Archive for March 2nd, 2010

The Arthritis Handbook: Improve Your Health and Manage the Pain of Osteoarthritis

• ISBN13: 9780979356414
• Con­di­tion: NEW
• Notes: Brand New from Pub­lisher. No Remain­der Mark.

Prod­uct Descrip­tionAc­cord­ing to con­ven­tional wis­dom, arthri­tis pain is an inevitable part of aging. Not so, says Dr. Grant Cooper in this prac­ti­cal, acces­si­ble guide. For those who do develop osteoarthritic con­di­tions, this book offers a blend of com­mon­sense advice, dietary info, tar­geted exer­cise, and tips on use­ful sup­ple­ments. Accord­ing to the author, suf­fer­ers can often entirely avoid the use of med­ica­tion, injec­tion ther­apy, and surgery — approaches that, when nec­es­sary, can be used as an oppor­tu­nity to return to exer­cise and nutri­tion to slow the disease’s progress. The book fea­tures easy, illus­trated exer­cises, includ­ing aer­o­bics and strength train­ing, that can be done at home, at a gym, or under a trainer’s or phys­i­cal therapist’s super­vi­sion. Nutri­tional and sup­ple­ment strate­gies — includ­ing glu­cosamine and fish oil — are pre­sented in detail, along with sug­ges­tions for ways to keep on track. Dr. Cooper not only explores each topic in depth but explains how it fits into an over­all holis­tic treat­ment program. 

The Arthri­tis Hand­book: Improve Your Health and Man­age the Pain of Osteoarthritis 

Rheumatoid arthritis and DMARDs

Rheuma­toid arthri­tis and DMARDs

Quote from Clin­i­cal trial: Con­tem­po­rary dis­ease mod­i­fy­ing antirheumatic drugs (DMARD) in patients with recent onset rheuma­toid arthri­tis in a US pri­vate prac­tice: methotrex­ate as the anchor drug in 90% and new DMARD in 30% of patients.

OBJECTIVE: To describe ther­a­pies with dis­ease mod­i­fy­ing antirheumatic drugs (DMARD) and bio­log­i­cal agents in patients with early rheuma­toid arthri­tis (RA) who were receiv­ing rou­tine clin­i­cal care in 2001 in a pri­vate prac­tice of 5 rheuma­tol­o­gists in Nashville, TN, USA. METHODS: A cohort of 232 patients with ini­tial symp­toms of RA in 1998 or later were enrolled between Feb­ru­ary and Octo­ber 2001 into a longterm obser­va­tional study, designed to eval­u­ate treat­ments and longterm out­comes of RA. The base­line eval­u­a­tion included review of all DMARD that had been taken since dis­ease onset, clin­i­cal mea­sures on a mul­ti­di­men­sional health assess­ment ques­tion­naire, joint counts, and lab­o­ra­tory mea­sures. RESULTS: Among the 232 patients, methotrex­ate (MTX) was the first DMARD used in 192 patients (82.8%), includ­ing 3 in com­bi­na­tions. Since ini­ti­a­tion of the first DMARD to the study visit, over a median inter­val of 12.1 months, 125 (66.1%) patients of the 189 whose ini­tial DMARD was MTX as a sin­gle DMARD con­tin­ued MTX as a sin­gle DMARD, 43 (22.8%) had another DMARD or bio­log­i­cal agent added in com­bi­na­tion with MTX, and 21 (11.1%) dis­con­tin­ued MTX. Since the onset of RA, 89.2% of the patients had taken MTX, 15.9% hydrox­y­chloro­quine, 3.9% sul­fasalazine, 22.0% lefluno­mide, 9.5% etan­er­cept, 4.3 inflix­imab, and 87.0% pred­nisone. CONCLUSION: After a median dura­tion of 12.1 months of DMARD ther­apy, almost 90% of patients with recent onset RA took MTX as the anchor drug. More than 60% took MTX as a sin­gle DMARD or in com­bi­na­tion with tra­di­tional DMARD, while 30% took lefluno­mide, etan­er­cept, or inflix­imab, usu­ally in com­bi­na­tion with MTX.

My opin­ion methotrex­ate (MTX) is most pop­u­lar drug in   Rheuma­toid arthritis.

Con­clu­sions. When choos­ing DMARD monother­apy in early RA, rheuma­tol­o­gists in ERAN seem to pref­er­en­tially pre­scribe MTX for patients with a poor prog­no­sis and SSZ for patients with good prog­no­sis. No DMARDs were used in older patients or in those with a low HAQ.

KEY WORDS: Rheuma­toid arthri­tis, DMARD choice, Prog­nos­tic factors

Methotrex­ate has dis­placed other DMARDs, espe­cially sul­phasalazine, as agent of first choice and newer agents have dis­placed older DMARDs. Whether the expressed pref­er­ence for par­tic­u­lar DMARDs accu­rately reflects actual use, and is opti­mal in rheuma­toid arthri­tis, remains to be deter­mined.

KEY WORDS: Sur­vey, DMARD, Pre­scrib­ing pref­er­ence, Rheuma­tol­o­gists, Rheuma­toid arthri­tis.

Rheumatoid arthritis or not

Rheuma­toid arthri­tis or not

Cal­cium pyrophos­phate dihy­drate (CPPD) crys­tal depo­si­tion dis­ease can lead to many clin­i­cal syn­dromes. One syn­drome sim­u­lates rheuma­toid arthri­tis and is thus called “pseudo-rheumatoid arthri­tis.” Since some patients have true rheuma­toid arthri­tis with CPPD crys­tal depo­si­tion dis­ease, the clin­i­cian may have dif­fi­culty dif­fer­en­ti­at­ing those patients from oth­ers who have the pseudo-rheumatoid syn­drome. Such a diag­nos­tic prob­lem can be solved radi­ograph­i­cally. Eleven patients with CPPD crys­tal depo­si­tion dis­ease were stud­ied; five had true rheuma­toid arthri­tis and six had pseudo-rheumatoid arthri­tis. Because osseous ero­sions were not appar­ent in the arthropa­thy of uncom­pli­cated CPPD crys­tal depo­si­tion dis­ease, the detec­tion of skele­tal ero­sive changes indi­cated a true rheuma­toid arthri­tis process.

Many attempts have been made to define the entity which has been var­i­ously called arthro­pathic pso­ri­a­sis, pso­ri­atic arthropa­thy, arthropathia pso­ri­at­ica, and pso­ri­atic arthri­tis. Some def­i­n­i­tions have required a rea­son­able amount of syn­chro­nous activ­ity, as evi­denced by remis­sions and relapses in arthri­tis and cuta­neous manifestations,2 arthri­tis restricted to the dis­tal inter­pha­langeal joints,3 or, con­versely, a pecu­liar destruc­tive form of arthri­tis asso­ci­ated with psoriasis.4 Hensch5 defined it as an atrophic arthri­tis fol­low­ing long con­tin­ued and uncon­trolled pso­ri­a­sis, while Dawson6 felt that the cuta­neous lesions and joint changes must both be atypical.