New Shock Wave Therapy for Rheumatoid Arthritis
A new therapy, called radial extracorporeal shock wave therapy (rESWT) has been developed for the beneficial treatment of rheumatoid arthritis (RA) in patients with RA with arthralgia, as published in the medical journal PAIN Practice. The study was conducted by Yiming Liu, MD, and colleagues from the Peking University People's Hospital in Beijing and included 15 RA patient participants who had been on disease-modifying antirheumatic drugs for over 3 months. Over the course of 12 weeks, the participating patients were given adjuvant rESWT. The team of investigators found drastic decreases in health assessment questionnaire scores, morning stiffness duration, disease activity score, visual analogue scale scores in resting state, and visual analogue scale scores in active state during the post-therapy follow-ups over the following 3 months after the therapy as compared with the baseline prior to the therapy.
The differences between the pre-treatment erythrocyte sedimentation rate and C-reactive protein and the post-treatment rates were not found to be significant. The researchers found no adverse effects with the patients who received rESWT. The report is thought to be the first study involving this type of therapy to treat a patient who has RA with arthralgia.
RA-Associated Pain and Swelling Reduced by Eating Fish
The medical journal Arthritis Care & Research published a study in June, 2017, reporting that eating fish twice per week could drastically decrease the swelling and pain often found in patients with RA. A team of researchers at the Brigham and Woman's Hospital in Boston took the data from a trial that investigated the risk factors that patients with RA have for heart disease and conducted a secondary trial study. The researchers performed an analysis on the results compiled from a food frequency questionnaire that was used to assess the diet of RA patients over the course of 12 months. The study excluded shellfish, fried fish, and fish that was mixed in meals, but included the consumption of raw fish (such as sushi and sashimi) and fish that was cooked by itself, regardless of whether it was baked, steamed, or broiled. The research also considered the frequency that the fish was consumed under the categories of two or more times per week, from once a month to less than once per week, and from never to less than once per month.
The study revealed that the 17.6 percent of patient participants who consumed fish more than twice per week reported significantly less swelling and pain than the 19.9 percent of participants who ate fish less than one time per month or never. The results led the researchers to suggest that consuming fish at least twice per week may actually reduce the inflammation related to RA disease activity. In a press release, the authors stated that fish has already been found to result in a number of health benefits and its positive effect on RA patients imply that RA patients should increase their consumption of fish.
Rheumatoid Arthritis Injection Treatment Approved by FDA
Kevzara (sarilumab) injections have been approved by the U.S. Food and Drug Administration (FDA) to treat adults with moderate or severe RA, as announced by Sanofi and Regeneron Pharmaceuticals, Inc. The Kevzara injection treatment is recommended for patients who have RA and who have had a poor response or have demonstrated intolerance two previous attempts at taking disease-modifying antirheumatic drugs (DMARDs), such as methotrexate.
The human monoclonal antibody, Kevzara, combines with the interleukin-6 receptor (IL-6r) and may then be used as monotherapy or along with either methotrexate or other DMARDs. Patients are recommended to receive a dosage of 200 mg once every 14 days as a subcutaneous injection. The injection can either be administered by a member of the patient's healthcare team or administered by themselves. If the injections prove to be successful, then the patient can begin to reduce the dosage amount to 150 mg once every 14 days.
The FDA approved Kevzara from the data they reviewed from about 2900 patients who had moderate or severe RA and who had shown inadequate responsiveness to previously attempted treatments. In two separate Phase 3 clinical trials, the Krevzara, when accompanied by a history of DMARDs, showed statistically drastic improvements when compared with patients who had not been given Kevzara.
Pedometer-Based Intervention Reduces Fatigue in Rheumatoid Arthritis
According to a recent study published in Arthritis Care & Research, having an RA patient use a pedometer and keep track of the steps that they take may significantly improve fatigue and increase the patient's level of physical activity.
Patients with RA often have severe issues with fatigue, even those patients who have most of their other RA symptoms under control. Patricia Katz, PhD from the University of California believes that there should be better ways for RA patients to deal with the often-debilitating symptom of fatigue.
Dr. Katz and her colleagues conducted one research study that found that in patients with RA, those with the highest levels of fatigue were also those which were relatively less active than those with lower levels of fatigue. Exercise interventions have been found to improve levels of fatigue in RA patients, however, a strict exercise regimen typically requires trained exercise staff and specialized classes that make the suggested treatment difficult to implement.
However, Dr. Katz and colleagues believe that the use of a pedometer and a diary that records the number of steps taken may be much easier to implement than a loosely followed exercise therapy. A pedometer is fairly easy to use and patients have shown excellent levels of adherence to using the pedometer and recording the steps in the diaries. Kats believes that the pedometer and step diaries could drastically improve the overall physical activity levels of patients with RA, as well as reduce the patients' fatigue.
The study included a total of 96 patient participants with RA and randomly assigned the participants to three separate groups. In the first group, participants were given the pedometer intervention along with the diary for recording steps; in the second group, participants were also given the pedometer intervention and the step-monitoring diary, but were also given step targets to try to reach; and in the third group, participants were only given education on how to increase their levels of physical activity.
The primary end points of the research study were defined as average weekly steps at week 21 compared with the baseline and changes in fatigue. Changes in fatigue were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS).
In both of the groups that were given the pedometers and diaries, the average weekly step counts increase at 21 weeks, while the group that was only given education on exercise needs showed an interested decrease in the average steps taken.
Dr. Katz stated that while we know that some medications can help fight fatigue, medications alone won't cut it. Taking steps simply by walking is easy for most people to carry out without having to a special gym or a trainer for exercise. The pedometer and diary seem to help provide motivation and patients enjoy keeping a record of their progress as it improves.
References
RA-Associated Pain, Swelling Reduced by Eating Fish (2017, June 29). [Web]. In Rheumatology Advisor. Retrieved from: http://www.rheumatologyadvisor.com/rheumatoid-arthritis/fish-diet-eases-ra-symptoms/article/671204/
Shock Wave Therapy Treatment for Arthralgia in RA Patients (2017, July 19). [Web]. In Rheumatology Advisor. Retrieved from: http://www.rheumatologyadvisor.com/rheumatoid-arthritis/shock-wave-therapy-for-arthralgia-in-ra-patients/article/673867/
Strassler, D. (2017, June 5). Rheumatoid Arthritis Injection Treatment Approved by FDA. [Web]. In Rheumatology Advisor. Retrieved from: http://www.rheumatologyadvisor.com/rheumatoid-arthritis/rheumatoid-arthritis-kevzara-injection-fda-approval/article/666267/
Wong, C. (2017, June 06). Pedometer-Based Intervention Reduces Fatigue in Rheumatoid Arthritis. [Web]. In Rheumatology Advisor. Retrieved from: http://www.rheumatologyadvisor.com/rheumatoid-arthritis/fatigue-in-ra-reduced-with-fitness-activity/article/666562/
