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Monday, November 2, 2015

New medicine for Psoriasis arthritis soon available in Dubai UAE

Psoriatic arthritis is a type of arthritic inflammation that occurs in about 15% of patients who have a skin rash called psoriasis, and it can affect any joint in the body.
Results of a recent clinical trial has revealed that Ixekizumab not only shows considerable promise for the treatment of moderate to severe psoriasis, it looks like it may be a winner for comorbid psoriatic arthritis, too.
According to Dr. Alice B Gottlieb of the Tufts University School of Medicine, the investigational IgG4 humanized monoclonal antibody directed against interleukin-17A brought marked improvements in joint pain, systemic inflammatory burden, and quality of life as well as skin disease in patients with both psoriasis and self-reported psoriatic arthritis. This result of a combined analysis of three phase III clinical trials was reported by Dr. Alice B. Gottlieb at the annual congress of the European Academy of Dermatology and Venereology in Copenhagen recently.
Details of the Study
Of the 3,126 patients with moderate to severe psoriasis who participated in the 12-week trials, 751 (24%) also had self-reported psoriatic arthritis. Dr. Gottlieb’s analysis focused on them.
She was quick to note that the UNCOVER trials were primarily psoriasis studies that relied upon patient self-report of psoriatic arthritis. Nevertheless, it seems likely that the great majority of self-reported psoriatic arthritis patients really did have the rheumatologic disease, since the mean baseline C-reactive protein (CRP) level in that group was 8.43 mg/L, a level far higher than expected in patients with psoriasis only.
In any case, more-rigorous phase III studies of ixekizumab conducted specifically in patients with formally rheumatologist-diagnosed psoriatic arthritis and treated in rheumatology practices are due to be presented at the annual meeting of the American College of Rheumatology in November 2015. And while Dr. Gottlieb wasn’t at liberty to discuss those results, she did hint that the data will be strongly positive.
“If you’re happy about these UNCOVER findings, you’ll be ecstatic about those,” predicted Dr. Gottlieb, professor of dermatology and dermatologist in chief at Tufts Medical Center, Boston.
Also coming up at the American College of Rheumatology meeting will be the results of the first-ever head-to-head comparison of an IL-17 inhibitor versus a tumor necrosis factor–alpha blocker in psoriatic arthritis patients. While at present most physicians consider a TNF inhibitor to be the treatment of choice in patients with psoriatic arthritis,  that view may change as a result of the forthcoming comparative study, according to the dermatologist.
In each of the three phase III UNCOVER studies, patients were randomized to 12 weeks of subcutaneous ixekizumab at 80 mg every 2 or 4 weeks following a 160-mg loading dose, or to placebo. At baseline, the subgroup with self-reported psoriatic arthritis had a mean Psoriasis Area and Severity Index ( PASI) 0f about 21, a self-rated joint pain severity of 50 on a 0-100 scale, a CRP of 8.43 mg/L, and a Dermatology Life Quality Index (DLQI) score of 14.
The Results
Joint pain decreased dramatically in the two ixekizumab groups as early at 2 weeks into the trial, at which point, patients on treatment every 2 weeks averaged a 13.1-point reduction from baseline, with a similar 14.1-point drop noted in those on an every 4 weeks schedule. At week 12, the mean reductions from baseline were 25.2 and 26.8 points, compared with a 1.1-point increase in joint pain among placebo-treated controls.
Inflammatory burden plunged quickly, as evidenced by mean reductions in CRP of 4.63 mg/L and 4.33 mg/L at week 1 with biweekly and monthly dosing, respectively. These reductions were then maintained through week 12.
In terms of improvement in skin symptoms, with ixekizumab dosed every 2 weeks, the PASI 75 response was 89.8% at 12 weeks, the PASI 90 response was 69.3%, and the PASI 100 response (clear skin) was 37.1%. In patients treated every 4 weeks, the rates were 81.1%, 60.8%, and 34.7%.
“There’s good news in both groups, but I think the news is even better in the every-2-weeks group,” Dr. Gottlieb commented.
The ixekizumab-treated groups also showed what Dr. Gottlieb described as “dramatic” improvements – in the 4+ to 5+ point range – in both the mental and physical component scores on the SF-36, another widely used quality of life measure.
Improvements in skin and self-reported joint symptoms appeared to correlate. “Obviously, one needs to look at this more carefully in a phase III psoriatic arthritis study. That’ll provide a more robust answer. But this gives a hint,” she said.
The UNCOVER program was sponsored by Eli Lilly. Dr. Gottlieb serves as an adviser to Lilly and numerous other pharmaceutical companies.

#PsoriaticArthritis #JoinPain #Inflammation #Arthritis

Friday, October 30, 2015

Living in Dubai with arthritis. Does air pollution makes it worse?

Studies of 500 patients with rheumatoid arthritis showed that flares got worse when air pollution was high..  Similar studies for Los Angeles.  Some types of arthritis may improve in Dubai due to the warm temperatures.
http://www.healthline.com/health-news/dirty-air-linked-to-rheumatoid-arthritis-flares-102915

Monday, October 26, 2015

Arthritis medicine can cure baldness! Posted by Rheumatologist in Dubai

A new kind of medicine called JAK (janus kinase ) inhibitor is making waves for being able to cure alopecia areata (a type of baldness), read the full story with the link below

http://news.sciencemag.org/health/2015/10/arthritis-drug-doubles-hair-fertilizer

Sunday, October 25, 2015

Diet for Rheumatoid arthritis in Dubai. posted by Rheumatologist in Dubai

Many arthritis patients are sensitive to several foods. The mechanism by which food sensitivity is involved in arthritis remains unknown. Some evidence implicates the gut flora. Some of the commonly used drugs for arthritis increase the permeability of the gut, causing it to become “leaky”, allowing larger molecules of foods to pass through than would normally be the case, causing food sensitivity. Many studies have shown that 30-40% of rheumatoid arthritis (RA) patients can improve substantially by using an elimination diet to identify foods that precipitate symptoms and the avoiding of these foods. Some studies have shown, that gluten and/or dairy products may be involved in this food sensitivity at some arthritis patients.
Elimination diets typically involve entirely removing the suspected food from the diet for a period of time from two weeks to two months, and waiting to determine whether symptoms resolve during that time period. If symptoms resolve after the removal of a food from the diet, then the food is reintroduced to see whether the symptom reappear.
Some people feel that cutting out ‘acidic fruit’ such as oranges, lemons and grapefruit helps arthritis. Others believe that vegetables from the so-called nightshade family (which includes several foods – potatoes, tomatoes, sweet and hot peppers and eggplants) are bad for arthritis. There is no scientific evidence that leaving out either of these groups of fruits and vegetables helps arthritis, and such diets may have the undesired effect of reducing the beneficial antioxidants in the diet.
Food sensitivity is highly individual, and varies from person to person. Elimination diet should be done under the supervision of your doctor to eliminate the risk of nutrient deficiency.
Food intolerance tests which test for IGG Antibodies against 200 foods are available at our center
Recently we presented our findings - results of the immune pro food intolerance test on 35 patients with arthritis.  About 100 % were intolerant to cow's milk and 85% to gluten / wheat.  Eliminating these foods has shown to be beneficial to majority of patients.