The American College of Rheumatology 2009 Annual Scientific Meeting took place October 17 to 21 in Philadelphia. This annual meeting, the premier event for specialists in the field of rheumatology, included clinical sessions, poster exhibits, and presentation of research and clinical findings that emphasized "from the bench to the bedside."
Jeffrey R. Curtis, M.D., of the University of Alabama at Birmingham, reported research results showing that biologic therapy does not significantly increase the risk of infection in patients with rheumatoid arthritis. Biological therapy was compared with other disease-modifying antirheumatic drugs (DMARDs) frequently used to treat rheumatoid arthritis. Using a North American patient registry, 18,305 rheumatoid arthritis patients were identified. Among these patients, 586 hospitalized infections and 21,258 outpatient infections were reported. Using an adjusted analysis for comparison, there was no significant increase in risk of serious infection associated with biological therapy versus DMARDs.
In a statement, Curtis said that "the most important risk factors for serious infections were not biologic medications, as some might have expected, but instead were age, medical conditions such as emphysema, and rheumatoid arthritis-specific factors like disease duration."
Several study authors reported financial relationships with various pharmaceutical companies.
C. Kent Kwoh, M.D., of the University of Pittsburgh, shared research which suggested that glucosamine may not help to prevent joint damage in osteoarthritis of the knee. This 24-week study included 201 patients with mild to moderate knee pain. Patients were randomized to receive either glucosamine or placebo. Neither the odds of worsening cartilage defects (0.9) nor the odds of worsening in bone marrow lesions (0.73) were significantly improved by glucosamine treatment. Additionally, glucosamine was not found to significantly improve levels of the urinary secreted biomarker C-terminal cross linking telopeptide of type II collagen.
According to a statement, Kwoh explained that "in this six-month study using state-of-the-art magnetic resonance imaging we were not able to demonstrate any benefit of glucosamine on the prevention of worsening joint damage in individuals with mild to moderate knee pain."
M. Pirjo Tynjala, M.D., of the Helsinki University Central Hospital in Finland, presented findings from a study which showed a combination of infliximab and methotrexate was promising for the treatment of pediatric arthritis. This study included 59 children for evaluation who were treated with either a combination of infliximab and methotrexate; a combination of methotrexate, sulfasalazine, and hydroxychloroquine; or methotrexate alone. Overall, 71 percent were considered to be successfully treated. The highest rates of disease remission were observed in children who were treated with the two-drug combination (68 percent) compared with the three-drug combination (40 percent) or single-agent methotrexate (25 percent). The duration of remission was also longest in the group of children receiving the two-drug combination.
In a statement, Tynjala concluded that "this study in children is in line with findings in adult rheumatology. The current target of the treatment in juvenile idiopathic arthritis is minimal disease activity and, preferably, remission. When that is the target, in polyarticular juvenile idiopathic arthritis, combination therapy with new biologic agents plus methotrexate is more effective than combination therapy with 'older' synthetic antirheumatic drugs, and clearly more effective than methotrexate alone."
One author reported a financial relationship with UCB-Pharma.
Jennifer M. Hootman, Ph.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, reported findings from a survey which showed that only half of adults with arthritis in the United States received the seasonal flu vaccine during 2007. Importantly, seasonal flu vaccinations are recommended for people with disease- or drug-induced immunosuppression, such as arthritis patients. The standardized national telephone survey included 430,912 U.S. adults. An analysis of the data showed that the prevalence of flu immunization among adults with arthritis was only 52.3 percent; however, this was significantly higher than when compared to adults without arthritis (31.4 percent). Multivariate analysis found that the prevalence of flu vaccination was affected by race/ethnicity, and that African-Americans, Hispanics, and multi-racial participants were less likely to have been vaccinated. Other factors associated with decreased vaccination included less than a high school education, current smoking, obesity, lack of health insurance, and the absence of a personal health care provider. Conversely, age over 45 years and comorbidities (diabetes, heart disease, or a disability) increased the prevalence of vaccination among adults with arthritis.
In a statement, Hootman cautioned that "the seasonal flu vaccination is the best way to prevent the flu and is highly recommended for young children, those over age 50, and adults with chronic health conditions. All health care providers should recommend seasonal influenza vaccination for those patients at high risk of complications from the flu. Persons with reduced immune capacity due to inflammatory rheumatic diseases such as rheumatoid arthritis or lupus should also get a 2009 H1N1 influenza vaccination."
ACR: Rituximab Found Helpful for ANCA-Associated Vasculitis
MONDAY, Oct. 19 (HealthDay News) -- In patients with severe ANCA-associated vasculitis, treatment with rituximab may be as effective as standard treatment with cyclophosphamide, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting, held from Oct. 17 to 21 in Philadelphia.
ACR: Gleevec Found Promising for Systemic Sclerosis
MONDAY, Oct. 19 (HealthDay News) -- In patients with systemic sclerosis, treatment with imatinib mesylate (Gleevec) may be a safe and effective therapy, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting, held from Oct. 17 to 21 in Philadelphia.
ACR: Video Games Linked to Joint Pain in Children
MONDAY, Oct. 19 (HealthDay News) -- A significant portion of children playing with stationary or hand-held video game devices may have hand and wrist pain, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting, held from Oct. 17 to 21 in Philadelphia.
ACR: Insecticides Linked to Rheumatic Disease
MONDAY, Oct. 19 (HealthDay News) -- Frequent exposure to insecticides may increase the risk of autoimmune rheumatic disease in postmenopausal women, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting, held from Oct. 17 to 21 in Philadelphia.
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