Patients with moderate RA as likely to need joint surgery as those with high disease

Data support the use of lower disease activity cut-off points for more intensive treatments such as biologics

2015-06-10

(Press-News.org) Rome, Italy, 10 June 2015: The results of a study presented today at the European League Against Rheumatism Annual Congress (EULAR 2015) Press Conference showed that patients with Rheumatoid Arthritis (RA) taking conventional DMARD therapy who have moderate disease activity have a similar risk of joint failure that requires surgery as those with high disease activity.

In some countries, additional treatment with a biological DMARD is based on a disease activity cut-off that excludes RA patients with moderate disease activity. These findings suggest it is not just the RA patients with high disease activity, but also those with moderate RA, who need more intensive treatment, to reduce their risk of needing joint surgery.

"It is well-established that sustained high disease activity in RA results in worse outcomes," said lead author Dr. Elena Nikiphorou of the Rheumatology Department, St Albans City Hospital, UK. "In reality, however, many treated RA patients remain in low or moderate disease activity states and their outcomes, especially in the long term, are less well studied," she added.

"Our data provide an argument for updating existing disease activity cut-off points to allow RA patients with moderate disease activity to receive a biological agent in addition to conventional DMARDs," Dr. Nikiphorou concluded.

In this study, orthopaedic surgery was used as a surrogate marker of joint destruction and failure in RA patients who remained at different disease activity levels over the first five years from the onset of their disease. Joint interventions were categorised into major (mainly large joint replacements), intermediate (e.g. synovectomies, joint fusions and excision arthroplasties of the wrist/hand, foot), or minor (mainly soft tissue surgery).

A total of 2,071 patients were recruited from the 'Early RA Study' and the 'Early RA Network'. Of these, 2,044 had at least two drug activity states (DAS) recorded between years 1 to 5: 21% were in remission, 15% in low DAS, 26% in low-moderate DAS, 21% in high-moderate DAS, and 18% in high DAS categories. Disease activity was evaluated by calculating the mean DAS28 score for each patient from year 1 (after treatment-onset) to year 5.

Using a statistical model that controlled for numerous factors including age at disease onset, gender, recruitment year, symptom duration, baseline rheumatoid factor, BMI, HAQ , erosions and haemoglobin, patients with low-moderate DAS, high-moderate DAS, and high DAS categories were all predictive of an increased risk of major joint surgery (p END

ELSE PRESS RELEASES FROM THIS DATE:

Ultrasound screening for abdominal aortic aneurysms: Advantages for men, but not for women

2015-06-10

Men benefit from one-time screening for abdominal aortic aneurysms via ultrasound. Studies provide proof that their risk of dying is reduced, the abdominal aorta ruptures less often, and emergency surgery can be avoided more often. Far fewer data are available for women and they show no relevant differences between the groups investigated. This is the result of the final report published on 28 May 2015 by the German Institute for Quality and Efficiency in Health Care (IQWiG). Rupture is often fatal, even if emergency surgery is performed An abdominal aortic aneurysm ...

Light pollution threatens the Balearic shearwater

2015-06-10

Petrel fledglings leave the nest after dark, but these marine birds' maiden flights towards the sea are hampered by city lights. Many collide or fall to the ground where they are in danger of being run over and vulnerable to predators. Now, a study has evaluated the impact of light pollution on three species of petrels on the Balearic Islands, including the Balearic shearwater, the most threatened sea bird in Europe, and concludes that between 30 and 47% of colonies are exposed to high levels of light pollution. This is not a new phenomenon. The dangers that fledglings ...

Fast and accurate synchronization in the 'blink' of an eye

2015-06-10

"Let's synchronize our watches." It's the classic line before a group goes out on a mission. We are all familiar with the concept of synchronized clocks - less known, but equally important, is that wireless devices need to be synchronized too. However, instead of requiring a precision of minutes, wireless devices have to make their clocks match within very small fractions of a second. This so-called "clock synchronization" is needed for a large range of purposes - from increasing cellphone coverage, to increasing data speed rates, to enabling precision localization in ...

Epic fails in 2015 elections: Does polling jeopardize fairness?

2015-06-10

Britain, Queensland, Israel, Poland - 2015 has been a year of electoral polling failure and it could have major implications on election outcomes, say QUT economics researchers. The recent definitive Conservative win in the recent British elections, when polling had produced the near universal prediction of a 'hung parliament', mirrors Labor's surprise win in Queensland where the election outcome was unrelated to the poll prediction, says Professor Lionel Page from QUT's Queensland Behavioural Economics Group (QuBE). "The magnitude of the failure to predict these elections' ...

First-ever observation of the native capside of a retrovirus

2015-06-10

This news release is available in Spanish. Bovine leukemia virus (BLV) is an infectious disease that affects the immune system of cattle, causing immunodeficiency and in some cases triggering the development of leukemia or solid tumors in the form of lymphomas. This illness causes significant losses in productivity and even premature death of animals mostly in dairy farms. It also raises sanitary barriers for commerce of livestock and derived goods. As such, it has become a very prevalent veterinary issue, notably in Uruguay, which needs urgent solving. BLV is a virus ...

Coral colonies more genetically diverse than assumed

2015-06-10

Coral colonies are more genetically diverse than it has been assumed to date. This is the conclusion drawn by biologists at Ruhr-Universität Bochum, who have conducted comprehensive studies into the genetic variability in individual colonies of different reef-forming coral species. "However, this doesn't mean we should expect that this variability can compensate for corals dying worldwide due to climate change," says Maximilian Schweinsberg from the Department of Animal Ecology, Evolution and Biodiversity, headed by Prof Dr Ralph Tollrian. In collaboration with colleagues, ...

PCOS sufferers appear to benefit from lifestyle modification combined with metformin

2015-06-10

A systematic review publishing today in the journal Human Reproduction Update has found that women who suffer from polycystic ovary syndrome (PCOS) could manage some of the symptoms by combining a change in lifestyle with taking the drug metformin. PCOS is associated with a range of features including irregular cycles, infertility, obesity, diabetes, and depression. Researchers at Monash University in Australia compared the effects of change in lifestyle alone or with placebo, to lifestyle plus metformin. They found that lifestyle changes combined with taking metformin ...

New treatment hope for amyotrophic lateral sclerosis

2015-06-10

A previously unknown link between the immune system and the death of motor neurons in Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, has been discovered by scientists at the CHUM Research Centre and the University of Montreal. The finding paves the way to a whole new approach for finding a drug that can cure or at least slow the progression of such neurodegenerative diseases as ALS, Alzheimer's, Parkinson's and Huntington's diseases. The study, published today in Nature Communications, shows that the immune system in the animal model C. elegans, ...

New study explores whether newborns delivered by c-section face higher risk of chronic health problems later in life

2015-06-10

New York, June 10 -- A new paper in the British Medical Journal by Jan Blustein, M.D., Ph.D., of New York University's Wagner School and a professor of Medicine and Population Health at NYU School of Medicine and Jianmeng Liu, M.D., Ph.D., of Peking University examines the evidence as to whether newborns delivered by Cesarean section are more likely to develop chronic diseases later in life. While the jury is still out and research is ongoing, recent studies underscore the need for health care providers to discuss with expectant parents the risk of babies born through cesarean ...

Companies are making cybersecurity a greater priority

2015-06-10

Companies are spending increasing amounts on cybersecurity tools, but aren't convinced their data is truly secure and many chief information security officers believe that attackers are gaining on their defenses, according to a new RAND Corporation study. Charting the future of cybersecurity is difficult because so much is shrouded in secrecy, no one is entirely certain of all the methods malicious hackers use to infiltrate systems and businesses do not want to disclose their safety measures, according to the report. While worldwide spending on cybersecurity is close ...

LAST 30 PRESS RELEASES:

Herpes zoster vaccination and dementia occurrence

UTEP launches artificial intelligence think tank to address regional challenges

Sun earns UTA's highest research honor

Association for Chemoreception Sciences (AChemS) 47th Annual Meeting

Age-related genetic changes in the blood associated with poor cancer prognosis

Atomic imaging and AI offer new insights into motion of parasite behind sleeping sickness

Maternal childhood trauma may lead to early metabolic changes in male children

Helping computers perceive and interact with the visual world

New precision mental health care approach for depression addresses unique patient needs

Metabolic syndrome linked to increased risk of young-onset dementia

Hotter temps trigger wetlands to emit more methane as microbes struggle to keep up

ATP prevents harmful aggregation of proteins associated with Parkinson’s and ALS

Water quality could be degraded by development and conversion of forests upstream, with sediment levels and nitrogen concentrations also worsened, per modelling analysis of the Middle Chattahoochee wa