Moderate alcohol consumption may not affect liver blood tests in people taking methotrexate

Weekly alcohol consumption of less than 14 units per week does not appear to be associated with an increased risk of abnormal liver blood tests.

Introduction
Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. It can also affect internal organs. Rheumatoid arthritis is more common in older people, but there is also a high prevalence in young adults, adolescents and even children, and it affects women more frequently than men. People with rheumatoid arthritis who take a drug called methotrexate are advised to limit their alcohol intake due to concerns that it may affect the liver.

Continue reading Moderate alcohol consumption may not affect liver blood tests in people taking methotrexate

Chondroitin sulfate works as well as non-steroidal anti-inflammatory drugs (NSAIDs) for relieving the pain of knee osteoarthritis

Chondroitin sulfate works as well as non-steroidal anti-inflammatory drugs (NSAIDs) for relieving the pain of knee osteoarthritis Pharmaceutical-grade chondriotin sulfate 4&6 should be considered a first-line treatment for people with osteoarthritis of the knee.

Introduction
Osteoarthritis is a common condition that makes a person’s joints stiff and painful, particularly in the morning. It is caused by thinning of the cartilage within the joints, which allows the bones to rub against each. Joint swelling and pain are frequent symptoms. It is the most common of all the different types of arthritis, and typically becomes more common as people get older. Chondroitin sulfate is a dietary supplement. Versions of chondroitin sulfate for pharmaceutical use have different preparation and composition, and higher purity than food-grade products. Pharmaceutical chondroitin sulfate 4&6 has been shown to improve pain and function and to delay joint damage in osteoarthritis of the knee. The 4&6 refers to the particular structure of the molecule.

Continue reading Chondroitin sulfate works as well as non-steroidal anti-inflammatory drugs (NSAIDs) for relieving the pain of knee osteoarthritis

Health inequity for people with psoriatic arthritis (PsA) before and after diagnosis

People with psoriatic arthritis have healthcare costs, lower income, higher unemployment rates, higher risk for disability pension and more comorbidities than the general population.

Introduction
Psoriatic arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. The disease often causes swelling of the fingers and toes, mainly because of joint inflammation. It gets its name from the link between this type of arthritis and a skin condition called psoriasis, which causes skin redness and scaling. Continue reading Health inequity for people with psoriatic arthritis (PsA) before and after diagnosis

Sticking to a healthy diet over many years may protect against rheumatoid arthritis

Women with a healthy diet may be less likely to develop rheumatoid arthritis

Introduction
Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. It can also affect internal organs. Rheumatoid arthritis is more common in older people, but there is also a high prevalence in young adults, adolescents and even children, and it affects women more frequently than men. Food and diet are one of the many things that can contribute to the development of rheumatoid arthritis. It has been suggested that eating a healthy diet rich in fish, olive oil and cooked vegetables may protect people from going on to develop rheumatoid arthritis.

Continue reading Sticking to a healthy diet over many years may protect against rheumatoid arthritis

Disease activity definitions do not always identify the same patients

Definitions of disease activity are important to help define and identify appropriate treatment plans, with the aim of achieving disease remission

Introduction 
Juvenile idiopathic arthritis is more commonly referred to as JIA, and includes most types of arthritis seen in children. JIA is a type of inflammatory arthritis that causes pain and swelling in one or more joints. The aim for children with JIA is for them to feel better and to have no symptoms of arthritis. This is referred to as clinically inactive disease (sometimes shortened to CID). Doctors may keep changing treatments until children achieve clinically inactive disease. However, there is no single test for clinically inactive disease, so doctors rely on different criteria. The challenge is that we do not know which are the perfect criteria, and there are many different definitions of clinically inactive disease being used in children with JIA. The fact that there are multiple definitions does not matter unless they do not identify the same children as being in or out of clinically inactive disease. However, we know that these definitions use different measurements (see table below), so it is
possible that they may identify different children as being in or out of clinically inactive disease.

Continue reading Disease activity definitions do not always identify the same patients

Eating more fibre may reduce the pain and symptoms of osteoarthritis

Including more dietary fibre can reduce pain and symptoms in people with osteoarthritis in their knees

Introduction
Osteoarthritis is a common condition that makes a person’s joints stiff and painful. It is caused by thinning of the cartilage within the joints, which allows the bones to rub against each. Joint swelling and pain are frequent symptoms. It is the most common of all the different types of arthritis, and typically becomes more common
as people get older.
Dietary fibres are carbohydrates in plant-based foods such as cereal grains, nuts, fruit and vegetables. Fibre cannot be digested, but instead some is fermented in the gut and some fiber passes through the GI tract relative intact. Eating fibre has been shown to lower the risk of getting many diseases, including heart diseases and diabetes. It can also help people to lose weight. It is thought that this is because it helps to trap sugars and fats, and makes you feel full so that you don’t overeat.

Continue reading Eating more fibre may reduce the pain and symptoms of osteoarthritis

Managing psoriatic arthritis

This is the lay version of the EULAR recommendations for the management of people with psoriatic arthritis.
The original publication can be downloaded from the EULAR website: www.eular.org.

Gossec L, Smolen JS, Ramiro S, et al European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Annals of the Rheumatic Diseases 2016;75:499-510. doi:10.1136/annrheumdis-2015-208337

Introduction
EULAR recommendations give advice to doctors, nurses and patients about the best way to treat and
manage diseases. EULAR has updated its recommendations on the management of people with psoriatic
arthritis (usually abbreviated as PsA). Psoriatic arthritis is a condition where the joints become stiff, painful and damaged due to the immune system attacking the body’s own tissues and causing inflammation. It is often associated with a skin condition called psoriasis. Psoriasis and psoriatic arthritis are not contagious and you cannot get them from other people.
Doctors, health professionals and patients worked together to develop these recommendations. Including
patients in the team ensured that the patient point of view was integrated in the recommendations. The
authors looked at the evidence on drug interventions in psoriatic arthritis.

Continue reading Managing psoriatic arthritis

No new safety signals with long-term use of tofacitinib

Side effects with tofacitinib are generally stable over time and there are no new safety signals with long-term use

INTRODUCTION

Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. It can also affect internal organs. Rheumatoid arthritis is more common in older people, but there is also a high prevalence in young adults, adolescents and even children, and it affects both men and women.
Tofacitinib is a fairly new drug for rheumatoid arthritis. It belongs to a group of medicines called JAK (janus kinase) inhibitors or targeted synthetic disease-modifying antirheumatic drugs (DMARDs), which you may see shortened to tsDMARDs. Tofacitinib is different from biologic DMARDs (also called biologics or bDMARDs). Tofacitinib works by targeting a specific pathway inside cells, blocking JAK signaling and helping to reduce inflammation throughout the body and in the joint.
The approved dose of tofacitinib in most countries is 5 mg taken two times a day as an oral pill, although there is an 11 mg once daily formulation available in some countries, such as the US. In clinical trials, tofacitinib has shown that it works well and that it is well tolerated in people with rheumatoid arthritis.

Continue reading No new safety signals with long-term use of tofacitinib

People with psoriatic arthritis have a higher risk of atherosclerosis

People with psoriatic arthritis have increased prevalence, burden and severity of coronary atherosclerosis.

INTRODUCTION

Psoriatic arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. The disease often causes swelling of the fingers and toes, mainly because of joint inflammation. It gets its name from the link between this type of arthritis and a skin condition called psoriasis, which causes skin redness and scaling.
Psoriatic arthritis is linked to an increased risk of blocked arteries (also called atherosclerosis). Atherosclerosis happens when your arteries become clogged with fat (also called plaques). This can make you more likely to get cardiovascular diseases such as heart attacks or strokes. Doctors need to be able to identify people at high risk of getting cardiovascular diseases so that they can give lifestyle advice and any treatment that might be needed. However, it has been reported that the normal risk assessment scores that doctors use might underestimate the risk in people with psoriatic arthritis.
Coronary computed tomography angiography (shortened to CCTA) is a type of imaging technique that can be used to help doctors see whether people have atherosclerosis in their heart.

Continue reading People with psoriatic arthritis have a higher risk of atherosclerosis

Immunosuppressant drugs may help in systemic sclerosis (dcSSc), but new treatments are needed

Immunosuppressants show some benefit in early dcSSc, but better treatments are still needed.

INTRODUCTION

Systemic sclerosis is a rare but serious disease of the connective tissues, where the tissue grows abnormally and triggers the immune system to attack itself (autoimmunity). This can cause hardening (fibrosis) and swelling of the skin, as well as joint pain, digestive problems and lung disease caused by fibrosis and scarring. It can also affect the heart and kidneys. It usually starts in people aged 30–50 years of age, and is more common in women than men.
The diffuse cutaneous subtype of systemic sclerosis (often shortened to dcSSc) is even rarer, affecting just one in every four people with the disease. It is linked with early damage to a person’s internal organs, as well as painful skin thickening that quickly gets worse. Only half of people diagnosed with dcSSc will survive for 10 years or more.
Medicines for dcSSc are very limited, and there are no options at the moment that have very good results. Immunosuppressant medicines work by lowering the body’s immune response. These sorts of medicines are sometimes used in dcSSc, although there have not been trials to see how well they do in people with this specific form of the disease. Because the disease is so rare, it is difficult to research.

Continue reading Immunosuppressant drugs may help in systemic sclerosis (dcSSc), but new treatments are needed