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Arthritis

“Arthritis is common among adults with heart disease, diabetes, or obesity, and the combination of arthritis and one of these chronic conditions has been associated with higher levels of physical inactivity, suggesting that arthritis-specific barriers to physical activity (concerns about worsening pain, damaging joints, and safely exercising) might be important concerns for adults with those conditions,” lead author Kamil E. Barbour, PhD, Arthritis Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA, and colleagues stated in the report.

There is limited information about the relative safety of selective cyclooxygenase-2 inhibitors. In particular, concerns exist regarding the adverse cardiovascular effects associated with celecoxib. In the aftermath of the withdrawal of rofecoxib from a placebo-controlled trial because of evidence of adverse cardiovascular outcomes associated with the cyclooxygenase-2 inhibitor, Steven E. Nissen, MD, Cardiologist, Cleveland Clinic, OH, and colleagues designed the 10-year PRECISION trial to compare the cardiovascular, gastrointestinal, and renal outcomes of celecoxib with those of naproxen or ibuprofen (Nissen SE, et al. N Engl J Med. 2016; 375:2519-2529).

Although treatment options are available in elderly patients with shoulder arthritis, they are limited in young patients. In a recent review, Jonathan D. Barlow, MD, Shoulder and Elbow Surgeon, Department of Orthopaedics, The Ohio State University, Columbus, and Joseph Abboud, MD, Shoulder and Elbow Surgeon, Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, discussed ongoing diagnostic and treatment challenges, including surgical options in young patients with glenohumeral arthritis.
By Phoebe Starr Madrid, Spain—It is well known that patients with rheumatoid arthritis (RA) have a greater frequency of depression than the general population. A study presented at the 2013 Euro­pean League Against Rheumatism (EULAR) annual meeting showed that depression in patients with early RA was the strongest predictor of early retirement, even stronger than disease activity level, response to RA therapy, work-related stress, or comorbid conditions. These findings underscore the need for rheumatologists to ask patients about their mood and to refer them for help if they exhibit signs or symptoms of depression.
By Rosemary Frei, MSc New Orleans, LA—Researchers are highlighting the lack of quality-of-life (QOL) data in studies related to the treatment of patients with rheumatoid arthritis (RA).
By Wayne Kuznar Washington, DC—In patients with seropositive rheumatoid arthritis (RA) who have an inadequate response to a tumor necrosis factor (TNF) inhibitor, switching to rituximab (Rituxan) may be a better option than switching to another TNF inhibitor, according to data discussed by Andrea Rubbert-Roth, MD, a Rheumatologist and Senior Physician at the Klinik I für Innere Medizin at the University of Cologne, Germany.
By Rosemary Frei, MSc Winnipeg, Manitoba—For the first time, a study has confirmed that acceptance of pain among patients with rheumatoid arthritis (RA) is a strong predictor of their engaging in the recommended 150 minutes or more of weekly moderate-to-vigorous physical activity for this patient population. Pain intensity does not appear to be a significant predictor for physical activity level in these patients.
By Phoebe Starr New Orleans, LA—The role of opioids in the management of patients with rheumatoid arthritis (RA) is controversial. A 2011 Cochrane Review showed insufficient evidence to support the role of weak opioids in this setting for >6 weeks, or for the role of strong opioids (Whittle SL, et al. Cochrane Database Syst Rev. 2011;[11]:CD003113)
Hospitalizations or emergency department visits for serious infections are relatively common in older adults with rheumatoid arthritis (RA), according to a recent analysis (Widdifield J, et al. Arthritis Care Res. 2013;65:353-361). By Rosemary Frei, MSc
Washington, DC—Tapering the doses of anti–tumor necrosis factor (TNF) drugs can be done successfully in some patients with rheumatoid arthritis (RA) who achieve remission. A step-down strategy was possible in >80% of patients without significant increases in disease activity or functional impairment, although relapses occurred more frequently than in those who remained using a full regimen, said Bruno Fautrel, MD, PhD, a professor at the University of Paris Medical Center, at the 2012 meeting of the American College of Rheumatology. By Wayne Kuznar
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