Treating Rheumatoid Arthritis Early May Cut Damaging Effects

Study suggests that delaying treatment leads to more joint inflammation, disability down the road

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.

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Sugary Drinks and Rheumatoid Arthritis Linked?

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.

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Can You Have Both Rheumatoid Arthritis and Gout?

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.

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