StemCell Therapy

Each Tuesday, Doctor Rob Riley joins us to answer viewers' medical questions. Here are the questions he addressed on April 18.

"I had a total thyroidectomy back in August. My scar turned into a keloid. What can I do to make the keloid go away?"

Dr. Riley: Keloids are thickened scars. When most people have surgery, the scar that forms can be pretty thin and flat and tends to fade over time. But some of us, due to our genetics, form big, thick keloids instead. They don't generally do harm, but understandably, people don't like the way they look. Silicone sheets can be obtained at the drug store without a prescription and may help keloids to flatten over time. In the office, we can inject these keloids with a cortisone-like preparation which is often effective. There's some evidence to suggest that freezing keloids in the office may be helpful, too. Unfortunately, surgically cutting the keloid out usually results in a new keloid forming, so that's usually tried as a last resort.

"I just found out I have arthritis so bad in my one knee it's bone on bone. I am taking meloxicam and starting therapy soon. Any other over-the-counter meds that will help this?"

Dr. Riley: Meloxicam is an anti-inflammatory medicationlike ibuprofen or naproxen. Some people find they do just as well or better with these over-the-counter meds as they do with the prescription versions. There's also something called capsaicin, which comes as a cream or gel, which can be applied directly over the painful joint several times daily, and some people get some relief from that. When things get to the bone on bone point, we certainly try all the medications possible plus physical therapy, but often times that's when we start to have the conversation about considering knee replacement surgery.

"I have a tender spot on the back of my right ankle that only hurts when I wear tennis shoes. What could that be?"

Dr. Riley: The most common causes of pain in that location are irritation of the Achilles tendon and bursitis from pressure on the little sac that sits just beneath the Achilles tendon. The tendon tends to hurt when the person is using that big calf muscle on the back of their leg, while the bursa is often tender to direct pressure in the area. Both of these are overuse issues, though, so the best initial approach is to back off on painful activity somewhat and give things a chance to heal. If a certain pair of shoes seems to make things worse, then probably the shoes are applying too much pressure in that area and should be avoided. If the simple things aren't taking care of things, a visit to the doctor may be in order. Some medications, some home exercises, and working with a physical therapist may all be effective for this problem.

Dr. Riley joins us from Memorial Family Medicine.

Continue reading here:
Ask the Doctor: Keloids, arthritis, ankle tenderness - WNDU-TV

UA softball Coach Mike Candrea hopes to hit a home run in support of the University of Arizona Arthritis Center and its research efforts at the 2017 Bear Down Luncheon on April 26.

The affiliation between Wildcat athletics and the UAAC is a long-standing tradition that goes back to the early days of Lute Olson. Supporting the UAACs mission and efforts to defeat arthritis as a debilitating disease is a privilege for me, said Candrea, featured speaker at the event.

An eight-time NCAA champion who will be inducted into the coaching Hall of Fame this October, Candrea will share anecdotes and insights gleaned during 32 seasons. Candreas talk is sure to be unforgettable, said Paul Cicala, sports director at KVOA, who will serve as master of ceremonies.

I feel honored to be able to introduce Mike Candrea, who has had an amazing coaching career: He is a UA standout and he is going out of his way, along with doctors at the UAAC, to help others, said Cicala, one of the more than one million Arizonans battling arthritis.

Cicala, who has psoriatic arthritis, said he is proof arthritis impacts those of every age, including children and young adults. Psoriatic arthritis is a chronic inflammatory disease that occurs when the immune system mistakenly begins attacking healthy joints and skin.

I was in my mid-20s and in the best shape of my life. I could still dunk a basketball and I was lifting weights every day when I started having sharp pains in my legs that spread to the rest of my body. My digits on my hands and feet started swelling and they tested me for multiple sclerosis and many other ailments, but they never considered psoriatic arthritis, said Cicala.

Cicalas condition deteriorated rapidly. Walking caused extreme pain, he was unable to open jars or complete simple household tasks and it became increasingly difficult to work. When he was finally diagnosed with psoriatic arthritis, Cicala said the medications Enbrel and Methotrexate saved his life.

I am almost back to being the person I used to be and I am so thankful to the UAAC and all of the fine doctors who continue to do research to find treatments for arthritis. To this day I dont take walking for granted; I take pride in walking when I run errands, walking up A Mountain or Tumacoc Hill and doing other things I thought were taken away forever, he said.

Dr. C. Kent Kwoh, arthritis center director, said the center offers specialized care for patients who are living with cutaneous autoimmune diseases such as psoriatic arthritis, lupus, and scleroderma.

Kwoh said the centers multi-disciplinary approach, which includes bench-to bedside research, also utilizes specialists in orthopedic surgery, geriatrics, immunology, medical imaging, pharmacology, integrative medicine, epidemiology, public health, exercise, nutritional sciences, podiatry and biomechanics.

The list of specialists is expanding with the recruitment of new physicians and the centers ongoing distinction as Arizonas only rheumatology training program for medical students, medical residents and fellows. Kwoh attributes many positive developments to the partnership between Banner and University Medical Center and the continued support of the community and institutions such as the UA Department of Athletics.

There is a shortage of rheumatologists nationwide and here in Tucson. We want to continue to expand our programs to try to meet the need for caring for patients with arthritis in clinics where different specialties can practice together to provide specialized care in an academic medical center. This allows patients to see a number of specialists at the same time or on the same day, which is particularly important for patients with arthritis because these are multi-system diseases, Kwoh said.

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UA softball coach pitches in for arthritis center fundraiser - Arizona Daily Star

By Teresa Rivas

Incyte Corp. (INCY) and Eli Lilly (LLY) are both falling Monday, on news that the FDA issued a complete response letter concerning its rheumatoid arthritis treatment baricitinib, delaying approval.

The FDA didnt kill the drug, but it didnt approve it either, saying that more clinical trials would be needed to determine the correct dosage. Of course, more trials will increase the time and money that the companies will have to spend on baricitinib before its approval. Incyte and Lilly both said they are committed to working with the agency to get approval.

Plenty of analysts are weighing in on the stocks today.BMO Capital Markets M. Ian Somaiya reiterated an Outperform rating but cut his price target on Incyte to $144 from $170:

We are pushing out U.S. launch timelines for baricitinib by three years following CRL where FDA cited need for additional dosing and safety data, implying need for new trials. In our conversation, management suggested that the issue in the CRL was not raised previously by the FDA, nor was it the reason for the recent data submission. Our review of published data suggests that the issue could be related to increase in creatinine phosphokinase (CPK), which can be causing drug-induced myopathy (i.e., alectinib) and addressed via a REMS.

SunTrust Robinson Humphreys Peter Lawson reiterated a Buy rating but cut his price target from $160 to $145:

On Friday the FDA issued a complete response letter (CRL) for the NDA for baricitinib in moderate-to-severe rheumatoid arthritis (RA). This was unexpected considering the strength of the data which was published in highly respected medical journals, and the recent EU approval. The FDA is seeking additional clinical data to determine dose, and to further characterize safety. While still early, we have re-assessed our model, we have assumed a conservative 2 year delay in filing, lowered the probability of success in the U.S, and removed milestone payments.

Raymond Jamess Reni Benjamin reiterated a Market Perform rating on Incyte:

While the timing of the FDAs decision was on the PDUFA date, the CRL certainly came as a surprise to us and, we expect, many other investors given the recent approval of the drug by the European agency as well as the multiple positive phase III results generated during clinical development. Whats more surprising and concerning to us is the agencys request for additional clinical data to determine the appropriate doses and further address the safety concerns associated with the drug, a decision that both companies plan to appeal.

As for Eli Lilly, Credit Suisses Vamil Divan reiterated an Outperform rating but lowered his price target by $1 to $87:

While we like LLY for its diversified new product story, baricitinib is a key component of the story and the press release reads ominously to us. The FDA is requesting additional clinical data to determine the most appropriate doses and also to characterize safety concerns across various treatment arms. The timing of a resubmission is still to be determined but for now we assume it will take at least 12 months, pushing back a US launch to potentially 2019 or later. It will likely also limit the peak potential of the product given the competitive nature of the rheumatoid arthritis market and the fact that we expect PFEs Xeljanz will lose it US patent exclusivity by 2025, opening the door for generic oral JAK inhibitors to enter the US marketOur updated baricitinib estimates, including a 2019 US launch and peak 2025 sales of $1.2Bn in the US and $2.1Bn globally, led to our LLY target price reduction to $87 (from $88).

Incyte is down 11.2% to $125.03 in recent trading, while Eli Lilly is down 3.9% to $82.52.

See the original post:
Incyte, Eli Lilly Tumble As FDA Delays Arthritis Drug Approval - Barron's (blog)

Eli Lilly & Co. (LLY) and Incyte (INCY) chose to disclose the FDA rejection of their rheumatoid arthritis pill baricitinib on Friday, a market holiday, so the repercussions from the regulatory setback are hittingboth stocks Monday.

Lilly shares were down just over 4% to $ 82.33through mid-morningtrading, while Incyte shares were down just over 11% to $125.09

Baricitinib was expected to secure U.S. approval and deliver $2 billion or more in peak sales as the most effective, once-daily oral JAK inhibitor for rheumatoid arthritis, supplanting Pfizer's (PFE) Xeljanz.

Those plans are now on hold indefinitely. In a statement, Lilly said the FDA's complete response letter included a request for additional clinical data to determine appropriate doses of baricitinib. The FDA also asked for more safety data.

Lilly and Incyte said they disagree with the FDA's conclusions and plan to resubmit baricitinib for another shot at approval. A timeline for resubmission was not provided.

The European Medicines Agency approved baricitinib for the treatment of rheumatoid arthritis in February. The drug is marketed there under the brand name Olumiant.

Piper Jaffray analyst Josh Schimmer downgraded Incyte to neutral and cut his price target to $124 from $140. "Incyte has a differentiated flagship product in Jakafi, a leading management team, a strong R&D engine and strategic sense, and still strong growth prospects. But baricitinib in the U.S. was an important part of the valuation and outlook for us," Schimmer wrote, in his downgrade note.

Leerink analyst Michael Schmidt said baricitinib contributes 18%, or $25, to his Incyte $141 price target. "We expect Incyte shares to be weak on Monday given that approximately one-year U.S. approval delay now seems likely in our view, in a best case scenario," Schmidt said in a research note.

Lilly licensed baricitinib from Incyte in 2009. The pharma giant took the lead on the drug's development, conducting all the clinical trials and handling regulatory duties. Lilly retains the bulk of baricitinib's sales under the Incyte licensing deal, so the FDA rejection hits the pharma giant -- desperate for new blockbuster drugs -- particularly hard.

Lilly reiterated 2017 earnings guidance but has not said how the baricitinib setback will impact its 2018 financial outlook.

Why FDA turned away baricitinib is not entirely clear, although analysts speculate regulators picked up a concerning safety signal with the higher 4 mg dose. Pfizer faced the same problem with Xeljanz before FDA ultimately approved a lower dose.

Excerpt from:
Lilly and Incyte Fall After FDA Rejects Potential Blockbuster for ... - TheStreet.com

New Delhi, April 17:

Drug firm Unichem Laboratories today said it has received approval from the US health regulator for Piroxicam capsules, used in the treatment of osteoarthritis and rheumatoid arthritis, in the US market.

In a BSE filing, Unichem Laboratories said it has received ANDA approval from the US Food and Drug Administration (USFDA) for Piroxicam Capsules USP 10mg and 20mg.

The approved product is therapeutically equivalent to Feldene Capsules 10mg and 20mg of Pfizer Inc.

Piroxicam is a non-steroidal anti-inflammatory drug (NSAID) indicated for relief of the signs and symptoms of osteoarthritis (OA) and rheumatoid arthritis (RA).

Unichem Laboratories said the product will be commercialised from its Goa plant.

Active Pharmaceutical Ingredient will also be made in-house at Roha API Plant, it added.

Shares of Unichem Laboratories were trading 1.49 per cent higher at Rs 290 on BSE.

(This article was published on April 17, 2017)

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Unichem Labs gets USFDA nod for arthritis drug - Hindu Business Line

Over 20 years, patients given drugs were apparently more able to walk, get dressed and less likely to die

RHEUMATOID arthritis sufferers given early and aggressive treatment have better and longer lives, researchers say.

Experts studied 602 patients with one in four receiving drugs within six months of showing symptoms.

Alamy

Over 20 years they were more able to walk, get dressed and less likely to die, said teams from Manchester and East Anglia Universities.

Author James Gwinnut said: Though there is a broad range in terms of how people are affected by the disease, the number of patients whose lives have improved has increased thanks in part to early treatment.

The good news is that early intervention has become more and more common in the NHS over these past 20 years.

Alamy

Dr Natalie Carter, head of research liaison and evaluation at Arthritis Research UK, added: This study confirms how important early diagnosis and the commencement of treatment is.

It is also encouraging to hear about the progress that has been made over the last 20 years.

Now the scientific community must continue to build on this so that together we can continue to harness the power of exceptional science and make everyday life better for all people with arthritis.

Biomedcentral.com

The study was published in Arthritis and Rheumatology.

There are 400,000 Brits with incurable rheumatoid arthritis.

It causes inflammation in your joints with main symptoms being joint pain and swelling and flare ups.

The incurable disease leads to progressive joint destruction which leads to disability and premature death.

Excerpt from:
Rheumatoid arthritis sufferers given early and aggressive treatment live 'better and longer lives' - The Sun

LINDA A. JOHNSON, AP Medical Writer 1:09 p.m. ET April 14, 2017

Eli Lilly made the list.(Photo: Joe Vitti/IndyStar)Buy Photo

Eli Lilly said U.S. regulators have rejected its much-anticipated pill for the immune disorder rheumatoid arthritis, the drugmakers second drug development setback since November.

The Food and Drug Administration said in a letter to the company that it needed more information about the drugs safety and the best doses, Lilly said Friday in a statement.

Lilly said it disagrees with FDAs conclusions but will work with the agency on a plan to eventually get the drug, baracitinib, approved for U.S. patients.

In November, Lillys experimental medicine solanezumab flopped in a closely watched test in patients with mild Alzheimers disease, after having already failed in testing in patients with more advanced Alzheimers.

The arthritis drug, which has the proposed brand name Olumiant and was approved for use in Europe in February, was expected to be a big seller in part because most other new rheumatoid arthritis drugs are injected, making them less appealing for patients.

Christi Shaw, president of the Lilly division that developed the drug, said the company remains confident in the drugs ability to safely treat moderate and severe rheumatoid arthritis.

About 23 million people worldwide, three-fourths of them women, have rheumatoid arthritis, a chronic disorder in which the immune system attacks the bodys tissues. It causes painful swelling and progressive destruction of joints, which can leave them deformed and, in severe cases, lead to disability. It can also damage other body parts, including the skin, eyes, lungs, heart and blood vessels.

Eli Lilly & Co. and Incyte Corp., its partner in developing baracitinib, applied for FDA approval of the drug in January 2016. Normally the review process takes 10 months, but this January, FDA said it needed three additional months to review more information. Still, drug industry analysts as recently as this week were advising clients that approval of baracitinib was likely.

Despite the setback, Lilly reaffirmed its 2017 financial forecasts Friday, for earnings per share of $2.69 to $2.79, excluding one-time items, and revenue between $21.8 billion and $22.3 billion. It said Incyte, which is based in Wilimington, Delaware, was evaluating the rejections impact on its position and would update investors when it reports first-quarter results, likely in mid-May. Lilly is expected to report its quarterly results on April 25.

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Feds reject Lilly's rheumatoid arthritis pill - Indianapolis Star

Patients with rheumatoid arthritis who receive pedometers may be more active and feel less fatigued even if they are not told to use the trackers to aim for a specific number of steps, a small study suggests.

All 96 study participants had rheumatoid arthritis, an immune system disorder that causes debilitating swelling and pain in the joints. Researchers randomly assigned patients to get a pedometer with or without a daily step goal, or to get only educational brochures with advice on becoming more active.

After 21 weeks, all of people with pedometers were walking more on average each day: 1,441 additional steps without a step goal and 1,656 extra steps with a goal. But the patients who didnt get pedometers actually got 747 fewer steps a day on average by the end of the study.

Patients with pedometers reported statistically meaningful declines in fatigue during the study, but people who only got education did not.

We found that increasing activity just through walking decreased fatigue, said lead study author Dr. Patricia Katz of the University of California, San Francisco.

Most of us probably dont realize how inactive we are until we start measuring our daily activity, Katz said by email. Having a concrete goal, such as the number of daily steps, seems to help people become and stay active.

Every patient received the same educational brochure at the start. In the two groups that received pedometers, all of the participants were asked to keep a daily diary to record how many steps they logged.

For one group with pedometers, researchers also assessed their activity levels at the start of the study and set goals for them to increase their average daily steps by 10 percent every two weeks.

At the start of the study, participants were 54 years old on average and were typically getting about 4,891 steps a day, which researchers classified as sedentary. Very few of them were getting at least 8,000 steps a day, which the researchers say is a healthy activity level.

Beyond its small size, another limitation of the study is that researchers lacked data on how often participants wore the devices, which makes it difficult to get an accurate daily step count, the authors note in Arthritis Care and Research.

Its also possible that the pedometer groups might not have improved as much if they hadnt also been recording their steps in a daily diary, which increases their engagement with the effort to be more active, said Dr. Mitesh Patel, a researcher at the University of Pennsylvania in Philadelphia who wasnt involved in the study.

Research indicates that for most people, pedometers and wearable devices are more likely to help change health behaviors if they are combined with an engagement strategy, Patel said by email.

Generally, pedometers are most useful for people who are sedentary and unaware of their own level of inactivity, said Dr. Lucas Carr, a physiology researcher at the University of Iowa who wasnt involved in the study.

This relatively simple intervention helped a very sedentary group of rheumatoid arthritis patients increase their activity at a level that is considered clinically significant, Carr said by email. The largest health benefits are realized when an individual changes from doing nothing to doing something.

While the study included only people with rheumatoid arthritis, its possible pedometers might be useful for people with other chronic medical problems, said Dr. David Geier, an orthopedic surgeon sports medicine specialist in Charleston, South Carolina who wasnt involved in the study.

It seems reasonable to think they could help stimulate activity, Geier said by email. Physical activity would be helpful for almost everyone.

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Pedometers tied to less fatigue for rheumatoid arthritis patients - Geo.tv - Geo News, Pakistan

(CBS News/AP) -

Drug company Eli Lilly says their much-awaited pill forrheumatoid arthritishas been rejected by the Food and Drug Administration. Its the companys second drug development setback since November.

A letter to the company from the FDAsaid that they needed more information about baricitinibs safety and the best doses, Lilly said Friday in a statement.

The drugmaker disagrees with FDAs conclusions but will work with the agency on a plan to eventually get baracitinib approved for U.S. patients.

In November, Lillys experimental medicinesolanezumabflopped in a closely watched test in patients with mildAlzheimers diseaseafter already failing in patients with more advanced Alzheimers.

The arthritis drug, which has the proposed brand name Olumiant and was approved for use in Europe in February, was expected to be a big seller in part because most other new rheumatoid arthritis drugs are injected, making them less appealing for patients.

We are disappointed with this action, said Christi Shaw, president of the Lilly division that developed the drug, in the companys statement, adding that the company remains confident in the drugs ability to safely treat moderate and severe rheumatoid arthritis.

About 23 million people worldwide -- three-fourths of them women -- have rheumatoid arthritis, an autoimmune disorder that happens when the immune system mistakenly attacks a persons own body tissues. The chronic disorder causes painful swelling and progressive destruction of joints, which can leave them deformed and, in severe cases, lead to disability. It can also damage other body parts, including the skin, eyes, lungs, heart and blood vessels.

Rheumatoid arthritiscan strike at any age, but typically begins between the ages of 40 and 60, and if someone in your family has had it, your odds for the condition may be higher.

Eli Lilly & Co. and Incyte Corp., its partner in developing baracitinib, applied for FDA approval of the drug in January 2016. Normally the review process takes 10 months, but this January, FDA said it needed three additional months to review more information. Still, drug industry analysts as recently as this week were advising clients that approval of baracitinib was likely.

Despite the setback, Lilly reaffirmed its 2017 financial forecasts Friday, for earnings per share of $2.69 to $2.79, excluding one-time items, and revenue between $21.8 billion and $22.3 billion. It said Incyte, which is based in Wilimington, Delaware, was evaluating the rejections impact on its position and would update investors when it reports first-quarter results, likely in mid-May. Lilly is expected to report its quarterly results on April 25.

2017 CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.

Excerpt from:
FDA rejects drugmaker's much-anticipated arthritis pill - | WBTV ... - WBTV

Lifestyle HEALTH LINES: Arthritis common condition, but not easily understood by all

WILLIAM PILLOW

Arthritis is a condition that is very common, but not well understood by most. It is not a single disease. There are actually more than 100 types of arthritis.

More than 50 million adults and 300,000 children have some type of arthritis. It is more common in women and is the leading cause of disability in America. Common arthritis complaints are joint pain, swelling and stiffness.

Inflammatory arthritis (rheumatoid, lupus) is an overreaction of the bodys immune system. The body attacks the cartilage and destroys it. Metabolic joint disease (gout) occurs when crystals are deposited in the joints and cause acute pain. These are best treated by a primary care physician, nurse practitioner or specialist (rheumatologist) with medications and changes in diet. Blood tests are often used in the diagnosis.

Osteoarthritis (wear and tear arthritis) is the most common type. Cartilage is the thick cushioning surface on the ends of bones. With time this cartilage can wear down (thinning/mild arthritis) and progress to the point where bone rubs on bone (severe arthritis).

Orthopaedic Sports Medicine has significantly advanced the diagnosis and treatment of arthritis. As a physician at NEO Sports Medicine, I am often asked when someone should seek medical treatment. Anyone in their teenage years or younger with a joint that stays swollen for more than a few days should be seen urgently to rule out cartilage damage or juvenile rheumatoid arthritis.

Mild non-traumatic joint pain in someone 30 or older can start initial treatment with weight loss, anti-inflammatory medication (Aleve, Advil, Tylenol), and reasonable exercise that does not cause pain. Primary care physicians can prescribe stronger anti-inflammatories.

If this does not provide relief, a referral to an orthopaedist is the next step. Patients should not assume an appointment means imminent surgery. X-rays will give the doctor a good idea of the condition of the joint. At NEO Sports Medicine, physicians look at the whole person not just a joint. Many times a course of physical therapy to strengthen the muscles (the shock absorbers of a joint) will help. A steroid injection into the joint can also provide relief. Braces can also be used on a short-term basis to give the joint a rest.

Joint pain is not always arthritis. Torn cartilage can often be repaired with an outpatient arthroscopic surgery using a small camera that is quite minor. An MRI can be helpful to get a better picture of the joint. For major joint damage that has failed conservative treatment, a joint replacement can provide life-changing relief. Replacements are available for the knee, hip, shoulder and even finger joints.

Modern joint replacements are now meant to last longer than 15 years and can allow patients to get back to a more active lifestyle. My partners and I provide accurate diagnoses and seek to exhaust all forms of conservative treatment. If surgery is indicated, we provide minimally invasive joint surgery to get patients back to the lifestyle they desire.

Dr. William Pillow is an orthopedic surgeon at North East Orthopaedics and Sports Medicine.

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HEALTH LINES: Arthritis common condition, but not easily ... - Northeast Mississippi Daily Journal

Sandra Quinn Journalist and editor living with psoriatic arthritis

I SUFFER FROM psoriatic arthritis. Its a bit of a pain, literally, and often decides to flare up at the most inconvenient times.

It is the best form of arthritis to have in fairness, as it is not degenerative. It can be treated effectively with weekly injections, steroids, medication to prevent stomach ulcers, pain killers, anti-inflammatories and a host of other things.

My diagnosis

I was diagnosed when I was in college at the age of 19.It is a dehabilitating and life-long auto-immune disease, which when flared up causes severe pain, swelling and reduced mobility in my major joints, with my hips, spine, shoulders and knees being the worst affected.

The disease is relatively well controlled through a strict cocktail of daily maintenance drugs and weekly injections. Then for the flare-ups, which are unpredictable in nature, severity and duration, there are stronger medications, such as painkillers, anaesthetic topical patches (like plasters), anti-inflammatories, steroids and more.

It is very much an invisible illness because I look and appear to be fine and while I may be in a lot of pain, I would often still try to be in good form.

People often tell me I seem fine, not realising that they only see me when Im well enough to be seen. If I am really bad and in a lot of pain, I will be at home in bed hiding away from the world.

Managing flare ups

So, when it flares up, I have a list (its intimidatingly long to be frank) with a secondary bag of medication to match, which I can refer to and there are stages and steps to follow.

I have been going through the motions of the first steps since last week and all was going according to plan-ish, until I woke at 5am on Saturday (never a good sign) and had an upset stomach and bouts of vomiting from the severe waves of pain coming over me.

As it was a Saturday and my own GP practice was closed, I rang SouthDoc and got great medical advice and help. But as they were in Mallow and I was in Rockchapel (both in Cork, but a good 40-minute drive away from each other), it was not practical for me to go there, with the possibility of then having to go onto Limerick to the hospital.

I rang my own GP and left messages. Then I rang the assigned 24 hour rheumatology nurse specialist, then the rheumatology secretary and then the hospital itself.

No service available until Monday

The upshot of all those calls and chasing people was that there is no rheumatologist on call and the service is not available until Monday.

Armed with that knowledge, I assessed what SouthDoc had told me and started a process of self-medication and dosage.

The options were to self-medicate in the comfort of my own home or go to hospital, where they would only be able to give me pain relief, but nothing to treat the direct source of the flare up, without consulting a rheumatologist.

So, I ask you, is it fair or right that anyone with a severe illness or disability has to schedule their flare ups to tie in with the supposed schedule of Monday to Friday, 9 to 5, within business hours service of specialist care?

Its unacceptable

I think this story will evolve quite a lot, as it is clearly unacceptable in this day and age to only have access to vital medical experts and services within regular business hours.

I appreciate that people need time off and that services have wind down times, but the health system should not be one of those un-manned areas.

Sandra Quinn is a journalist and editor. Shes from Cork and lives in Limerick. Youll find her personal blog over onwww.quinnsquandries.blogspot.ie, while her work has been published in daily and weekly local, regional and national publications.

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Psoriatic arthritis: 'It is very much an invisible illness because I look and appear fine' - thejournal.ie

Drug company Eli Lilly says their much-awaited pill for rheumatoid arthritis has been rejected by the Food and Drug Administration. Its the companys second drug development setback since November.

A letter to the company from the FDA said that they needed more information about baricitinibs safety and the best doses, Lilly said Friday in a statement.

The drugmaker disagrees with FDAs conclusions but will work with the agency on a plan to eventually get baracitinib approved for U.S. patients.

In November, Lillys experimental medicine solanezumab flopped in a closely watched test in patients with mild Alzheimers diseaseafter already failing in patients with more advanced Alzheimers.

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An investigation into the cost of prescription drugs reveals huge price hikes over the past five years. Several brand name medications more than ...

The arthritis drug, which has the proposed brand name Olumiant and was approved for use in Europe in February, was expected to be a big seller in part because most other new rheumatoid arthritis drugs are injected, making them less appealing for patients.

We are disappointed with this action, said Christi Shaw, president of the Lilly division that developed the drug, in the companys statement, adding that the company remains confident in the drugs ability to safely treat moderate and severe rheumatoid arthritis.

About 23 million people worldwide -- three-fourths of them women -- have rheumatoid arthritis, an autoimmune disorder that happens when the immune system mistakenly attacks a persons own body tissues. The chronic disorder causes painful swelling and progressive destruction of joints, which can leave them deformed and, in severe cases, lead to disability. It can also damage other body parts, including the skin, eyes, lungs, heart and blood vessels.

Rheumatoid arthritis can strike at any age, but typically begins between the ages of 40 and 60, and if someone in your family has had it, your odds for the condition may be higher.

Eli Lilly & Co. and Incyte Corp., its partner in developing baracitinib, applied for FDA approval of the drug in January 2016. Normally the review process takes 10 months, but this January, FDA said it needed three additional months to review more information. Still, drug industry analysts as recently as this week were advising clients that approval of baracitinib was likely.

Despite the setback, Lilly reaffirmed its 2017 financial forecasts Friday, for earnings per share of $2.69 to $2.79, excluding one-time items, and revenue between $21.8 billion and $22.3 billion. It said Incyte, which is based in Wilimington, Delaware, was evaluating the rejections impact on its position and would update investors when it reports first-quarter results, likely in mid-May. Lilly is expected to report its quarterly results on April 25.

2017 CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.

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FDA rejects drugmaker's much-anticipated arthritis pill - CBS News

By TIM TROGLEN Reporter Published: April 16, 2017 12:10 AM

HUDSON -- Paula Phillips will lead her team, "I Give Back," May 13 in the 2017 Walk to Cure Arthritis 5K walk at the Cleveland Metroparks Zoo.

However, Phillips will not only be walking as her team's leader but as a person who has suffered through the torment of arthritis for more than a decade.

In addition, Phillips, of Hudson, will be representing all of Northeast Ohio as the local adult honoree for the annual walk. The organization also honors youth advocates and doctors regionally and locally for their work.

Phillips is being honored for her volunteer work with the foundation after her diagnosis of rheumatoid arthritis in 1999, according to the foundation.

"I'm just there to give back," said Phillips, who also raises funds on her own and was diagnosed with rheumatoid arthritis more than 17 years ago. "I feel I was born to give back."

The Arthritis Foundation, specifically in Northeast Ohio, raises funds to educate, advocate and provide research for those diagnosed and identified with all the forms of arthritis, according to Phillips.

"Seventeen short years ago, I reached out to the Arthritis Foundation of Northeast Ohio as directed by my rheumatologist, Dr. Rochelle Rosian, at the Cleveland Clinic," Phillips said. "Because of the Arthritis Foundation I have never been alone in my pain and suffering which I am sorry to say does occur."

And while Phillips is walking to raise funds for everyone, her heart especially goes out to the the children who suffer with arthritis.

"It really is all about the kids," Phillips said. "They suffer immeasurably."

Phillip's son, Michael, and her husband, Mike, are members of her 10-member team and will join her on the May 13 walk.

According to Phillips, arthritis is the leading form of disability in the country.

"It's a bad thing," she said.

Phillips was shocked when she received the telephone call stating she had been named adult honoree.

"I was surprised," Phillips said. "I don't like to be the focus of attention when it comes to this [arthritis]."

Phillips said she would like to see more people donate until they cannot give anymore or until it hurts, she said.

"For me, that's what I do," she said.

According to Phillips, giving back is not about her but the children suffering, the doctors working to find a cure, the researchers, therapists working to help increase patient quality of life and nurses who take care of the patients. It's also about those who are creating the medication allowing sufferers to function.

"If it wasn't for that [the medications] I would be in a wheelchair right now," she said of the medications. "When you are sick on this journey, with this, you are really sick."

While Phillips has not been able to volunteer a lot lately with various organizations, she has been active in volunteer circles for years. Phillip's volunteer list included being treasurer of the Hudson PTO, Hudson Garden Club, Laurel Lake Retirement Community and is actively involved in Arthritis Foundation of Northeast Ohio and a member of the Cleveland Walk Committee and the First Congregational Church of Hudson.

Phillips still enjoys gardening when she can but cannot spend as much time tilling and weeding as she did in the past.

"I do it all, every single day, the best that I can do," she said.

Phillips' team will be among the thousands of Northeast Ohioans raising money for the Arthritis Foundation May 13. The Cleveland Zoo walk is a 5K walk with a 1-mile option. There will be a wellness expo, music giveaways and a variety family activities.

The walk begins at 9 a.m. with registration beginning at 7 a.m.

Opening ceremonies will begin at 8:30 a.m.

Cleveland Metroparks Zoo is located at 3900 Wildlife Way in Cleveland. Event proceeds support the 1.3 million Northeastern Ohioans suffering from arthritis.

Funds support areas such as advocacy and access to care, juvenile arthritis, help and support tools and critical arthritis research conducted at local institutions throughout Northeastern Ohio.

"Arthritis is the number one cause of disability in America--affecting one in every five adults, an estimated 300,000 children and countless families," according to the foundation's webpage. "The Arthritis Foundation's Walk to Cure Arthritis is an annual event that supports our mission to conquer the disease by spreading awareness and raising money for research aimed at finding a cure."

The Cleveland Walk to Cure Arthritis attracts over 2,200 attendees including corporate, community and family teams, as well as individuals from across Northeastern Ohio whose lives have been affected by arthritis, according to the foundation.

To learn more or to find a team visit http://www.arthritis.org/get-involved/walk-to-cure-arthritis.

Email: ttroglen@recordpub.com

Phone: 330-541-9435

Twitter: @Trog_RPC

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Hudson woman Paula Phillips to be adult honoree at 2017 Walk to Cure Arthritis - Hudson Hub-Times

(Reuters Health) - Patients with rheumatoid arthritis who receive pedometers may be more active and feel less fatigued even if they are not told to use the trackers to aim for a specific number of steps, a small study suggests.

All 96 study participants had rheumatoid arthritis, an immune system disorder that causes debilitating swelling and pain in the joints. Researchers randomly assigned patients to get a pedometer with or without a daily step goal, or to get only educational brochures with advice on becoming more active.

After 21 weeks, all of people with pedometers were walking more on average each day: 1,441 additional steps without a step goal and 1,656 extra steps with a goal. But the patients who didnt get pedometers actually got 747 fewer steps a day on average by the end of the study.

Patients with pedometers reported statistically meaningful declines in fatigue during the study, but people who only got education did not.

We found that increasing activity just through walking decreased fatigue, said lead study author Dr. Patricia Katz of the University of California, San Francisco.

Most of us probably dont realize how inactive we are until we start measuring our daily activity, Katz said by email. Having a concrete goal, such as the number of daily steps, seems to help people become and stay active.

Every patient received the same educational brochure at the start. In the two groups that received pedometers, all of the participants were asked to keep a daily diary to record how many steps they logged.

For one group with pedometers, researchers also assessed their activity levels at the start of the study and set goals for them to increase their average daily steps by 10 percent every two weeks.

At the start of the study, participants were 54 years old on average and were typically getting about 4,891 steps a day, which researchers classified as sedentary. Very few of them were getting at least 8,000 steps a day, which the researchers say is a healthy activity level.

Beyond its small size, another limitation of the study is that researchers lacked data on how often participants wore the devices, which makes it difficult to get an accurate daily step count, the authors note in Arthritis Care and Research.

Its also possible that the pedometer groups might not have improved as much if they hadnt also been recording their steps in a daily diary, which increases their engagement with the effort to be more active, said Dr. Mitesh Patel, a researcher at the University of Pennsylvania in Philadelphia who wasnt involved in the study.

Research indicates that for most people, pedometers and wearable devices are more likely to help change health behaviors if they are combined with an engagement strategy, Patel said by email.

Generally, pedometers are most useful for people who are sedentary and unaware of their own level of inactivity, said Dr. Lucas Carr, a physiology researcher at the University of Iowa who wasnt involved in the study.

This relatively simple intervention helped a very sedentary group of rheumatoid arthritis patients increase their activity at a level that is considered clinically significant, Carr said by email. The largest health benefits are realized when an individual changes from doing nothing to doing something.

While the study included only people with rheumatoid arthritis, its possible pedometers might be useful for people with other chronic medical problems, said Dr. David Geier, an orthopedic surgeon sports medicine specialist in Charleston, South Carolina who wasnt involved in the study.

It seems reasonable to think they could help stimulate activity, Geier said by email. Physical activity would be helpful for almost everyone.

SOURCE: bit.ly/2oHjzBn Arthritis Care and Research, online April 5, 2017.

WASHINGTON The U.S. Food and Drug Administration on Friday declined to approve a new drug for rheumatoid arthritis made by Eli Lilly and Co and partner Incyte Corp, the companies said on Friday.

(Reuters Health) - Spine surgeons are noticing an increase in patients with neck and upper back pain, likely related to poor posture during prolonged smartphone use, according to a recent report.

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Pedometers tied to less fatigue for rheumatoid arthritis patients ... - Reuters

Eli Lilly said U.S. regulators have rejected its much-anticipated pill for the immune disorder rheumatoid arthritis, the drugmaker's second drug development setback since November.

The Food and Drug Administration said in a letter to the company that it needed more information about the drug's safety and the best doses, Lilly said Friday in a statement.

Lilly said it disagrees with FDA's conclusions but will work with the agency on a plan to eventually get the drug, baracitinib, approved for U.S. patients.

In November, Lilly's experimental medicine solanezumab flopped in a closely watched test in patients with mild Alzheimer's disease, after having already failed in testing in patients with more advanced Alzheimer's.

The arthritis drug, which has the proposed brand name Olumiant and was approved for use in Europe in February, was expected to be a big seller in part because most other new rheumatoid arthritis drugs are injected, making them less appealing for patients.

Christi Shaw, president of the Lilly division that developed the drug, said the company remains confident in the drug's ability to safely treat moderate and severe rheumatoid arthritis.

About 23 million people worldwide, three-fourths of them women, have rheumatoid arthritis, a chronic disorder in which the immune system attacks the body's tissues. It causes painful swelling and progressive destruction of joints, which can leave them deformed and, in severe cases, lead to disability. It can also damage other body parts, including the skin, eyes, lungs, heart and blood vessels.

Eli Lilly & Co. and Incyte Corp., its partner in developing baracitinib, applied for FDA approval of the drug in January 2016. Normally the review process takes 10 months, but this January, FDA said it needed three additional months to review more information. Still, drug industry analysts as recently as this week were advising clients that approval of baracitinib was likely.

Despite the setback, Lilly reaffirmed its 2017 financial forecasts Friday, for earnings per share of $2.69 to $2.79, excluding one-time items, and revenue between $21.8 billion and $22.3 billion. It said Incyte, which is based in Wilimington, Delaware, was evaluating the rejection's impact on its position and would update investors when it reports first-quarter results, likely in mid-May. Lilly is expected to report its quarterly results on April 25.

Follow Linda A. Johnson at https://twitter.com/LindaJonPharma .

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Lilly's rheumatoid arthritis pill rejected by regulators - ABC News

Lifestyle HEALTH LINES: Arthritis common condition, but not easily understood by all

WILLIAM PILLOW

Arthritis is a condition that is very common, but not well understood by most. It is not a single disease. There are actually more than 100 types of arthritis.

More than 50 million adults and 300,000 children have some type of arthritis. It is more common in women and is the leading cause of disability in America. Common arthritis complaints are joint pain, swelling and stiffness.

Inflammatory arthritis (rheumatoid, lupus) is an overreaction of the bodys immune system. The body attacks the cartilage and destroys it. Metabolic joint disease (gout) occurs when crystals are deposited in the joints and cause acute pain. These are best treated by a primary care physician, nurse practitioner or specialist (rheumatologist) with medications and changes in diet. Blood tests are often used in the diagnosis.

Osteoarthritis (wear and tear arthritis) is the most common type. Cartilage is the thick cushioning surface on the ends of bones. With time this cartilage can wear down (thinning/mild arthritis) and progress to the point where bone rubs on bone (severe arthritis).

Orthopaedic Sports Medicine has significantly advanced the diagnosis and treatment of arthritis. As a physician at NEO Sports Medicine, I am often asked when someone should seek medical treatment. Anyone in their teenage years or younger with a joint that stays swollen for more than a few days should be seen urgently to rule out cartilage damage or juvenile rheumatoid arthritis.

Mild non-traumatic joint pain in someone 30 or older can start initial treatment with weight loss, anti-inflammatory medication (Aleve, Advil, Tylenol), and reasonable exercise that does not cause pain. Primary care physicians can prescribe stronger anti-inflammatories.

If this does not provide relief, a referral to an orthopaedist is the next step. Patients should not assume an appointment means imminent surgery. X-rays will give the doctor a good idea of the condition of the joint. At NEO Sports Medicine, physicians look at the whole person not just a joint. Many times a course of physical therapy to strengthen the muscles (the shock absorbers of a joint) will help. A steroid injection into the joint can also provide relief. Braces can also be used on a short-term basis to give the joint a rest.

Joint pain is not always arthritis. Torn cartilage can often be repaired with an outpatient arthroscopic surgery using a small camera that is quite minor. An MRI can be helpful to get a better picture of the joint. For major joint damage that has failed conservative treatment, a joint replacement can provide life-changing relief. Replacements are available for the knee, hip, shoulder and even finger joints.

Modern joint replacements are now meant to last longer than 15 years and can allow patients to get back to a more active lifestyle. My partners and I provide accurate diagnoses and seek to exhaust all forms of conservative treatment. If surgery is indicated, we provide minimally invasive joint surgery to get patients back to the lifestyle they desire.

Dr. William Pillow is an orthopedic surgeon at North East Orthopaedics and Sports Medicine.

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HEALTH LINES: Arthritis common condition, but not easily understood by all - Northeast Mississippi Daily Journal

Morningside Maryland Site (press release) (blog)

New Study Reveals Rheumatoid Arthritis Tests May Be Impacted By Obesity Morningside Maryland Site (press release) (blog) A group of researchers from the University of Pennsylvania Health System obesity may impact blood tests that are utilized for diagnosing and monitoring rheumatoid arthritis (RA) in women. Blood tests for erythrocyte sedimentation rate (ESR) and C ...

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New Study Reveals Rheumatoid Arthritis Tests May Be Impacted By Obesity - Morningside Maryland Site (press release) (blog)

Oncology Nurse Advisor

AntiCancer, Rheumatoid Arthritis Drug Combination Produced Synergistic Attack on Tumor Cells Oncology Nurse Advisor Auranofin, a drug used to treat arthritis, helped boost the effectiveness of RAPTA-T in attacking tumors. The combination of 2 unrelated drugs, RAPTA-T and auranofin, results in synergistic effects that improve the ability of RAPTA-T to kill tumors in ...

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AntiCancer, Rheumatoid Arthritis Drug Combination Produced Synergistic Attack on Tumor Cells - Oncology Nurse Advisor

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Arthritis is commonly known as painful inflammation and stiffness of the joints, but the fact that arthritis is so common among Montanans is quite a surprise. Program Manager for Montana Arthritis Program Heather Welch explains.

Here in Montana, about one in four Montanans have been diagnosed with arthritis, said Welch. That is about 215,000 adults and about one in three adults with arthritis report that they do not engage in physical activity. We do have exercise and self-management programs throughout the state to help people with arthritis and other chronic conditions they may have.

Welch says many people are under the assumption that arthritis only affects those who are older, but that is not the case.

I think people forget it is not just older folks that get arthritis, but there are still working age adults that do have arthritis, Welch said. Some people will notice some pain and joint stiffness, but really what we recommend is going to see your doctor if you do think you have arthritis. There are over 100 different types of arthritis.

According to Welch, Montana is an aging population and there is a higher prevalence of arthritis in rural areas due to occupation. Exercise and self-management programs in Montana for arthritis can be found right here.

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One In Four Montanans Have Been Diagnosed With Arthritis, Numbers Are Expected To Increase - Newstalkkgvo

Danbury Walk to Cure Arthritis Welcomes Sanjay Gupta, MD, of Orthopaedic Specialists of Connecticut as Event Chair

Gupta to help reach goal of $75,000

The Arthritis Foundation announced today that Sanjay Gupta, M.D. of Orthopaedic Specialists of Connecticut has been named the corporate chair of the 2017 Danbury Walk to Cure Arthritis. As chair, Dr. Gupta will provide leadership in helping the Danbury Walk to Cure Arthritis reach its fundraising goal of $75,000.

The Arthritis Foundations Walk to Cure Arthritis is an annual, nationwide fundraising event focused on accelerating the search for a cure and building a better life for the 50 million Americans, including 300,000 children, living with this painful and debilitating disease. In Connecticut more than 663,000 adults and an estimated 3,400 children have arthritis the nations leading cause of disability.

Dr. Gupta is a long-time Arthritis Foundation advocate and volunteer, and was chosen as the 2017 Walk to Cure Arthritis chair because of his strong leadership skills, passion for helping others and dedication to removing the burden of arthritis from local communities.

The majority of my day-to-day professional life is dedicated to helping people and their families deal with arthritic pain, said Dr. Gupta. The pain of arthritis may not be visible but it is incredibly real and the # 1 cause of disability in America. More must be done to help.

Dr. Gupta is an orthopedic surgeon with Orthopaedic Specialists of Connecticut and widely recognized as one of the top joint replacement surgeons in the state. He is currently the chief of orthopedics at Danbury Hospital. He completed a two-year fellowship at the Hospital for Special Surgery in New York and specializes in hip and knee disorders and joint replacement. Orthopaedic Specialists of Connecticut is known for providing personalized, compassionate care. Their physicians trained all the top hospitals and universities in the country. Recent data shows that they have the best surgical outcomes in the area. Dr. Gupta and his family reside in Ridgefield.

The Walk to Cure Arthritis is nationally sponsored by Amgen.

The Danbury Walk to Cure Arthritis will be held on Sunday, April 30, 2017, 9:00 a.m. at Immaculate High School in Danbury. All proceeds support the Arthritis Foundations mission to conquer and cure arthritis. Learn more or register for the Walk at http://www.WalkToCureArthritis.org/Danbury. For more information contact Emily Roberson at 860-781-7776.

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Danbury Walk to Cure Arthritis Welcomes Sanjay Gupta, MD - HamletHub