Spleen tyrosine kinase (Syk) is an important mediator of inflammatory signals from extracellular receptors to the nucleus of immune cells. Inhibiting Syk with the oral, small-molecule inhibitor fostamatinib has shown efficacy compared to placebo in a short term study of RA patients on background methotrexate. Here, Weinblatt et al (NEJM 2010; published online ahead of […]
Lower Dose of Rituximab for RA Treatment Explored
The dosage of rituximab commonly used in clinical practice (1000 mg infused twice, separated by two weeks) is largely empirically based. It is unclear whether lower doses will result in reduced efficacy or improved safety. Here, Emery et al (Ann Rheum Dis 2010; 69: 1629) explore patient outcomes in RA patients treated with 2 x […]
Urate Lowering Effects of Milk Explored
Ingestion of dairy products has been associated with a lower risk of gout in observational studies. However, the mechanism underlying this protective effect is unstudied. In addition, the association could be related more to health behaviors associated with milk drinking, such as better general health and less consumption of alcohol and red meat, rather than […]
Are TNF Inhibitors Efficacious for the Treatment of Sciatica?
Inflammatory cytokines are implicated in the painful symptoms of sciatica, a common form of lumbar radiculopathy associated with intense pain and dysfunction. Case reports have suggested that TNF inhibitors may improve pain in individuals with sciatica. However, since sciatica is often self-limited, uncontrolled reports of efficacy may be misleading. Here, Genevay et al (Arthritis Rheum […]
Does Antioxidant Intake Protect Against the Development of Rheumatoid Arthritis or Lupus?
Antioxidants may protect tissues against damage, reduce systemic inflammation, and modulate antigen presentation by inflammatory cells. However, no large-scale investigation on whether dietary and/or supplement intake of antioxidants is protective against the development of autoimmune rheumatic disease. Here, Costenbader et al (American Journal of Epidemiology 2010; 172(2): 205) explore antioxidant intake and the risk of […]
Are the Incidence and Prevalence of RA Changing in the United States?
The epidemiology of rheumatoid arthritis (RA) is influenced by a number of factors, including survival, changes in diagnostic tools, and temporal trends in environmental factors that may promote or protect from disease. Here, Myasoedova et al (Arthritis Rheum 2010; 62(6): 1576) explore the trends in RA incidence and prevalence over 50 years in a population-based […]
Denosumab Receives Approval Recommendation for the Treatment of Post-Menopausal Osteoporosis
On June 2, 2010, the Advisory Committee for Reproductive Health Drugs of the U.S. Food and Drug Administration recommended approval of denosumab, which will be marketed under the trade-name Prolia, for the treatment of post-menopausal osteoporosis. The drug was also recommended for the treatment of bone loss in men receiving hormone suppressive therapy for prostate […]
Dynamic Knee Alignment During Walking as a Risk Factor for Knee Osteoarthritis
Knee alignment may be different during walking than when at rest. Prior studies have identified varus thrust, a worsening of bow-leg alignment that occurs only during the weight bearing phase of walking, as a risk factor for developing knee osteoarthritis (OA). Valgus thrust, or knock-knee alignment during walking, may also increase the risk of knee […]
Leflunomide and Pregnancy Outcomes Explored
Leflunomide use during early pregnancy is associated with fetal malformations in animal studies and is classified as a pregnancy category X by the U.S. Food and Drug Administration. However, little is known about pregnancy outcomes in humans exposed to leflunomide in early pregnancy, particularly in those who receive “wash-out” with cholestyramine (a drug sequestrant). Here, […]
Targeting Interleukin-17 Studied in Rheumatoid Arthritis
Recently, it has been recognized that a subset of T cells producing the cytokine IL-17 contribute to the pathogenesis of rheumatoid arthritis (RA). Animal studies have suggested that blockade of IL-17 may reduce the inflammatory signs and symptoms of inflammatory arthritis and reduce bone erosion. Here, Genovese et al report Phase I/II data for LY2439821, […]