The Latest in Treating Arthritis

Arthritis is a common ailment that receives a great deal of research. Here we discuss some recent findings.

With over 350 million people worldwide—and over 20 million in the U.S. alone—affected by osteoarthritis, it’s no wonder the condition receives its share of research.

This summer has been no exception with the reporting of numerous interesting results. Here are a few of the highlights:

EULAR 2018

The Annual European Congress of Rheumatology (EULAR 2018) took place last month in Amsterdam, and yielded some interesting findings concerning the early, aggressive treatment at the outset of arthritis cases.

EULAR, or the European League Against Rheumatism, hosts an annual conference dedicated to unveiling the latest studies, research, and pressing topics in the world of arthritis treatment.

Early, intensive treatment has benefits that include reduced mortality rates over time, researchers announced at this year’s conference, which took place from June 13–16.

“Our results confirm that early, intensive treatment of rheumatoid arthritis, including use of glucocorticoids, has long-term benefits,” said one of the study authors, Professor Maarten Boers, VU University Medical Center, Amsterdam. “This study is one of the first to show a normalization of RA mortality compared to the general population after 23 years of follow-up.”

Those 23 years of follow-up followed the COBRA (COmbinatietherapie Bij Rheumatoide Artritis) trial. In that original study, patients with early rheumatoid arthritis were treated with sulfasalazine (SSZ) monotherapy or a combination of SSZ, low-dose methotrexate, and initially high, followed by step-down prednisolone. Results showed the combination therapy offered benefits in disease control over SSZ alone.

This latest study offers proof that the combination therapy offers those same benefits over an extended period.

Physical Activity

The same conference saw experts create a new set of guidelines for advising people with arthritis in regards to physical activity. Emphasizing the importance of continued activity, researchers clarified that following public health recommendations showed no ill effects in people with arthritis; rather, it showed beneficial effects on symptoms and slowing progression.

“People with inflammatory arthritis and osteoarthritis may be reluctant towards engaging in PA, fearing flare-up or joint damage by exercising,” wrote Anne-Kathrin Rausch Osthoff, MSc, from the Institute of Physiotherapy at Zurich University of Applied Sciences in Winterthur, Switzerland. Osthoff led a group of colleagues in the authoring of the recommendations.

“Given the evidence for its effectiveness, feasibility and safety, PA is advocated as [an] integral part of standard care throughout the course of these diseases. It is advised that these recommendations should be implemented considering individual needs and national health systems.”

Stem Cell Research

Not long ago, a team of researchers at Washington University in St. Louis made news when they programmed stem cells to grow new cartilage on a 3-D template shaped like the ball of a hip joint. This was accomplished with the goal of treating worn, arthritic hips without the need for complicated, invasive surgery.

Described as a possible future alternative to hip replacement surgery, this procedure provides particular hope to younger patients, who are regularly made to wait until at least age 50 before receiving a hip replacement due to the reluctance of doctors to perform multiple such surgeries in one lifespan. The average replacement joint has a lifespan between 20–30 years. The hope is that this stem cell-reliant procedure can offer relief to those patients who have not yet qualified for replacement—or maybe become an alternative for the long term.

“Replacing a failed prosthetic joint is a difficult surgery,” said Farshid Guilak, PhD, a professor of orthopedic surgery at Washington University. “We’ve developed a way to resurface an arthritic joint using a patient’s own stem cells to grow new cartilage, combined with gene therapy to release anti-inflammatory molecules to keep arthritis at bay. Our hope is to prevent, or at least delay, a standard metal and plastic prosthetic joint replacement.”

Weight Loss

Overweight and obese individuals tend to suffer more pain associated with osteoarthritis due to the increased demand on their affected joints. Some time ago, researchers proved that individuals with knee osteoarthritis would enjoy a 50 percent reduction in pain by losing just 10 percent of their body weight over an 18-month period.

The same group of researchers’ latest findings—published in Arthritis Care & Research—reveal that a 20 percent or greater weight loss has the added benefit of continued improvement in physical health-related quality of life along with an additional 25% reduction in pain and improvement in function.

A total of 240 overweight or obese individuals were divided into four groups according to the amount of weight lost over 18 months: less than 5 percent, 5–10 percent, 11–20 percent, and greater than 20 percent (as a percentage of total body mass.)

The investigation found that those participants who experienced greater weight loss fared better in terms of:

  • Pain
  • Function
  • Six-minute walk test
  • Physical/mental health-related quality of life
  • Knee joint compression force
  • IL-6 (a measure of inflammation)

SOURCES: EULAR, Science Daily, Wiley

About The Author