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Arthritis
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Adalimumab therapy reduces hand bone loss in early rheumatoid arthritis: Explorative analyses from the PREMIER study.
Adalimumab therapy reduces hand bone loss in early rheumatoid arthritis: Explorative analyses from the PREMIER study.
Ann Rheum Dis. 2008 Sep 18;
Hoff M, Kvien TK, Kälvesten J, Elden A, Haugeberg G OBJECTIVE: The effect of adalimumab on hand osteoporosis was examined and related to radiographic joint damage in the three treatment arms of the PREMIER study: Adalimumab plus methotrexate (MTX), adalimumab and MTX monotherapy. We also searched for predictors of hand bone loss. METHODS: 768 patients (537 fulfilled 2 years) with RA for <3 years, never treated with MTX, were included. Hand bone loss was assessed by digital X-ray radiogrammetry (DXR) on the same hand radiographs scored with modified Sharp score at baseline, 26, 52 and 104 weeks. For DXR, metacarpal cortical index (MCI) was the primary bone measure. RESULTS: At all time points the rate of percentage DXR-MCI loss was lowest in the combination group (-1.15; -2.16; -3.03) and greatest in the MTX monotherapy group (-1.42; -2.87; -4.62), with figures in between for the adalimumab monotherapy group (-1.33; -2.45; -4.03). Significant differences between the combination group and the MTX group was seen at 52 (p=0.009) and 104 weeks (p<0.001). The order of hand bone loss across the three treatment arms was similar to the order of radiographic progression. Older age, elevated C-reactive protein, and non-use of adalimumab were predictors of hand bone loss. CONCLUSION: This study supports a similar pathogenic mechanism for hand bone loss and erosions in RA. The combination of adalimumab and MTX seems to arrest hand bone loss less effectively than radiographic joint damage. Thus quantitative measures of osteoporosis may be a more sensitive tool for assessment of inflammatory bone involvement in RA.
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Arthritis Treatment
The type of arthritis and intensity of the condition determine the course of treatment. There is no cure for arthritis, but there are traditional and alternative treatments that can bring arthritis pain relief. Prescription and over-the-counter medications are popular for treating arthritis pain. Acetaminophen (Tylenol) is often recommended for osteoarthritis patients with little or mild inflammation, while aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen work best for patients with inflammatory rheumatoid arthritis.
The healing touch of massage may stimulate the flow of blood, bringing heat and relief to stiff joints. Alternative therapies such as acupuncture, relaxation, yoga, and even emu oil are have proven effective for many arthritis sufferers.
Heat and cold can help alleviate pain too, but since moist heat, such as that from a bath, acts differently than the dry heat of a heating pad or the cold of an ice pack, this type of treatment needs to be discussed with a doctor or physical therapist. Doctors also often recommend patients wear splints or braces to relieve joint pressure and protect them from further injury. |
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