5.2. Japan

7.5.3. India

7.5.4. South Korea

7.5.5. Others

8. COMPETITIVE INTELLIGENCE

8.1. Competitive Benchmarking and Analysis

8.2. Strategies of Key Players

Story continues

8.3. Recent Investments and Deals

9. COMPANY PROFILES

9.1. Novartis Pharmaceuticals Corporation

9.2. Eli Lilly and Company

9.3. Amgen Inc.

9.4. GlaxoSmithKline plc

9.5. AbbVie Inc.

9.6. Merck & Co., Inc.

9.7. Sanofi

9.8. F. Hoffmann-La Roche Ltd.

9.9. Pfizer Inc.

9.10. Purdue Pharma L.P.

For more information about this report visit https://www.researchandmarkets.com/r/yq0q5w

View source version on businesswire.com: https://www.businesswire.com/news/home/20191223005511/en/

Contacts

ResearchAndMarkets.comLaura Wood, Senior Press Managerpress@researchandmarkets.com For E.S.T Office Hours Call 1-917-300-0470For U.S./CAN Toll Free Call 1-800-526-8630For GMT Office Hours Call +353-1-416-8900

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Analysis on the World's $140+ Billion Pain Management Drugs Market, 2019-2024 - Featuring Novartis, Eli Lilly, Amgen, GSK, AbbVie, and More -...

"When you become something on the internet and not something in real life," Clairo explains, "It's this very strange cognitive dissonance where you're like, 'Well, is something actually happening, or am I dreaming that people know who I am?' "

Clairo wasn't dreaming. She started college shortly after uploading a song called "Pretty Girl" to YouTube that same week, her bedroom music video reached a million views. Today, it has over 40 million views, and she's launched an entire music career from her viral success. She's appeared on late night television stages, played Coachella and is going on tour with Tame Impala in 2020. Clairo even produced her debut full-length album, Immunity, with a little help from Rostam Batmanglij.

We'll talk about how the former Vampire Weekend member reached out to Clairo on Instagram after hearing her 2017 song, "Flaming Hot Cheetos," how "Sinking" is a sexy song about rheumatoid arthritis ("Which is hilarious," she adds) and how she keeps up with her fans in relation to her rapidly rising profile. Hear the conversation in the player above, starting off with a live in-studio performance of "Bags."

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From 'Pretty Girl' To 'Immunity': Clairo On Her Rapid Rise : World Cafe - NPR

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The monthly joint mixer for the Coral Gables Bar Association and the Rotary Club of Coral Gables, held the second Wednesday of every month, had a twist in December.

That get together, held at Tapeo Eatery & Bar on Giralda, also served as a toy drive for three different organizations: the Marines Toys for Tots, Lighthouse for the Blind and the Coral Gables Free Childrens Dental Clinic for its holiday kids party. Among the many enjoying the event were RCCG president-elect Kelly Garces, Hadley Williams, Greg Martini, Walter Alvarez and Carol Brock.

Speaking of toy drives, Scott and Belinda Sime held their annual holiday party and toy drive, which is where many of the toys collected from the mixer were dropped off. The Simes party always is one that collects several hundred toys every year and is one of the best parties of the season for a cause. In addition to the Simes home. Toys were dropped off as Channel 10s Big Bus Toys for Tots caravan traveled the county with Jacey Birch and Eric Yutzy.

The Mitchell and West Family Fun 5K was one of many events held in front of Coral Gables City Hall on a picture perfect day. PJ Mitchell and Spencer West started this event years ago to raise funds for Alzheimers and now support various causes. This year the Coral Gables Womans Club Children Dental Clinic. The women of this club are everywhere and were among the many hundreds dressed in Santa and holiday attire who ran to support the Arthritis Foundation the morning of Dec. 8 at The Falls. The is the longest-running, holiday-themed 5K race series anywhere and it is no wonder why. It is hilarious. Two of the funniest were Eric Bradley and Phong Truong with their antler headpieces and colorful tutus.

CGWC had raised $1,000 for the Run at a Gringo Bongo fundraiser to match the annual $1,000 donation for a total gift of $2,000 that they presented at the race.

Representing the club that morning with this writer were board member Donna Myrill and dental clinic director Dr. Iris Torres. Club president Arely Ruiz also was on hand to emcee the event for the Foundations outgoing eecutive director and CGWC member Lisa Boccia.

The Arthritis Foundation is one close to the heart of this womans club whose past president Mireya Kilmon has been a spokesperson for the organization and has suffered with arthritis for years.

Speaking of events, Coral Gables Womans Club had two fundraisers just days before that weekend on Dec. 3, the club coordinated its monthly Gringo Bingo hosted by Clutch Burger to raise funds for the Junior Orange Bowl Festival and then two days later had a Prohibition Repeal Speakeasy Party at their clubhouse to benefit the Coral Gables Childrens Dental Clinic that serves currently 600 children of the working poor.

The Junior Orange Bowl, whose numerous events showcase our youth, and the Womans Clubs Dental Clinic and its Childrens Festival both serve our young people in their own unique ways. It was especially fun to have the JOBCs Youth Ambassadors and Jobie at Gringo Bingo to promote the festival and the JOBC Parade held Dec. 15.

Speaking of the JOBC, the festivals annual Junior Orange Bowl Parade was one of the best in years with a new date that certainly made it easier for visiting and local bands to participate. Coming off that event, the committee goes right into the JOBCs International Tennis Tournament (Dec. 14-23); the Junior Orange Bowls annual National Basketball Classic at Miami Palmetto High School on Dec. 27, 28 and 30, and the International Golf Tournament, Jan. 2-6, 2020. For more on these and other JOBC events, visit http://www.jrorangebowl.org.

Finally, save the date, Jan. 7, for the Gringo Bingo (7-9 p.m.). That night CGWC will direct the proceeds to Joshuas Heart Foundation. The Coral Gables Womans Club is extremely grateful for Clutch Burgers generous support in hosting these monthly events. As always, Clutch Burger owner Steven Bradley will entertain and call bingo while celebrity DJ Germain will once again donate his services providing music adding to the overall party atmosphere at these games.. For tickets, send email to gloria@cnews.net.

Until next time, keep making each day count.

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Gables Rotary and Bar Association mixer and toy drive benefits many - Miami's Community Newspapers

News Release

Monday, December 23, 2019

Mutations in the RIPK1 gene responsible for CRIA syndrome.

Over the last 20 years, three families have been unsuspectingly linked by an unknown illness. Researchers at the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health, and other organizations have now identified the cause of the illness, a new disease called CRIA syndrome. The results were published in the journal Nature.

NHGRI scientific director Daniel Kastner, M.D., Ph.D., a pioneer in the field of autoinflammatory diseases, and his team discovered CRIA, which has symptoms including fevers, swollen lymph nodes, severe abdominal pain, gastrointestinal problems, headaches and, in some cases, abnormally enlarged spleen and liver.

The disorder has characteristics typical of an autoinflammatory disease, where the immune system appears to be activated without any apparent trigger. Although the condition is not life-threatening, patients have persistent fever and swollen lymph nodes from childhood to old age, as well as other symptoms that can lead to lifelong pain and disability.

When confronted by patients symptoms, who were first seen at the NIH Clinical Center, researchers looked for infections and cancer as the cause. After those were ruled out, they sought answers in the genome, a persons complete set of DNA. Kastner and his team sequenced gene regions across the genome and discovered only one gene RIPK1 to be consistently different in all patients.

Researchers identified a specific type of variation in the patients: a single DNA letter at a specific location incorrectly changed. This change can alter the amino acid added to the encoded protein. These are called "missense" mutations.

Remarkably, each of the three families had its own unique missense mutation affecting the very same DNA letter in the RIPK1 gene. Each affected person had one mutant and one normal copy of the gene, while the unaffected family members had two normal copies of the gene.

The researchers also looked at 554 people with sporadic unexplained fever, swollen glands and other symptoms or diseases, and then at over a quarter million people from public sequence databases to see if they encountered the same RIPK1 mutations. When they did not find such mutations elsewhere, it was clear that they were onto something new.

"It was as if lightning had struck three times in the same place," said Kastner, who led the NHGRI team. "This discovery underscores the tremendous power of combining astute clinical observation, state-of-the-art DNA sequencing, and the sharing of sequence data in large publicly-accessible databases. We live in a very special time."

The RIPK1 gene encodes for the RIPK1 protein, which is involved in the bodys response to inflammation and programmed cell death. To make sure that RIPK1 action does not initiate inflammation and cell death in all cells, another protein cuts the RIPK1 protein at a specific location in the protein sequence. The research team noticed that all the mutations in CRIA patients occur at the location where RIPK1 usually gets cut, resulting in an uncuttable, seemingly indestructible RIPK1 protein.

This suggests that cutting RIPK1, thereby disarming it, is crucial to controlling cell death and inflammation. Recognizing this cause-effect relationship, Kastners team named the resulting disease cleavage-resistant RIPK1-induced autoinflammatory (CRIA) syndrome.

Although the researchers made the connection between CRIA syndrome and RIPK1 mutations, they still needed to understand the molecular mechanisms involved in the disease. To do this, Kastner and his team collaborated with Najoua Laloui, Ph.D., and John Silke, Ph.D., at the Walter and Eliza Hall Institute in Australia, who made specialized mouse models with similar RIPK1 mutations as seen in CRIA patients.

The Australian team discovered that mouse embryos with two mutant copies of RIPK1 (and no normal copy) did not survive in the uterus due to excessive cell death signals, which further confirmed the importance of cutting RIPK1 to limit its function in normal cells. However, mice bearing one mutant copy of RIPK1 and one normal copy, as is the case for CRIA patients, were mostly normal but had heightened responses to a variety of inflammatory stimuli, which the researchers think may suggest a possible mechanism for how the human disease occurs.

Kastner and his team worked to find a treatment for CRIA syndrome. Seven patients with the condition were given therapies that are known to reduce inflammation. While drugs such as etanercept and anakinra, which are routinely used to treat autoinflammatory and chronic diseases such as rheumatoid arthritis, had little effect on the patients, one biological drug called tocilizumab did. Tocilizumab, a drug that suppresses the immune system, reduced the severity and frequency of CRIA syndrome symptoms in five out of seven patients in some cases with life-changing effects.

Hirotsugu Oda, M.D., Ph.D., a post-doctoral researcher in Kastners laboratory and co-first author of the paper, said: "As a physician-scientist, the most thrilling experience to me was to hear the mother of a CRIA patient say that her son was a completely different, healthy child after the tocilizumab treatment. Through the genetic diagnosis, we were able to contribute to the treatment of a few patients. This is, after all, the ultimate goal."

Researchers are now trying to understand the detailed molecular mechanism that enables tocilizumab to treat CRIA. Specific inhibitors of RIPK1, which are under development, may also hold promise in both CRIA and other seemingly intractable inflammatory conditions.

The study included collaborations with the following NIH institutions: National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH Clinical Center, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases and NIH Intramural Sequencing Center.

About the National Human Genome Research Institute (NHGRI) is one of the 27 institutes and centers at the NIH, an agency of the Department of Health and Human Services. The NHGRI Division of Intramural Research develops and implements technology to understand, diagnose and treat genomic and genetic diseases. Additional information about NHGRI can be found at:www.genome.gov.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

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NIH researchers discover new autoinflammatory disease and uncover its biological cause - National Institutes of Health

An Up to Date Report onRheumatoid Arthritis and Lupus Treatments Market size | Industry Segment by Applications (Hospitals and Clinics, Ambulatory Surgery Centers and Homecare Settings), by Type (Rheumatoid Arthritis Treatments and Lupus Treatments), Regional Outlook, Market Demand, Latest Trends, Rheumatoid Arthritis and Lupus Treatments Industry Share & Revenue by Manufacturers, Company Profiles, Growth Forecasts 2025.Analyzes current market size and upcoming 5 years growth of this industry.

In accordance with the Rheumatoid Arthritis and Lupus Treatments market report, the industry is anticipated to amass returns while accounting a profitable yearly growth rate in the predictable time period. It provides an outline of Rheumatoid Arthritis and Lupus Treatments industry and also offers details related to the valuation the Rheumatoid Arthritis and Lupus Treatments market currently holds, breakdown of the Rheumatoid Arthritis and Lupus Treatments market, along with the growth opportunities in the business vertical.

Repot Scope:

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Rheumatoid Arthritis and Lupus Treatments Market Statistics by Types:

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A brief of the market segmentation

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The report also speaks about several other information such as assessment of the competitive landscape, data related to the market concentration rate and concentration ratio in the upcoming years.

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Rheumatoid Arthritis and Lupus Treatments Market Research Report, Growth Forecas - News by aeresearch

Age-related increases in erythrocyte sedimentation rate(ESR) and 28-joint swollen joint count (28-SJC) scores without relevantcorresponding increases in patient global assessment (PGA) and 28-joint tenderjoint counts (28-TJCs) may imply that age-related processes such asphysiological ESR increase and soft tissue changes contribute to a higher28-joint Disease Activity Score (DAS28) in older patients, according to resultsfrom a concise report published inRheumatology.

The current study used the DAS28 and its components to investigate the potential effect of aging on patients with rheumatoid arthritis who are nave to treatment with disease activity in disease-modifying antirheumatic drugs (DMARDs) from the Norwegian Register of DMARDs. Investigators used linear regression to explore associations between age (<45, 45-65, and >65 years) and each component of the DAS28 while accounting for sex and education. They calculated adjusted predicted scores for each component and total scores for each age range. Because significant interactions were found between age and sex for the 28-TJC, PGA, and ESR (P<.001), researchers stratified regression models for sex. Education was a signicant covariate, leading investigators to calculate predicted scores across age categories for different levels of education. Disease duration was not included in the model because it proved to not be a significant confounder.

Baseline data were available for 2037 patients (mean age55.2 years; 68% women). Compared with the youngest age group, men older than 65years with an intermediate education level had a 25% higher 28-SJC and 56%higher ESR, and women with an intermediate education level had a 27% higher28-SJC and 51% higher ESR. The differences between 28-TJC and PGA werenegligible (men: 28-TJC 3% and PGA 1%; women: 28-TJC 1% and PGA 2%). Thedifference in total DAS28-ESR score between the youngest and oldest agecategory was 10% for both men and women. In absolute values, the DAS28 was 5.5in the oldest group compared with 5 in the youngest.

Study limitations included using baseline data from patientswho were DMARD-nave entering the Norwegian Register of DMARDs and thepotential for confounding variables; however, the study investigators concludedthat the present study indicates that age has a significant positiverelationship with the DAS28-ESR, with the ESR and 28-SJC driving the increase.Validation of disease activity measures in elderly RA patients should be performedin future studies where the influence of comorbidity and physiologicalageingis studied. The age effect on DAS28 might be relevant in atreat-to-target strategy, but longitudinal data are needed to further explorethis.

Reference van Onna M, Putrik P, Lie E, Kvien TK, Boonen A, Uhlig T.What do we measure with 28-joint DAS in elderly patients? An explorative analysis in the NOR-DMARD study[published online October 26, 2019].Rheumatology (Oxford). doi:10.1093/rheumatology/kez490

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Effect of Aging on 28-Joint Disease Activity Score in Rheumatoid Arthritis - Rheumatology Advisor

A recently published report presented at the 2019 AIBD Annual Meeting in Orlando, FL, discussed the case of a patient who developed ulcerative colitis (UC) following treatment with Secukinumab for her psoriatic arthritis and highlighted a novel approach for the management of both of her conditions simultaneously.

The patient, a 52-year-old female with a long history ofpsoriatic arthritis, presented complaining of bloody diarrhea over the pastmonth. Stool studies and biopsies as well as a CT Scan of Abdomen and Pelvis wereperformed and revealed normal results. A colonoscopy, however, revealed thatthe patient had ulcerative colitis (UC) extending from the hepatic flexure torectum. Biopsies showed crypt abscesses consistent with inflammatory boweldisease (IBD) alone with a positive serum p-ANCA, the authors explained. Thepatient stated that she had no history of UC or IBD but did note that herpsoriatic arthritis had been unsuccessfully treated with Etanercept,Leflunomide, Adalimumab, and Methotrexate in the past.

The patients Secukinumab was discontinued and she wasinitiated on prednisone 40mg daily and mesalamine 4.8g daily. The patientimproved and was, therefore, discharged. To allow for a prednisone taper, shewas later initiated on Tofacitinib 10mg twice daily for treatment of bothpsoriatic arthritis and UC. In addition to complete resolution of her bloodydiarrhea, objective improvement of the patients psoriatic arthritis was alsoobserved.

In their discussion, the authors stated that, although therehave been case reports of Secukinumab-induced UC published in the past,treatment typically involves infliximab, a monoclonal TNF-alpha antibody, ifsteroids initially fail. For this patient, however, optimizing immunologic therapywas difficult since she was resistant to multiple forms of THF-alpha inhibitionwith Adalimumab and Etanercept. Because of this, a novel approach of initial steroidtherapy followed by treatment with Tofacitinib provided excellent resolution ofthe patients symptoms and conditions.

Nonetheless, psoriatic arthritis cases on Secukinumab who develop ulcerative colitis and have failed prior TNF-alpha antibody treatment merit this novel approach to therapy with Tofacitinib, the authors concluded. They added, We might consider Tofacitinib even in cases who have not failed prior TNF-alpha antibody treatment given greater acceptance by patients of oral medical therapy.

Reference

Sethi V, Jacobs A, Sethi A. Secukinumab induced ulcerative colitis in a patient with psoriatic arthritis: A novel approach to refractory cases. Presented at: 2019 AIBD Annual Meeting; December 12-14 in Orlando, FL.

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Case Highlights Novel Approach to Treatment of UC, Psoriatic Arthritis - Monthly Prescribing Reference

December 13, 2019, 6:46 PM

3 min read

Eerie X-rays portray a rare condition nicknamed "telescoping fingers," in which bone loss causes the fingers to buckle back into the hand, like a collapsing telescope.

A female patient, age 69, was diagnosed with rheumatoid arthritis 18 years prior and presented at a rheumatology clinic in Turkey with the condition, according to a case study published in the New England Journal of Medicine this week.

Her fingers could be stretched to their original length, but then retreated back into her hand when released. She could not completely flex her fingers, nor make a fist.

X-rays revealed that her bones had been reabsorbed as a late-state consequence of her severe arthritis.

A 69-year-old woman in Turkey developed a rare condition known as "telescoping fingers."

Doctors treated her with a series of arthritis drugs, which reduced her pain and swelling but did not improve her hand functionality.

While an estimated 23% of Americans have some form of doctor-diagnosed arthritis, according to the Centers for Disease Control and Prevention, developing telescoping fingers is extremely rare, even among people with arthritis.

The first case of the telescoping condition, described in the Journal of Bone and Joint Surgery, was documented in 1913, and referred to it as "la main en lorgnette," or opera-glass hand.

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Rare 'telescoping fingers' condition caused woman's bones to reabsorb - ABC News

Halloween has passed, but the scariest time of the year has just begun: cold and flu season. Winter can be unsettling when you have juvenile arthritis. Some medications used to treat JA can weaken the immune system, making it easier to catch any viruses going around. Getting sick can be hard on kids with JA; they might feel extra soreness, and it may take them longer to feel better than their peers. They may even need to put JA treatments on hold until they recover.

Its natural to feel anxious at this time of year. Its especially worrying because kids often spend hours together in tight quarters such as day care, locker rooms, and classrooms. But there are many precautions you can take to help prevent the spread of disease.

Youngsters with JA should get a flu vaccine, especially if theyre using immunosuppressants. The best line of defense is to have everyone in your house get a flu shot, to reduce the risk of someone getting sick and spreading germs.

Keep communal spaces in the house clean and wash shared blankets frequently. Remind your children to wash their hands after gym classes and sports practices. Older kids and teens should keep sanitizer sprays on hand for use on personal sports equipment.

Even when youre taking all the precautions possible, it can be hard to avoid worrying. The last thing you want is for your child to get sick. It can be tempting to want to put them in a bubble.

But try to have faith in the flu shot; its an excellent first line of defense. And other options, such as antiviral medication, can make the flu easier to cope with. While its not a cure, it can reduce flu symptoms by one day, which is nothing to sneeze at. If your child is showing signs of an infection, such as a fever, its important to call the doctor right away. The doctor may recommend using one of these medications as a precaution.

Have faith in your children to do their part to stay clean. Encourage them to wash their hands before eating and to keep their hands to themselves. Older kids and teens often understand that these precautions are necessary. Even little ones can come around to the idea when you incorporate it into a routine.

I think its important to note that though its easy to get sick, it might not happen. Its entirely possible to stay healthy. While some years I felt as if Id caught every cold going around, some flu seasons passed without a hitch. Youll never know how the season will go, so try to be as positive as possible. With the right precautions, your family might do just fine this cold and flu season.

***

Note: Juvenile Arthritis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Juvenile Arthritis News, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to juvenile arthritis.

Elizabeth Medeiros is a young adult who has dealt with juvenile arthritis since she was a small child. However, her pain hasnt stopped her from working on a product design degree in Boston. Her passion is to create products that make life easier for the chronically ill, such as shoes and walking canes. When shes not in class, Elizabeth enjoys writing about how shes coped with arthritis at such a young age. You can find more of her writings at ArthritisGirl.Blogspot.com and on Instagram @GirlWithArthritis.

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Flu Season Is the Scariest Time of the Year When You Have JA - Juvenile Arthritis News

It may have been a rainy day, but the dreary weather did little to dampen Sharon Stolbergs enthusiasm when speaking about SPARC (Sport, Art, and Recreation of Chattanooga) to the Civitan Club.

The teacher at Hunter Middle School, who has suffered from a severe form of arthritis for her entire life, has devoted herself to helping children with disabilities. She does so by encouraging disabled students to participate in adaptive sports.

Adaptive sports, such as wheelchair basketball, use unique equipment to make those activities accessible to people with disabilities. Possessing the ability to play these sports has several benefits to children and adults, said the middle school teacher.

Adaptive sports really increase confidence, said Ms. Stolberg on the benefits of adaptive sports, Theyre a good bridge builder between the disabled and the non-disabled population, and they help with strength and weight control.

Ms. Stolberg has been a proponent of adaptive sports for almost 15 years. Although they did not exist when she was a child, nothing stopped her from enjoying them as an adult.

I started horseback riding in 2005 in Cleveland, and then I got into adaptive water skiing, and it sort of avalanched after that, said the speaker on how she got into adaptive sports.

Ever since she started with SPARC, which is focused on adaptive sports, she has seen it grow from small beginnings into a widely accepted organization. And with growth, it has made her job much easier.

I think the demand has grown, and the acceptance has grown, said Ms. Stolberg, The willingness of people to work and modify has grown too. Going from having to scrounge for volunteers, and now we have many more volunteers than we would have a few years ago. Its just more public now, and more of an accepted thing, which is huge.

While adaptive sports are a blessing for many children, they can be a pricey endeavor for families. Organizations such as the Civitan Club often provide the funds necessary to make the crucial equipment needed for adaptive sports.

With the kids in the area, the Civitan Clubs are really essential to get things like adaptive bikes for them, said Ms. Stolberg.

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Teacher With Severe Arthritis Urges Others With Disabilities To Stay Active - The Chattanoogan

'Were expanding the [biosimilars] initiative to make sure that our drug programs in Alberta are going to be sustainable,' Alberta Health Minister Tyler Shandro, seen here, said in an exclusive interview.

Jason Franson/The Canadian Press

Alberta will force 26,000 patients on government-sponsored drug plans to switch from expensive drugs that are known as biologics to cheaper near-copies of the medications, a move that will save the province hundreds of millions of dollars in the coming years.

The major policy change in favour of the less-expensive versions, called biosimilars, will take effect by next summer and is expected to save $227-million to $380-million over the next four years. Alberta will become the second province after British Columbia to stop covering some of the brand-name biologic drugs that have driven significant increases in prescription-drug spending across the country.

But the provincial government intends to go even further than B.C., including more drugs in the first phase of its plan and introducing a tiered framework that will limit drug choices for patients with rheumatoid arthritis and Crohns disease who are starting biologics for the first time.

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Were expanding the [biosimilars] initiative to make sure that our drug programs in Alberta are going to be sustainable," Alberta Health Minister Tyler Shandro said in an exclusive interview. We committed in the last election that we would find efficiencies and make sure that we were investing those savings.

The government is working to rein in Albertas health-care spending more broadly, an effort that has already drawn the ire of health-care workers unions and the Alberta Medical Association.

The provinces initiative is likely to earn plaudits from those who see promoting the less-expensive medications as a sensible way to free up money for other health-care priorities.

However, some gastroenterologists and patient advocacy groups, including Crohns and Colitis Canada, have expressed concern that inflammatory bowel disease patients forced to switch wont do as well on the cheaper drugs.

Health Canada and drug regulators around the world say biosimilars are as safe and effective as the original drugs they mimic.

Biologics are complex medications produced from living organisms and injected or infused into patients. They have dramatically improved the health of people with debilitating diseases such as rheumatoid arthritis and Crohns disease chronic illnesses for which there used to be few good treatment options.

In Alberta, government spending on biologics skyrocketed to $238-million in 2018-19, up from just $21-million a decade earlier.

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Four of the top five drugs in terms of public spending in Alberta are biologics. At the top of that list is Remicade, also known as infliximab, an intravenous infusion for rheumatoid arthritis, Crohns disease and ulcerative colitis, which cost the provincial government as much as $91.2-million last year more than any other single drug.

The list price for Remicade in Alberta is $962.68 a vial, while the biosimilar versions, Inflectra and Renflexis, sell for $525 and $493 a vial, respectively. (List prices dont reflect the confidential discount deals that are now commonplace in the global pharmaceutical industry, meaning the Alberta government could be paying less.)

Biosimilars are almost like generics: They are cheaper near-copies of original biologic drugs whose patents have expired. However, biologics, unlike simple chemical pills, cant be replicated perfectly from batch to batch, even within the same brand.

That complexity has allowed some opponents to argue that biosimilars arent as safe or effective as original biologics, especially for patients who are being asked to switch for financial instead of health reasons.

But the bulk of the international evidence mainly from Europe, where more than 40 approved biosimilars are available has shown no significant differences in safety or efficacy after switching.

Albertas plan will require existing patients on government-sponsored drug plans to switch to the biosimilar versions of Remicade and four other drugs: Enbrel, which treats rheumatoid arthritis; Lantus, a long-acting insulin for diabetics; and Neulasta and Neupogen, both of which boost white-cell counts for chemotherapy patients.

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Existing users of a drug called Copaxone for multiple sclerosis will be switched to a complex generic at the same time. The government is including the drug in its initiative even though it is not technically a biologic.

The changes are expected to affect about 22,000 Albertans with diabetes, 2,000 with Crohns disease or ulcerative colitis, 1,400 with rheumatic diseases, 750 with multiple sclerosis, 450 with low white-blood cell counts and 35 with plaque psoriasis.

The changes, which kick in July 1, 2020, do not apply to patients with private insurance or patients who pay out of pocket for their prescription drugs.

Children and pregnant women will be exempt. Physicians who believe there is a medical reason why a patient should not switch will be allowed to apply to the province for an exemption.

For patients with Crohns disease, rheumatoid arthritis and related rheumatic diseases who are either starting biologics for the first time or switching away from a biologic that has stopped working, a new tiered framework means they will have to try cheaper biologic options first.

For example, Crohns patients new to biologics will first have to try one of the two Remicade biosimilars or another IV drug called Entyvio before they are allowed to access public coverage of Humira, an expensive treatment that patients can self-inject but for which biosimilar alternatives are not yet available in Canada.

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Current Humira patients will be allowed to retain government coverage for the drug.

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Alberta will force patients to switch from biologics to cheaper biosimilar medications - The Globe and Mail

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The endocrine system is a collection of glands all over the body that is responsible for the secretion of hormones into the bloodstream. An endocrine disorder happens when this system is no longer able to function properly.

The endocrine system is composed of a set of glands responsible for the production of hormones that play a vital role in the regulation of body signals. These include appetite, sleep, weight, breathing, and even puberty. Almost every aspect of the body has something to do with hormones.

Diseases such as diabetes, Graves Disease, and Cushings Syndrome are all endocrine disorders. Each of them is a unique disease treated in different ways, but CBD and endocrine diseases have become tangled one as a remedy for the other in the recent past.

How endocrine system disorders occur

Endocrine disorders occur when one or more endocrine glands no longer functions properly. If even one gland starts to produce too much or too little of a particular hormone, chances of an endocrine disorder occurring go up. Such a disorder can either be generic, or due to tumors, nodules or lesions inhibit an endocrine glands normal functioning.

In diabetes, for example, the pancreas does not produce enough insulin; and in hypothyroidism, the thyroid gland doesnt produce enough thyroid hormone. Hyperthyroidism is the opposite of this.

All in all, most endocrine disorders dont have a specific cure and can last with the patient for years or even their whole lives. If left untreated, they can result in the poor quality of life, general body pain, loss of weight, total inability to move, work or function and death.

However, there exist medications and therapies that can be used to manage the symptoms they exhibit. One of the ways these symptoms can be suppressed and managed is through the use of CBD.

CBD and the endocrine system

According to recent studies, CBD has the potential to regulate the endocrine system and manage harmful symptoms exhibited by some endocrine disorders. One case that stands out, in particular, is when the disorder is caused by the presence of a tumor on endocrine glands. CBD and endocrine diseases caused by cancer cells can be inhibited and, possibly have an invasion of prostate tumors prohibited.

There is also some evidence available that suggests CBD has some degree of influence over the production of hormones in some glands in the body, including the thyroid gland. Keep in mind that research into the effect of CBD on the endocrine system is in very preliminary stages, however.

What we are sure of, though, is the effect CBD has when it comes to keeping the symptoms of certain endocrine disorders under control. The most common of these are insomnia and anxiety.

Of all the uses CBD has found in the modern age, the most well-documented is its ability to reduce feelings of anxiety. This is thought to be as a result of its ability to bind directly with CB1 receptors in the brain and affect the production of cortisol and serotonin.

Serotonin is a mood-regulating hormone, whose deficiency is usually manifested via feelings of anxiety and depression. A high level of cortisol also leads to feelings of stress and impending doom, as exhibited by people with anxiety.

Another well-known property of CBD is getting rid of insomnia. Sleep is yet another part of human life thought to be controlled, at least in part, by the endocannabinoid system. This is done via the circadian rhythm, which keeps wakefulness and sleepiness in check. In people with anxiety, this rhythm can be thrown off, making them unable to fall asleep.

On the other hand, another common symptom of endocrine disorders is unsatisfying sleep. REM sleep is the part of sleeping where, if experienced properly, a person feels well-rested. In people with certain endocrine disorders and anxiety, REM sleep may be lacking. A CBD dropper or CBD tincture right before bed is a good way to

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Benefits of CBD and Arthritis in the Human Body - MMJ Reporter

Ru-Yin Hu,13,* Xiao-Bin Tian,3,* Bo Li,3 Rui Luo,3 Bin Zhang,3 Jin-Min Zhao1

1Department of Orthopaedics, Guangxi Medical University, Nanning 530021, Peoples Republic of China; 2Department of Orthopaedics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Peoples Republic of China; 3Department of Orthopaedics, Guizhou Provincial Peoples Hospital, Guiyang 550002, Peoples Republic of China

*These authors contributed equally to this work

Correspondence: Jin-Min ZhaoDepartment of Orthopaedics, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, Guangxi 530021, Peoples Republic of ChinaTel +86 771 13985048001Email zhao948586007@126.com

Background: Existing drugs are far from enough for investigators and patients to administrate the therapy of rheumatoid arthritis. Drug repositioning has drawn broad attention by reusing marketed drugs and clinical candidates for new uses.Purpose: This study attempted to predict candidate drugs for rheumatoid arthritis treatment by mining the similarities of pathway aberrance induced by disease and various drugs, on a personalized or customized basis.Methods: We firstly measured the individualized pathway aberrance induced by rheumatoid arthritis based on the microarray data and various drugs from CMap database, respectively. Then, the similarities of pathway aberrances between RA and various drugs were calculated using a KolmogorovSmirnov weighted enrichment score algorithm.Results: Using this method, we identified 4 crucial pathways involved in rheumatoid arthritis development and predicted 9 underlying candidate drugs for rheumatoid arthritis treatment. Some candidates with current indications to treat other diseases might be repurposed to treat rheumatoid arthritis and complement the drug group for rheumatoid arthritis.Conclusion: This study predicts candidate drugs for rheumatoid arthritis treatment through mining the similarities of pathway aberrance induced by disease and various drugs, on a personalized or customized basis. Our framework will provide novel insights in personalized drug discovery for rheumatoid arthritis and contribute to the future application of custom therapeutic decisions.

Keywords: rheumatoid arthritis, drug repositioning, individualized pathway aberrance, differential pathway

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

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Individualized Drug Repositioning For Rheumatoid Arthritis Using Weigh | PGPM - Dove Medical Press

COLUMBUS (WCMH) Did you know the No. 1 cause of disability in the United States is arthritis?

More than 54 million Americans live with arthritis including 2.8 million people in Ohio.

On Saturday, at Genoa Park by COSI over 1,000 people came together to rally behind the arthritis foundation.

The annualJingle Bell Run for arthritis is bringing holiday cheer to downtown Columbus. Theirgoal was to raise $205,000 this year.

There is often a misconception that arthritis only affects older people, but thats far from the truth.

Five months ago I was diagnosed with rheumatoid arthritis, my life was miserable in the mornings, said 18-year-old, Colten Phay.

When I would wake up my whole body would be aching with pain, miserablewith pain and I couldnteven eat breakfast or put on clothes on, Colton said.

With the help of the research from the Arthritis Foundation, Colten went on a medication they helped discover and now his life is back to normal. It changed my life, expressed Colten. It helps so much. I feel fine now.

Christopher Haverlock with the Arthritis Foundation says that this is something that is a big deal.

It affects more people in the country than any other disease.

He also told us the Jingle Bell Run is more than just a way to raise money.

An event like this is great because they can be around other people who understand what theyre going through. They can celebrateliving and saying yes to doing more things, explained Haverlock.

Taking place in more than 100 cities nationwide, with Columbus being a Top Five Race, the Arthritis Foundations Jingle Bell Run benefits the more than 54 million Americans (1 in 4 adults), including 300,000 children (1 in every 250), living with arthritis every day.

From funding cutting-edge research for new treatments and ultimately a cure, to advocating for health care access, the Arthritis Foundation helps those living with arthritis score everyday victories, one step at a time.

To learn more visit JBR.org/Columbus or contact the Arthritis Foundation at 614-362-7370

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More than 1,000 participate in annual Jingle Bell Run for arthritis - NBC4 WCMH-TV

Joint pain in winter can be reduced by keeping yourself covered with layers of warm clothes

Joint pain in winter: Arthritis is surely a difficult time for people suffering from arthritis. Not only does joint pain worsen during the cold winter months, patients also experience more joint stiffness and reduced range of motion. Proper health care, diet and lifestyle measures can together help arthritis patients deal with worsening symptoms this time of the year. The link between temperature drop and worsening of joint pain is still unclear and needs more research. However, a few tips and tricks can help improve quality of life and day-to-day functioning in arthritis patients in winter.

Dressing up appropriately by covering yourself top to bottomwith proper layers, can help you keep warm and reducedebilitating joint pain. Wear gloves and extra layers on your knees and legs to keep them warm and protected. Wearing multiple layers protect you from fluctuations in temperature.

Keep yourself warm and covered during the cold winter monthsPhoto Credit: iStock

Also read:Start Your Day With This Golden Drink To Prevent Bloating, Lose Weight And Reduce Joint Pain

Well, this is one important step in all seasons. Drinking sufficient water can prevent muscle cramps, keep your immunity in check and also prevent incidence of diseases. Drinking water time to time can help you be more active. Also, even mild dehydration can make you more sensitive to pain so make sure your water intake is optimum. Apart from drinking water, you can also include chicken soups, bone broth, vegetable soups, bone broth, etc in your diet to keep your hydration in check.

Being overweight or obese can make you feel lazier and less active. An effective way to deal with arthritis pain is by keeping yourself active and alsolosing weight if required. Make sure you exercise regularly. Include both cardio and weight training exercises in your routine. They will keep you warm and prevent worsening of arthritis symptoms. If going to the gym in cold weather seems too difficult a task, then exercise indoors. The idea is to not skip exercising for better management of arthritis.

Also read:Achieve Your Weight Loss Goals This Winter By Adding These Seasonal Fruits To Your Diet

There is nothing more comforting than a warm bath in winter. Warm baths can provide relief to arthritis patients, according to the Arthritis Foundation. Warm baths can relax your muscles and help you feel calm. Just don't step directly in cold after taking the bath. Your body needs some time to normalise temperature after a warm bath. Cover yourself properly before you come out of the bathroom. Similarly, you can also opt for warm compresses in to deal with worsened joint pain.

Warm baths in winter can help in reducing joint pain in arthritis patientsPhoto Credit: iStock

Low levels of Vitamin D in the body can make you more sensitive to pain, especially in winter. Vitamin D deficiency also puts you at risk of osteoporosis. It is recommended to spend some time under the sun. Anything from 15 minutes to half an hour can help your body synthesise some amount of the sunshine vitamin.Besides, include Vitamin D-rich foods like eggs, mushrooms, fatty fish, milk and milk products in your diet. You can also opt for supplements, but only under the supervision of your doctor.

Also read:Signs And Symptoms Of Vitamin D Deficiency; Best Sources Of Vitamin D Other Than Sunlight

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Joint Pain In Winter: 5 Tips To Deal With Joint Pain And Other Arthritis Symptoms In Cold Winter Months - NDTV News

The prevalence of arthritis in children with Down syndrome may be 2 to 3 times greater than previously reported, according to study data presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting, held November 8 to 13, 2019, in Atlanta, Georgia.

Investigators screened children (aged 0-21 years) with Down syndrome at a regional screening clinic, where a detailed musculoskeletal examination was performed by a pediatric rheumatology clinical fellow. Suspected cases of arthropathy of Down syndrome (A-DS) were confirmed by a second physician at an affiliated clinic. Children with arthropathy received treatment according to existing guidelines for juvenile idiopathic arthritis (JIA). Data from a convenience sample of 21 children newly diagnosed with JIA were collected and compared with the Down syndrome cohort.

Over 18 months, 503 children with Down syndrome were screened for arthritis, among whom 18 were newly diagnosed with A-DS. The total number of A-DS cases was 33, including children with a diagnosis prior to screening. Based on these results, prevalence of A-DS was indicated to be 20 in 1000. Significant delay in A-DS diagnosis was observed.

The majority of A-DS cases presented with polyarticular rheumatoid factor negative arthritis, with small joints of the hands and wrists predominantly affected. No children with A-DS were positive for antinuclear antibodies. Erosive changes were reported on radiographs in a significantly greater number of children with A-DS (42%) than with children with JIA (14%; P <.05). In the majority of A-DS cases, erythrocyte sedimentation rate and C-reactive protein levels were not helpful in arriving at a diagnosis.

These data support the addition of a musculoskeletal examination to the health surveillance guidelines for children with Down syndrome. Investigators also proposed a new clinical term to better capture A-DS: DS-associated arthritis. Further research in a larger cohort is necessary to describe the pathogenesis of DS-associated arthritis and to identify biomarkers.

Reference

Foley C, Deely D, MacDermott EJ, Killeen O. Arthropathy of Down syndrome: an under-diagnosed inflammatory joint disease that warrants a name change. Presented at: 2019 ACR/ARP Annual Meeting; November 8-13, 2019; Atlanta, GA. Abstract 1817.

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Prevalence of Arthropathy in Children With Down Syndrome Higher Than Previously Reported - Rheumatology Advisor

BACKGROUND:

Total hip arthroplasty (THA) is a frequently performed, highly successful orthopedic procedure. Although primary osteoarthritis (PA) is the most common reason for (THA), there are several secondary conditions that lead to degenerative hip disease that are successfully treated with THA. The purpose of this study was to examine the incidence of these secondary causes of arthritis (SA) leading to THA and to compare the relative surgical costs, operating times, and hospital length of stay (LOS) for THA done for PA versus SA.

Electronic medical records from 836 continuous patients undergoing primary THA over a 2-year period were reviewed at a single high-volume joint arthroplasty center. Data obtained included age, sex, laterality, diagnosis leading to THA, surgical costs based on hospital fees, operating room time, and hospital LOS. Using operative reports, office visit notes, and radiology reports or images, patients were categorized into PA or SA groupings. PA was defined as osteoarthritis of no other known etiology, whereas SA was defined when a known underlying diagnosis led to degenerative joint disease of the hip. SA included hip dysplasia, post-traumatic arthritis (PTA), avascular necrosis (AVN), inflammatory arthropathy, Perthes disease, and slipped capital femoral epiphysis (SCFE). Means and proportions of the variables from both groups were analyzed and compared using t-tests and chi-squared tests where applicable.

There were 599 patients in the PA group and 237 patients in the SA group. The SA group was significantly younger than the PA group (54.4 years versus 64.0 years; p = 0.0001). The SA cohort had significantly higher mean surgical costs ($29,662 versus $27,078; p = 0.0005), operating room times (189 minutes versus 179 minutes; p = 0.0042), and LOS (4.2 days versus 3.9 days; p = 0.0312). Within the SA group, the hip dysplasia subgrouping had the lowest cost and operating room time, whereas the PTA subgrouping had the highest cost and operating room time.

More than a quarter of primary THAs are performed due to secondary arthritis, most commonly due to hip dysplasia. Cases of THA due to secondary arthritis are associated with significantly increased hospital costs, operating time, and postoperative length of stay compared to THAs performed for primary osteoarthritis. Patients with post-traumatic hip arthritis may contribute the highest economic burden and present the most complex cases for arthroplasty surgeons.

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Total Hip Arthroplasty for Secondary Causes of Arthritis An Increase in Time and Money - DocWire News

Despite a higher overall frequency of pneumonia and greater use of immunosuppressive therapies, the occurrence of serious pneumonias has decreased in Finnish children with juvenile idiopathic arthritis(JIA) over time, a study shows.

The researchers hypothesized that this may reflect better clinical care and early detection of lung infections in these children.

The work also suggested that active JIA, the presence of comorbidities, or simultaneous diseases, and receiving combination therapy may be associated with an increased risk of developing pneumonia. However, there was no link between the use of immunosuppressants and pneumonia severity.

The study, Decreasing trend in the incidence of serious pneumonias in Finnish children with juvenile idiopathic arthritis, was published in the journal Clinical Rheumatology.

The main treatment goals in JIA today include achieving inactive disease as early as possible in childrens lives and preventing joint damage caused by inflammation. The development of disease-modifying anti-rheumatic drugs (DMARDs) which are designed to block inflammation has significantly improved the lives of children with JIA.

Yet, the immune system suppression that occurs with standard JIA medications, such as DMARDs and glucocorticoids along with the disease itself and the presence of comorbidities have been associated with an increased risk of infections in these children.

A recent analysis of the 15-year period between 1999 and 2014 showed that pneumonia one of the most common serious infections in JIA patients has become more frequent in Finnish children with the disease. That increase has been mirrored by a significant jump in the use of DMARDs in this patient population during the same time period.

Now, that same team of researchers set out to determine the severity of pneumonia in these children, and whether it was associated with the use of immunosuppressive therapy.

The team analyzed data from 59,048 JIA patient-years a measure obtained by multiplying the number of persons per time between 1998 and 2014, using a national patient registry that covers the entire hospital network in Finland. The number of children with JIA per year in the registry varied between 2,292 and 3,575 from 1998 through 2006, and between 3,633 and 4,511 in the years 2007 to 2014.

Pneumonia was classified as serious if the child was hospitalized or given antibiotics directly into the bloodstream. It was deemed hospital-acquired if the illness developed 48 hours or later following hospital admission for reasons other than lung infection.

The results showed 157 pneumonia episodes of which 111 (70.7%) were serious in 140 children with JIA. Only one case was hospital-acquired.

The mean age of children with at least one pneumonia episode was 9.4 years; 83 (59.3%) of the children were girls. Most had either oligoarthritis (45%) or polyarthritis (45.7%).

The rate of serious pneumonia decreased from the first time period 1998 through 2006 to the second, from 20072014. The team hypothesized that this trend may be a result of better contact between patients and the health care system, which would promote earlier detection and treatment of lung infections.

It is also worth noting that a decrease in pneumonia rates has been reported after introduction of pneumococcal vaccination into the Finnish national vaccination program in 2010, the researchers said.

Data also showed that nearly half of the children with pneumonia had active disease, comorbidities with asthma (17.9%) and Down syndrome (7.1%) being the most common and were receiving combination therapy.

At the time of the pneumonia episodes, 86% of the children were receiving DMARDs, with 61.8% receiving methotrexate and 25.8% taking TNF inhibitors. This inhibitors block the activity of TNF-alpha, a pro-inflammatory molecule.

Among the children treated, 15 (10.7%) had recurrent pneumonias; 12 of them had comorbidities. Patients were taking DMARDs during 28 of the 32 (87.5%) recurrent pneumonia episodes.

The team noted that they found no significant association between pneumonia severity and the use of DMARDs or glucocorticoids.

The data showed that, overall, active JIA, comorbidities and combination medication were associated with nearly half of the pneumonias, the researchers said.

Still, future studies are required to confirm these findings and to evaluate the potential association between pneumonia and specific types of JIA, they added.

Clinicians should always keep in mind the possibility of serious infectious complications in these immunocompromised patients, the investigators said.

Less Severe Pneumonias Over Time in Finnish Children With JIA, Study Shows

Marta Figueiredo holds a BSc in Biology and a MSc in Evolutionary and Developmental Biology from the University of Lisbon, Portugal. She is currently finishing her PhD in Biomedical Sciences at the University of Lisbon, where she focused her research on the role of several signalling pathways in thymus and parathyroid glands embryonic development.

Total Posts: 11

Jos is a science news writer with a PhD in Neuroscience from Universidade of Porto, in Portugal. He has also studied Biochemistry at Universidade do Porto and was a postdoctoral associate at Weill Cornell Medicine, in New York, and at The University of Western Ontario in London, Ontario, Canada. His work has ranged from the association of central cardiovascular and pain control to the neurobiological basis of hypertension, and the molecular pathways driving Alzheimers disease.

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Severe Pneumonia in Finnish Children With JIA Has Decreased Over Time, Study Shows - Juvenile Arthritis News

A working group of rheumatologists and rheumatology professionals convened to update the American College of Rheumatology (ACR) recommendations for rheumatoid arthritis (RA) disease activity measures by identifying 11 measures that met the minimum standard and 5 that were preferred for regular use in clinical settings, according to a systematic literature review published in Arthritis Care & Research.1

Researchers examined articles published between January 2009 and January 2017 on the Ovid Medline, EMBASE, and Cochrane databases. Study details and psychometric properties were abstracted, and study quality was assessed by the Consensus-Based Standards for the Selection of Health Measurement Instruments 4-point scoring template. Psychometric properties for each RA disease activity measure were classified as strong, moderate, limited, conflicting, or unknown level of evidence. Researchers also considered prior literature performed as part of the 2012 ACR RA Disease Activity Recommendations.2 They scored feasibility of RA disease activity measures on a scale of 0 to 4, with scores 1 indicating measures feasible for regular use and scores of 4 indicating the most feasible measures.

During the selection process, researchers identified 2 recommendations on RA disease activity measures for use in clinical settings: measures that met a minimum standard for regular use and measures with the most favorable psychometric properties and feasibility for preferred use.

Of the 5199 articles identified, 110 met the study inclusion criteria. Data included in these studies indicated that patients were mostly women with a mean age 60 years.

The search resulted in 47 disease activity measures, based on patient-reported, provider assessment, laboratory, and imaging data. Clinical Disease Activity Index (CDAI), Disease Activity Score (DAS) 28, Multibiomarker Disease Activity (MBDA) score, Routine Assessment of Patient Index Data (RAPID) 3, and Simplified Disease Activity Index (SDAI) were the most frequently studied RA disease activity measures, with a strong level of evidence. Among 25 measures scored for feasibility of regular use, 11 (44%) received the highest grading score of 4, 6 measures (24%) received a score of 3, 5 (20%) received a score of 2, and 3 (12%) received a score of 1.

Researchers found that 11 measures, including CDAI, DAS, DAS28-erythrocyte sedimentation rate/C-reactive protein (ESR/CRP), Patient Derived DAS28, Hospital Universitario La Princesa Index, MBDA (MBDA score, VECTRA), Rheumatoid Arthritis Disease Activity Index (RADAI), RADAI-5, RAPID3, RAPID5, and SDAI, met the minimum criteria for RA disease activity measures for regular use. Among these, CDAI, DAS28-ESR/CRP, RAPID3, and SDAI were part of the prior ACR recommendations for RA disease activity measures.

According to results from the modified Delphi voting process, 4 measures, including CDAI, DAS28, RAPID3, and SDAI (mean scores, 8.8, 7.6, 7.6, 7.6 [range, 2.6-5.6], respectively), met the criteria for RA disease activity measures for preferred use. The ACR Quality Measures Subcommittee added another recommendation to these measures, based on its feasibility, current use, and strength of inclusion in previous ACR recommendations: Patient Activity Scale-II.

These recommendations can assist clinicians with adhering to a treat-to-target approach for the management of RA but should not be interpreted as dictating the proper measure to be used in individual circumstances or clinical practices. As additional measures are developed and performance of measures is further characterized, these recommendations should again be evaluated, the researchers concluded.

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

References

1. England BR, Tiong BK, Bergman MJ, et al. 2019 update of the American College of Rheumatology recommended rheumatoid arthritis disease activity measures [published online November 11, 2019]. Arthritis Care Res. doi:10.1002/acr.24042

2. Anderson JK, Zimmerman L, Caplan L, Michaud K. Measures of rheumatoid arthritis disease activity: Patient (PtGA) and Provider (PrGA) Global Assessment of Disease Activity, Disease Activity Score (DAS) and Disease Activity Score With 28Joint Counts (DAS28), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), Patient Activity Score (PAS) and Patient Activity ScoreII (PASII), Routine Assessment of Patient Index Data (RAPID), Rheumatoid Arthritis Disease Activity Index (RADAI) and Rheumatoid Arthritis Disease Activity Index5 (RADAI5), Chronic Arthritis Systemic Index (CASI), PatientBased Disease Activity Score With ESR (PDAS1) and PatientBased Disease Activity Score Without ESR (PDAS2), and Mean Overall Index for Rheumatoid Arthritis (MOIRA) [published online November 7, 2019]. Arthritis Care Res. doi:10.1002/acr.20621

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Updated 2019 ACR Recommendations for Rheumatoid Arthritis Disease Activity Measures - Rheumatology Advisor

A research team led by biomedical scientists at the University of California, Riverside, has found that a drug approved by the FDA to treat rheumatoid arthritis and ulcerative colitis can repair permeability defects in the guts epithelium.

Affecting roughly 1 million Americans, ulcerative colitis is a chronic inflammatory bowel disease of the large intestine in which the lining of the colon becomes inflamed and leaky. Affecting more than 2 million Americans, rheumatoid arthritis is an autoimmune disease in which the bodys immune system attacks the joints.

The study is the first to show the drug, tofacitinib, also called Xeljanz, has a direct effect on cells lining the gut by correcting defects that occur in inflammation. Until now, the effects of tofacitinib on intestinal epithelial cell functions were largely unknown.

Our work increases our understanding of how this drug is useful for treating ulcerative colitis, said Declan McCole, a professor of biomedical sciences in the UCR School of Medicine, and the lead author of the study that appears in the journal Inflammatory Bowel Diseases. We now better understand where in the gut the drug is working, and how.

McCole explained that increased intestinal permeability or leakiness is a feature of ulcerative colitis and plays a critical role in promoting inflammation. His team tested tofacitinib in human intestinal epithelial cell lines, as well as in organoids, or colonoids, that were derived from primary human colonic stem cells isolated from human subjects primarily patients undergoing elective colonoscopy for colon cancer screening and found tofacitinib repaired inflammation-induced permeability defects in both.

The epithelium is a thin layer that lines the alimentary canal. The gastrointestinal epithelium is comprised of cells that have gaps between them, making them selectively permeable and providing a barrier that keeps out pathogens, toxins, and antigens from entering the gut, while allowing the absorption of nutrients. In ulcerative colitis, this epithelial permeability becomes leaky, allowing bacterial products to cross into the gut and nutrients and water to leak out. This, in turn, triggers immune responses, resulting in fluid loss and diarrhea.

We found tofacitinib fixes the leakiness in the intestinal barrier, McCole said. Specifically, it fixes intestinal epithelial permeability defects caused by interferon-gamma, an inflammatory cytokine involved in autoimmune diseases such as ulcerative colitis and rheumatoid arthritis.

By targeting specific molecules, the drug inhibits a pathway that is activated by inflammation, said Anica Sayoc-Becerra, a graduate student in the Biomedical Sciences Graduate Program, a member of McColes lab, and the first author of the research paper. Our study shows tofacitinib is not just acting on immune cells, as was first thought, but can have a direct effect on the epithelial cells that are the key factor in maintaining gut barrier function.

A major focus of McColes lab is PTPN2, a protein-coding gene associated with autoimmune diseases such as Crohns disease, ulcerative colitis, and rheumatoid arthritis. Individuals with mutations in this gene that cause it to lose function have an increased risk of getting these diseases. McColes research group was the first to identify PTPN2 normally helps to protect the barrier function of the epithelial cells that line the gut.

A patient that has a PTPN2 loss-of-function mutation is predicted to have a leakier gut, McCole said. Rather than trying to repair PTPN2, my lab was successful in inhibiting some of the consequences of the loss-of-function mutation in this gene.

Sayoc-Becerra explained PTPN2 deactivates the same signaling pathway as tofacitinib.

We thought tofacitinib might be a very effective way of correcting the defects that occur from the loss-of-function mutations of PTPN2 without having to introduce new genes into a cell, animal, or patient, she said.

McCole and Sayoc-Becerra were joined in the study by UC Riversides Moorthy Krishnan, Jossue Jimenez, Rebecca Hernandez, Kyle Gibson, and Reyna Preciado; as well as Shujun Fan and Grant Butt of the University of Otago in New Zealand. Sayoc-Becerra expects to graduate with her doctoral degree in December 2019. This is her first paper as first author.

Next, the researchers plan to identify specific patients who may derive the greatest benefit from the drug. This will allow more targeted treatment of patients likely to be good responders to tofacitinib in a personalized medicine approach to treating this disease.

Reference:Sayoc-Becerra, et al. (2019) The JAK-Inhibitor Tofacitinib Rescues Human Intestinal Epithelial Cells and Colonoids from Cytokine-Induced Barrier Dysfunction.Inflammatory Bowel Diseases DOI: https://doi.org/10.1093/ibd/izz266

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

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Drug Decreases Gut Leakiness Linked to Ulcerative Colitis - Technology Networks