So what are some of the differences between rheumatoid arthritis and psoriatic arthritis?
While many physicians treat
rheumatoid arthritis and psoriatic similarly, they are very different. In a recent article Dr. Christopher Ritchlin
from the University of Rochester pointed out some key distinctions. Unlike rheumatoid disease, patients with psoriatic
arthritis have nail disease, obesity, hypertension, type 2 diabetes, elevated
blood lipids, fatty liver, metabolic syndrome, and anxiety as well as
depression. 10-15% also develop inflammatory bowel disease.
The drug treatment for these two
diseases will diverge in the future as our understanding increases.
Women With RA May Have A Harder Time Becoming Pregnant.
Amy Norton writing in Reuters reported that, according to a study of 68,000 women in the journal Arthritis & Rheumatism, rheumatoid arthritis may make getting pregnant more difficult. Investigators found that 25 percent of the subjects had tried unsuccessfully for at least a year before they finally became pregnant, versus 16 percent of subjects without RA. This is unfortunate…. But the upside is that if pregnancy does take place, women will often go into spontaneous remission for the duration of the pregnancy.
Knee Replacement Surgery Less Heart Failure, Mortality
Tara Parker-Pope writing in the New York Times reported, “New research suggests that for some patients, knee replacement surgery can actually save their lives.” Researchers “examined the effects of joint replacement among nearly 135,000″ Medicare patients and found that “three years after diagnosis, the knee replacement patients had an 11 percent lower risk of heart failure. And after seven years, their risk of dying for any reason was 50 percent lower.” Researchers cautioned, however, that the “data…are not randomized and controlled” and point out that “not every patient with knee arthritis is a candidate for joint replacement surgery.”
Nancy Walsh writing in MedPage Today reported on a study presented at the annual meeting of the American College of Rheumatology. The study authors stated “Treatment of early rheumatoid arthritis with glucosteroids provides relief of symptoms, but the therapy comes with… worrisome changes in body fat composition that are significantly increased within the first year.” Researchers also said that “the increases in body fat mass do not bode well for long-term health of the patients – even though they may feel better initially.” Additionally, they “speculated that the phenomena they observed in their year-long study may relate to increased risk of cardiovascular events in rheumatoid arthritis patients.’
Brenda Goodman writing in Web MD described at study published in PLoS One. A Norwegian study was conducted in chronic fatigue syndrome. The researchers gave the patients, Rituxan, a biologic medication “FDA approved to treat non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, and two kinds of vasculitis.” The study involved 30 patients with chronic fatigue syndrome, half of whom received “two infusions of rituximab given two weeks apart,” while the others received “infusions of saline solution as a placebo.” Overall, “ten patients in the rituximab group (67%) and two patients in the placebo group (13%) saw at least moderate reductions in fatigue.” Pretty aggressive treatment I’d say.
Ira Kantor writing in the Boston Herald reported that “Rheumatoid arthritis sufferers who stop taking the prescription drug Enbrel may experience a painful return of symptoms within a matter of weeks.” Dr. Donald Bloch of Massachusetts General Hospital’s Rheumatology, Allergy and Immunology Department said, “The reason people haven’t toyed more with the idea of trying to take people off Enbrel is the fear that it won’t be able to go back in remission.”
Nancy Walsh writing in MedPage Today reported on a study appearing in the Journal of Arthritis and Rheumatism, “Subclinical carotid atherosclerosis – hardening of the arteries was already present and progressing in patients with rheumatoid arthritis (RA) who did not have known cardiovascular disease,” among a population of 158 patients with RA, “the plaque inside the carotid arteries in 82% by a median of 16 µm per year.”
Protein 21 is a molecule that apparently controls the overactive immune cells that cause rheumatoid arthritis. According to an article published in Arthritis and Rheumatism, scientists at Northwestern University School of Medicine studied animal models of rheumatoid arthritis and discovered that those animals who contracted the disease had much lower levels of protein 21. According to author Dr. Harris Perlman, Protein 21 acts like a bouncer in a bar. He states, “Imagine destructive customers in a bar and the bouncer says, You’re going to behave.” When the investigators injected an imitation form of protein 21 into their animal models of rheumatoid arthritis, the disease was halted.
Nancy Walsh writing in MedPage Today reported, “Rheumatoid arthritis patients will try almost anything to relieve symptoms — including special jewelry, household oils and even homemade concoctions – researchers reported” at the annual meeting of the American College of Rheumatology. “The researchers utilized data from the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis (CLEAR), created in 2000 and funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.”