Posts Tagged ‘DMARD’

Methotrexate affects lungs in RA less than previously thought

Wednesday, April 2nd, 2014


Next up… a commonly held belief about methotrexate shot down… thank goodness

Methotrexate affects lungs in RA less than previously thought

M Alexander Otto writing in Rheumatology News described a study that evaluated 22 double blinded randomized clinical trials comparing methotrexate to other drugs in rheumatoid arthritis. The results indicated that the risk of methotrexate induced lung disease was much lower than previously suggested.  The authors felt that other factors such as the disease itself or infections may be the more likely culprits.  The study was conducted at Galway University Hospital in Ireland and published in Arthritis and Rheumatism.

Comment: This is an important study because methotrexate is our workhorse disease modifying drug and this lends credence to the fact that it is less toxic to the lungs than we had previously thought.

Arthritis Treatment And Side Effects Of Azulfidine (sulfasalazine)

Monday, March 10th, 2014


Azulfidine (sulfasalazine)  is a common disease modifying anti-rheumatic drug used in the treatment of rheumatoid arthritis and psoriatic arthritis.  While effective, it has a whole host of potential side effects including allergic reactions, gastrointestinal disturbance, headache, mouth sores, skin color changes, alterations in hearing, blood abnormalities, liver damage, and Stevens-Johnson syndrome.

Side Effects of Methotrexate Experienced Even Before Treatment Starts

Friday, February 7th, 2014

Side Effects of Methotrexate Experienced Even Before Treatment Starts

Nancy Walsh writing in Medpage Today reported that the gastrointestinal side effects that commonly accompany treatment with methotrexate aren’t limited to post-treatment nausea and vomiting, but also include anticipatory, associative, and behavioral symptoms, Dutch researchers found.

In a group of 291 adults with rheumatoid or psoriatic arthritis, one-third reported nausea following methotrexate administration — but 8.6% also experienced nausea while awaiting treatment and 11% felt nauseous when just thinking about the treatment, according to Maja Bulatovic Calasan, MD, of University Medical Center Utrecht, and colleagues.

Comment: The mind has a powerful influence in how we feel about upcoming events. Definitely an interesting study.

Ultrasound Helps With Arthritis Treatment

Wednesday, February 5th, 2014

Ultrasound Helps With Arthritis Treatment

Nancy Walsh writing in Medpage Today reported on a Scottish study, which showed that incorporating musculoskeletal ultrasound into disease activity assessments helped with treatment decision-making in early rheumatoid arthritis.

In 29% of clinical evaluations that included a musculoskeletal ultrasound, the imaging study provided information that altered the decision of whether a change in disease-modifying anti-rheumatic drug (DMARD) therapy was appropriate, according to James Dale and colleagues from the University of Glasgow.

Comment: Ultrasound can provide useful information and it is less expensive than MRI.

Surgical Infection Rate Higher with RA Drugs

Friday, January 31st, 2014

Surgical Infection Rate Higher with RA Drugs

Marianne Wait writing in Arthritis Today reported that people with inflammatory forms of arthritis, such as rheumatoid arthritis, who take more than one traditional disease modifying antirheumatic drug (DMARD), or a type of biologic drug known as a TNF inhibitor, have an increased risk of infection following orthopaedic surgery, according to a new study published in Arthritis Care & Research in December.

It is not a new theory that drugs taken for inflammatory arthritis conditions, which in many cases work by suppressing the immune system, might increase post-surgical infections. Over the years, a host of studies has looked at which drugs might elevate the risk and by how much. The results have not been clear.

But this study “is one of the best out there regarding this topic,” says Tim Bongartz, MD, associate professor of rheumatology at Mayo Clinic in Rochester, Minn. Dr. Bongartz was not involved in the study.
Based on their results, senior study author Inès A. Kramers-de Quervain, MD, of the department of rheumatology at the Schulthess Clinic in Zurich, Switzerland, suggests “it may be advisable to consider stopping TNF inhibitors more than one administration interval before surgery, since the risk of postoperative infection appears to be higher if the operation occurs within this period.” An administration interval is the length of time between one injection and the next.

Do TNF inhibitors affect hemoglobin A1c levels?

Monday, November 25th, 2013

Do TNF inhibitors affect hemoglobin A1c levels?

Debra Hughes writing in MPR reported on a study from the United Kingdom.  Researchers asked the question, “Do tumor necrosis factor inhibitors (TNFi) improve HbA1c in patients with rheumatoid arthritis?” The answer depends on the agent and on whether patients have diabetes mellitus.

Some disease-modifying anti-rheumatic drugs (DMARDs)—including TNFis—may improve insulin resistance and risk of diabetes mellitus. “However, it is unknown whether TNFis improve HbA1c in patients with rheumatoid arthritis with or without diabetes mellitus,” they stated.

After adjusting for baseline HbA1c among patients without diabetes, those taking Humira had a significant increase in HbA1c levels between baseline and 12 months. In contrast, Enbrel therapy did not influence HbA1c levels over time.

Comment: Patients with RA who have diabetes need to be watched closely.

New study to evaluate methotrexate for osteoarthritis

Friday, November 1st, 2013

Can methotrexate be used for osteoarthritis… the answer next…

New study to evaluate methotrexate for osteoarthritis

Jo Willey writing in the Express reported on a study in the United Kingdom. Scientists are launching a nationwide trial on how effectively the drug methotrexate relieves the agony of osteoarthritis in the knees.

It is already prescribed for rheumatoid arthritis, a different condition. After a successful pilot trial, it is hoped methotrexate could also ease pain significantly for the UK’s six million osteoarthritis sufferers.

In the pilot, 37 per cent of patients with knee osteoarthritis had a 40 per cent reduction in discomfort.

Leader of the research, Professor Philip Conaghan from the University of Leeds, said: “Current drug treatments have significant side-effects and are not suitable for many people.

“As a result, people often live with severe pain and have significant difficulty in carrying out normal day-to-day activities. There is, therefore, an urgent need to find new and better ways of managing their pain.” Prof Conaghan, of the Leeds Institute of Rheumatology and Musculoskeletal Medicine, will run the 15-centre clinical trial from early next year on up to 160 people whose osteoarthritis is not helped by treatments such as painkillers.

He said: “Methotrexate (MTX) is very good at reducing inflammation in rheumatoid arthritis. Inflammation is also very common in osteoarthritis, though it is caused by a different mechanism.

“We think treating inflammation should reduce pain. We hope MTX will reduce pain and stiffness. Although it’s less likely to stop joint destruction, we will perform MRI scans to see if we have altered structure.

Comment: Methotrexate often is useful for inflammatory erosive osteoarthritis so the results of this study will be valuable.

Arthritis Drug Weapon Against Melanoma

Friday, June 8th, 2012

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Arthritis Drug Could Be  New Weapon Against Melanoma

Catherine Paddock writing in Medical News today reported that Leflunomide, brand name, Arava, a drug commonly used to treat rheumatoid arthritis, may also inhibit the growth of malignant melanoma, a deadly form of skin cancer, according to new research led by the University of East Anglia (UAE) in the UK and Children’s Hospital Boston in the US.  The researchers screened thousands of compounds looking for likely candidates by testing their ability to affect the development of pigment cells in tadpoles. They used tadpole pigment cells because they are similar to human melanocytes that produce melanin, the pigment that is mainly responsible for skin color. Melanoma occurs when melanocytes grow in an uncontrolled manner.  Very exciting news because Arava has already been FDA approved for rheumatoid arthritis and if this research pans out, it could quickly be used to treat melanoma without the usual bureaucratic red tape.


Pfizer Vs 3 New Rivals To Sell First RA Oral Biologic

Wednesday, June 15th, 2011

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