Showing posts with label Arthritis. Show all posts
Showing posts with label Arthritis. Show all posts

Tuesday, 5 November 2013

knee brace

Oct. 30, 2013 (San Diego) -- Osteoarthritis can be painful, but exercise can improve the quality of life for people with OA or those at high risk for it, according to new research.

For people who have OA of the knee, a simple brace can ease pain greatly, another new study says.

Both studies were presented this week at the annual meeting of the American College of Rheumatology in San Diego.

OA, or the ''wear-and-tear'' arthritis linked with age, is the most common form of arthritis. Its symptoms include joint pain and stiffness. 

Even a little exercise can help, says study researcher Kai Sun, MD. She is a researcher at Northwestern University in Chicago.

She compared the quality of life in three groups:

Inactive peopleThose who did some exerciseThose who did the recommended 150 minutes of moderate to vigorous exercise each week

"The overall quality of life is better with each increasing level of physical activity," she says.

At the study start and then 2 years later, patients answered questions about their quality of life. This included their energy levels,  social interactions, and general health.

People who exercised some said they had 10 more days of good health a year.

People who met the recommended guidelines reported 20 more days of good health a year.

For people with a form of knee osteoarthritis that affects the kneecap, wearing a knee brace may help pain, says David  Felson, MD, MPH. He is a professor of medicine and epidemiology at Boston University School of Medicine.

Knee OA is marked by progressive damage to the joint cartilage, the cushioning material at the end of long bones. The damage can lead to weakened muscles, pain, and swelling.

Patients who wore a knee brace said it reduced pain by about 40% over 6 weeks, Felson says. Based on the study, he recommends a soft Neoprene-like brace, with a hole for the knee cap.

A doctor can best diagnose knee OA, he says.

Felson reports working as a consultant for Knee Creations. Arthritis Research U.K. funded the study. 

The findings of both studies make sense, says Milton Helfenstein Jr., MD, a professor of rheumatology at the Federal University of Sao Paulo in Brazil. 

He recommends both aerobic exercise and strength training for his patients. He tailors the recommendation to their weight and level of fitness. He suggests that someone who hasn't been exercising start with 15 minutes, three times a week, and work up.

Helfenstein also recommends knee braces for patients with the type of knee OA studied, patellofemoral OA. But he is not certain everyone would keep the brace on for the average of 7 hours that the patients in the study did.

He says the brace stabilizes the knee, reducing friction between joints. This lessens the pain.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the ''peer review'' process, in which outside experts scrutinize the data prior to publication in a medical journal.


View the original article here

Study suggests that delaying treatment leads to more joint inflammation, disability down the roadScreening for smoking, obesity and diabetes may

By Robert Preidt

HealthDay Reporter

SATURDAY, Oct. 26 (HealthDay News) -- Immediate and effective treatment for rheumatoid arthritis reduces the risk that patients will have joint damage and disability within a few years, a new study suggests.

The findings show the need for doctors to discourage patients from delaying treatment, according to the researchers at the Hospital for Special Surgery in New York City.

"We need to educate people diagnosed with rheumatoid arthritis about this. Some want to delay treatment because they are afraid. They haven't wrapped their heads around the fact that they have this disease, or they are reluctant to start taking medication. Some resort to non-medicinal approaches, many of which have limited effect," study lead investigator and rheumatologist Dr. Vivian Bykerk said in a hospital news release.

"Unfortunately, I have seen too many people delay effective treatment approaches and they come back a year later very disappointed, often with joint damage that could have been prevented. The longer you have inflammation in the joints, the more likely you are to have joint damage, and it is going to impact how you function down the road," she added.

The study included 833 patients with early rheumatoid arthritis -- defined as having symptoms for a year or less. Six months into the study, the patients were classified as having achieved low disease activity or not. Low disease activity means that joint pain, swelling and other signs of inflammation are significantly reduced.

The 56 percent of patients who achieved low disease activity at six months were much less likely to have joint damage and disability at two years, according to the findings to be presented Monday at the annual meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals in San Diego.

"We believe there is a window in which people have a much better chance of getting rheumatoid arthritis under good control, often with less intense therapy, and the window is within the first three months of developing joint inflammation," Bykerk said.

These findings show the need for doctors to warn patients about the hazards of delaying therapy and to follow patients more often in the early stages of treatment, she added.

Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.


View the original article here

iced tea with lemon

Nov. 1, 2013 (San Diego)- Women who drink one or more sugar-sweetened sodas a day might raise their risk of getting rheumatoid arthritis, according to a new study that links RA risk to the sugary habit. The study does not prove cause and effect.

Other studies have linked sugary drinks to higher risks of obesity, diabetes, and heart disease, among other health problems.

The new study is believed to be the first to look at sugary beverages and RA. It did not include diet sodas.

About 1.3 million Americans have RA, a chronic and potentially disabling disease that causes pain, stiffness, and swelling in the joints, and limits how well they work.

''We found an association only for sugar-sweetened beverages," says Yang Hu, a researcher at Harvard School of Public Health who conducted the study. Hu presented the findings this week at the American College of Rheumatology annual meeting.

The link does not mean that sodas cause RA, Hu says. He says drinking sodas could reflect other lifestyle habits known to boost RA risk, such as smoking.

The American Beverage Association, an industry group, disputes the findings.

Hu and his colleagues looked at data from two large studies of nurses, which have evaluated diets and other data for decades.

Hu looked at the diet and other health information from about 173,000 women during two different time periods. Every 4 years, the women reported how many sugary beverages they drank. This included regular colas with sugar, caffeine-free colas with sugar, and non-cola sodas. Diet soda was not included.

During the time periods studied, 883 women were diagnosed with RA. Hu found those who drank one or more sugar-sweetened beverages a day, compared to those who drank either none or less than one a month, had a higher risk of getting a form of RA known as seropositive. It is often a more severe form of the disease.

The way the study was done has limitations. People often don’t accurately remember  what they ate or drank in the past.

The American Beverage Association says it needs more detail to fully evaluate the study. 

“The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that while the causes of rheumatoid arthritis are not known, genetic and hormonal factors are considered the most likely causes and women are more likely than men to develop this autoimmune inflammatory disease,” its statement says.

The study is interesting and the link is potentially plausible, says Eric Ruderman, MD, professor of medicine at Northwestern University Feinberg School of Medicine. He reviewed the findings but was not involved in the study.

"We're always looking at what drives risk in RA,'' he says. The disease has both genetic and environmental components, experts know. Those factors weren't taken into account in the study. The next step, he says, is to ''drill down into the pathology and try to understand why.''

The National Institutes of Health funded the study.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.


View the original article here

Nov. 4,  2013 (San Diego) -- Rheumatoid arthritis and gout, another form of arthritis, may occur together, despite previous thinking that having both is rare, according to new research.

Based on the new findings, doctors should consider looking for gout in RA patients, says study researcher Christina Petsch of the University of Erlangen-Nuremberg in Germany.

Both are inflammatory conditions. You get gout when uric acid builds up in joints, bones, and tissue. Gouty arthritis causes inflammation in the joints, often in the big toe.

RA affects the joints, surrounding tissues, and sometimes other organs.

Petsch evaluated 100 men and women, average age 63, who'd been diagnosed with RA. On average, they had RA for nearly 9 years. All had high blood levels of uric acid.

Petsch used a scan to look for uric acid deposits in their feet. She found that 13% of the patients had positive scans.

Even though the scan was positive, it doesn't mean for sure the patients have gout. The result could have been a false-positive.

Men were more likely to have both conditions than women.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.


View the original article here

folded hands

Nov. 4,  2013 (San Diego) -- Treating children with juvenile arthritis with multiple medications soon after the disease appears is more likely to make symptoms go away than treating them later or with fewer medications at the start, according to new research.

"Remission is achievable if you treat early and aggressively," says study researcher Carol Wallace, MD. She is a pediatric rheumatologist at Seattle Children's Hospital.

She presented the findings at the annual meeting of the American College of Rheumatology.

About 294,000 children under the age of 18 have childhood arthritis and other related conditions, according to the Arthritis Foundation. Juvenile RA is an umbrella term for several types of arthritis. The common thread: chronic, long-term joint inflammation along with fevers, rash, or eye inflammation.

Wallace and her team compared two treatment strategies for a kind of childhood arthritis known as polyarticular JIA. It affects five or more joints soon after the disease appears.

The study included 85 children ages 2 to 17. The researchers focused on which treatment could produce what doctors call ''clinically inactive disease'' within 6 months. For children, that means they have no arthritis, fever, rash, or other symptoms of JIA. After 6 months of no symptoms on JIA medication they are considered in remission.

The children either received:

Wallace followed the children for a year. Among the trends she notes from her research:

Children on the more aggressive therapy with three drugs got to remission a full month earlier than the others.Children in the aggressive group were symptom-free for close to 5 months, about 2 months longer than those on methotrexate alone.Children who received either treatment within 3 months after the disease started had fewer clinic visits compared to those treated later.Children who responded to either treatment within 4 months were more likely to go into remission.

Timothy Beukelman, MD, calls the study “important and impactful.” He is an associate professor of pediatrics in the division of rheumatology at the University of Alabama at Birmingham. He reviewed the findings.

"A clear result from this study is, it's best to treat juvenile arthritis as early as possible," he says. "This study only looked at 1-year outcome. The results may be ongoing."

Wallace's team is continuing to look at results.

Beukelman and Wallace report doing consulting for or receiving research grants from several pharmaceutical companies.

The study was funded by the National Institute for Arthritis and Musculoskeletal and Skin Diseases and the Howe Endowment for Juvenile Idiopathic Arthritis Research.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the ''peer review'' process, in which outside experts scrutinize the data prior to publication in a medical journal.


View the original article here

Friday, 21 June 2013

Register Today

Earn Free CME Credits by reading the latest medical news
in your specialty.

Sign Up
By Nancy Walsh, Staff Writer, MedPage Today Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse PlannerThis study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.High disease activity in psoriatic arthritis is associated with elevated total cholesterol and triglycerides, adding to a growing body of evidence linking psoriatic arthritis metabolically with dyslipidemia and obesity.Note that the study suggests that there may be common pathogenic mechanisms for obesity and psoriatic arthritis.

MADRID -- High disease activity in psoriatic arthritis is associated with elevated total cholesterol and triglycerides, adding to a growing body of evidence linking psoriatic arthritis metabolically with dyslipidemia and obesity, a researcher said here.

Patients considered to have high disease activity because of scores of 10 or higher on the Clinical Disease Activity Index, or the presence of enthesitis or dactylitis, were significantly more likely to have total cholesterol levels above 200 mg/dL (odds ratio 1.58, 95% CI 1.11-2.24, P=0.01), according to Anna Broder, MD, of Albert Einstein College of Medicine in New York City, and colleagues.

They also were more likely to have triglyceride levels above 150 mg/dL (OR 1.6, 95% CI 1.2-2.3, P=0.005), Broder reported at the annual meeting of the European League Against Rheumatism.

"More and more studies in recent years have reported a link between obesity and psoriatic arthritis. In addition, patients whose body mass index is high are less able to achieve or maintain low disease activity in psoriatic arthritis," she said.

The association between obesity and psoriatic is complex, but is related to the production of inflammatory cytokines such as interleukin 1 (IL1), IL6, and tumor necrosis factor (TNF) alpha.

These cytokines also cause dysregulation of lipid metabolism in obesity and type 2 diabetes, resulting in deactivation of lipoprotein lipase, increased production of fatty acids, increased triglycerides, and a shift from low- density lipoprotein (LDL) to very LDL.

This leads to a pro-atherogenic lipid profile with high triglycerides, decreased high-density lipoprotein (HDL), and high or normal LDL.

The lipid profile associated with rheumatoid arthritis (RA) is quite different, she noted, and varies according to the stage of disease.

In early and presymptomatic RA, triglycerides and total cholesterol are elevated and HDL is low, but with symptom onset, the levels of all measures of the conventional lipid profile decrease with a disproportionate decrease in HDL.

"Then, with treatment, an increase occurs in all lipid levels, and the implications of that for cardiovascular risk screening are the subject of a big debate," she said.

The relationship between lipid profiles and psoriatic arthritis has not been as well characterized as that for RA, however, so the researchers analyzed data from the prospective Consortium of Rheumatology Researchers of North America (CORRONA) registry.

CORRONA currently includes 4,500 patients with psoriatic arthritis. For inclusion in this study, patients had to have at least one visit when lipid values and disease activity were recorded.

This provided a study population of 725 patients and about 39% were considered to have medium to high disease activity.

The high disease activity group included more women (57% versus 46%, P=0.006) and smokers (12.7% versus 7.7%, P=0.029), had shorter disease duration (8.7 versus 11.2 years, P=0.001), and had higher erythrocyte sedimentation rate and C-reactive protein.

Patients with high disease activity also were more likely to be prescribed conventional disease-modifying anti-rheumatic drugs (63% versus 51%, P=0.002) and prednisone (13% versus 4.5%, P<0.001), but were less likely to be treated with TNF inhibitors (57% versus 66%, P=0.015).

Mean BMI in patients with high disease activity was 31.7 kg/m2 compared with 30.6 kg/m2 in those with low disease activity.

The presence of enthesitis or dactylitis showed a positive association with total cholesterol above 200 mg/dL, with an odds ratio of 1.6 (95% CI 1.1-2.5, P=0.02).

The researchers also performed a subgroup analysis that included 54 patients who had more than one lipid measurement while enrolled in CORRONA.

In that group, increased disease activity also was associated with lower HDL and higher triglycerides on a regression analysis after adjusting for the duration between visits.

These subgroup findings didn't reach statistical significance, but this may have related to underpowering, Broder said.

"We showed that higher disease activity in psoriatic arthritis is associated with elevated total cholesterol and triglycerides, and in a prospective subanalysis we found that disease activity was associated with high triglycerides and decreased HDL, a pattern that is similar to that observed in type 2 diabetes and metabolic syndrome and obesity, and quite different from what's seen in RA," she said.

"There may be common pathogenic mechanisms for obesity and psoriatic arthritis, and this should be studied further," she concluded.

Study limitations included possible selection bias, as lipid measurements are not required in CORRONA, and the potential for residual confounding with corticosteroids and triglycerides.

The authors reported no conflicts of interest.

Primary source: European League Against Rheumatism
Source reference:
Labitigan M, et al. "Moderate to high disease activity in psoriatic arthritis is associated with elevated total cholesterol and triglycerides" EULAR 2013; Abstract OP302.

Nancy Walsh

Staff Writer

Nancy Walsh has written for various medical publications in the United States and England, including Patient Care, The Practitioner, and the Journal of Respiratory Diseases. She also has contributed numerous essays to several books on history and culture, most recently to The Book of Firsts (Anchor Books, 2010).

Thursday, 20 June 2013

Register Today

Earn Free CME Credits by reading the latest medical news
in your specialty.

Sign Up
By Nancy Walsh, Staff Writer, MedPage Today Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse PlannerNote that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.Ustekinumab yielded significant and sustained improvements in signs and symptoms of psoriatic arthritis in both anti-TNF-naive and anti-TNF-experienced patients.

MADRID -- The monoclonal antibody ustekinumab (Stelara) had sustained benefits through a year of treatment among patients with active psoriatic arthritis, even for those who had previously not done well on a tumor necrosis factor (TNF) inhibitor.

Among those who had not previously received anti-TNF treatment, patients who saw a 20% improvement in their symptoms according to the criteria of the American College of Rheumatology (ACR20) ranged from 59% to 73% on ustekinumab (Stelara), Christopher Ritchlin, MD, of the University of Rochester in New York, reported here at the annual meeting of the European League Against Rheumatism.

And even among those who had already been given anti-TNF treatment but had stopped, whether for a lack of efficacy or adverse events, 50% to 55% showed ACR20 responses at week 52, Ritchlin and his colleagues found.

"Little has been known about treatment options for patients with psoriatic arthritis who haven't responded to either methotrexate or anti-TNF treatment -- patients who don't really have any good alternatives," Ritchlin said at a press briefing.

A previous study found that patients with active psoriatic arthritis who had not had an adequate response to methotrexate showed benefits with ustekinumab.

This agent is a monoclonal antibody targeting interleukins 12 and 23, which binds to p40 on natural killer and T cells and blocks subsequent immune events, he explained.

To see if the response extended to patients who also had failed on other biologics, he and his colleagues enrolled 312 patients, randomizing them to receive ustekinumab 45 mg or 90 mg at baseline, 1 month, and then every 3 months.

A control group was given placebo at baseline, 1 month, and month 4 followed by crossover to 45 mg ustekinumab at weeks 24, 28, and 40.

After 4 months, patients who had less than 5% improvement in their tender and swollen joint counts were switched. If they had been on placebo, they were given ustekinumab 45 mg, and if they had been on the 45 mg dose, they were switched to the 90 mg dose.

A total of 180 of the patients had previously received anti-TNF therapy. Of those, the baseline tender and swollen joint counts were 25 and 14, respectively.

At week 24, 43.8% of patients receiving ustekinumab had ACR20 responses compared with 20.2% of patients on placebo (P<0.001), said Ritchlin.

By 1 year, among patients receiving the 45 mg dose, 47% had ACR20 responses, while 28% and 13% had ACR50 and ACR70 responses.

For patients given the 90 mg dose, the corresponding numbers were 48%, 26%, and 18%.

The ACR20 responses among patients who had been anti-TNF naive were 40% in patients originally randomized to placebo and then switched, 60% in the original 45-mg group, and 58.5% in the 90-mg group, while that response was seen in 37% and 41% of the TNF-experienced group.

Even among patients who had received three or more anti-TNF agents, 29% of the 45-mg group had ACR20 responses, as did 13% of the 90-mg group.

Improvements in psoriasis skin scores of 75% or more were seen in 56% of patients originally receiving placebo and then given 45 mg, while that degree of improvement was seen in 57% and 64% of the initial 45 and 90 mg groups, respectively.

Serious adverse events were seen in 5.8% of both dose groups, which was similar to the placebo group, and events leading to discontinuation occurred in 5.8% and 3.8% of the 45-mg and 90-mg groups.

Two patients, both of whom had previously been treated with anti-TNF therapy, developed malignancies. One of these was breast cancer, in a patient receiving the 45 mg dose, and the other was squamous cell carcinoma in a patient on 90 mg.

Serious infections occurred in 0.7% of patients receiving ustekinumab, and three patients with multiple cardiovascular risk factors and previous anti-TNF treatment had mild myocardial infarctions, Ritchlin said.

There were no deaths, he added.

"This study showed that for patients who have had to stop an anti-TNF agent for some reason, ustekinumab is effective. So we now have an alternative for these patients, and it represents a major advance for those of us who treat this disease," he said.

"Moreover, for dermatologists who treat patients with psoriasis and who may also have joint involvement, they can be reassured that this agent has effects on the joints as well," he added.

"In some of these patients in the dermatologists' offices, they have arthritis that's not been diagnosed. So for those patients, whether or not they've been exposed to anti-TNF, there's a reasonable chance that this agent will not only work for their skin but also for their joints," he told MedPage Today.

The study was supported by Janssen Research and Development.

The investigators disclosed receiving support from Janssen R&D and being employees of the company.

Primary source: European League Against Rheumatism
Source reference:
Ritchlin C, et al "Maintenance of efficacy and safety of ustekinumab in patients with active psoriatic arthritis despite conventional nonbiologic and anti-TNF biologic therapy: 1-year results of the P-SUMMIT 2 trial" EULAR 2013; Abstract OP1.

Nancy Walsh

Staff Writer

Nancy Walsh has written for various medical publications in the United States and England, including Patient Care, The Practitioner, and the Journal of Respiratory Diseases. She also has contributed numerous essays to several books on history and culture, most recently to The Book of Firsts (Anchor Books, 2010).

Wednesday, 19 June 2013

Register Today

Earn Free CME Credits by reading the latest medical news
in your specialty.

Sign Up
By Nancy Walsh, Staff Writer, MedPage Today Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse PlannerNote that this study was published as an abstract and presented at a conference. These data and conclusions should be considered preliminary until published in a peer-reviewed journal.A year of treatment with apremilast, which targets inflammatory mediators, led to significant long-term reduction in disease activity among patients with psoriatic arthritis.Note that there were no new safety signals after 6 months regarding cardiac events, malignancies, or opportunistic infections, and no significant laboratory abnormalities were seen throughout the study.

MADRID -- A year of treatment with apremilast, which targets inflammatory mediators, led to significant long-term reduction in disease activity among patients with psoriatic arthritis, a researcher reported here.

At week 52 in a trial known as PALACE 1, 63% of patients receiving 20 mg of the new oral agent twice daily had experienced a 20% reduction in symptoms according to the criteria of the American College of Rheumatology, as had 54.6% of those receiving 30 mg of the drug, according to Arthur Kavanaugh, MD, of the University of California San Diego, and colleagues.

In addition, improvements of 50% were seen in 24.8% and 24.6% of the two dosage groups, respectively, while improvements of 70% were seen in 15.4% and 13.8%, Kavanaugh reported at the annual meeting of the European League Against Rheumatism.

Apremilast is a phosphodiesterase 4 inhibitor that breaks down cyclic AMP. "Cyclic AMP tends to be anti-inflammatory, and keeping it elevated seems to decrease some pro-inflammatory cytokines like tumor necrosis factor and interleukin 6 and to allow other anti-inflammatory cytokines like interleukin 10 to be increased," he explained during a press briefing.

The phase III trial included 504 patients with active psoriatic arthritis despite treatment with conventional disease-modifying anti-rheumatic drugs or biologic agents.

One-quarter of the patients had already been exposed to biologic treatment.

At baseline, patients were randomized to one of the two doses of apremilast or placebo. At week 16, those who had not reached a 20% improvement in swollen and tender joints were re-randomized to one of the active treatments if they had been in the placebo group, or remained at the same dose if in the active treatment groups.

After 4 months, 31.3% of patients receiving 20 mg of apremilast twice daily experienced a 20% reduction in symptoms according to criteria of the American College of Rheumatology (ACR), compared with 19.4% of those given placebo (P=0.0140).

In addition, 40% of patients receiving 30 mg of the drug twice daily had ACR20 responses, compared with placebo at that time point (P<0.0001).

At 6 months, all patients were re-randomized to 20 mg or 30 mg of apremilast, and they have now been followed for 1 year, with results for their arthritic symptoms that are "very respectable," Kavanaugh said.

"Another important outcome for patients with arthritis of the hands and feet is functional status, as measured on the Health Assessment Questionnaire, or HAQ, with scores from zero to 3," he said.

"Zero means 'I can do everything I want to do,' and 3 means 'I can't take care of myself at all,' and the baseline HAQ of 1.21 in this study reflects considerable functional impairment," he said.

After 52 weeks, there was a .35 point improvement in HAQ, "which is a level at which patients can certainly say they feel better and can do their daily activities," he noted.

The investigators also assessed effects of the treatment on the skin manifestations of disease using the Psoriasis Area and Severity Index (PASI).

In the 30 mg group, 37% had 75% improvements in PASI scores, as did 25% of those in the 20 mg group. Those improvements were sustained out through a year, Kavanaugh said.

With regard to safety, "the overall safety profile of apremilast appears to be pretty good," he noted.

All phosphodiesterase inhibitors can cause gastrointestinal adverse effects, but generally these occur early and decrease in frequency over time.

In this study, events such as diarrhea and nausea occurring in the second 6 months ranged from 0.6% to 3% in the 20 mg group and from 0% to 1.8% in the 30 mg group.

There were no new safety signals after 6 months regarding cardiac events, malignancies, or opportunistic infections, and no significant laboratory abnormalities were seen throughout the study.

"One tangible result of this could be that, if this drug is approved, we won't have to monitor lab tests to look for toxicity issues," Kavanaugh said.

"These results are encouraging for us as clinicians as well as for our patients. We have had more therapies in the past 10 years than we ever had, but success breeds success and we're happy to see even more new treatments," he said.

Apremilast is also being evaluated for use in psoriasis, ankylosing spondylitis, and rheumatoid arthritis.

The study was sponsored by Celgene.

The investigators reported financial relationships with a variety of companies, including Celgene, AstraZeneca, Amgen, Pfizer, Abbott, Novartis, and Genentech. Several are employees of Celgene.

Primary source: European League Against Rheumatism
Source reference:
Kavanaugh A, et al "Long-term (52-week) results of a phase 3, randomized, controlled trial of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with psoriatic arthritis" EULAR 2013; Abstract LB1.

Nancy Walsh

Staff Writer

Nancy Walsh has written for various medical publications in the United States and England, including Patient Care, The Practitioner, and the Journal of Respiratory Diseases. She also has contributed numerous essays to several books on history and culture, most recently to The Book of Firsts (Anchor Books, 2010).