Whitney Palmer

Healthcare. Politics. Family.

Only Minimal Pain Relief from VitD for Knee Pain

Published on the April 5, 2016, Rheumatology Network website

By Whitney L.J. Howell

Current evidence about the benefits of Vitamin D supplementation in knee osteoarthritis (OA) is contradictory. This finding disagrees with observational evidence that points to a positive impact, shows a study presented at the OARSI 2016 World Congress held in Amsterdam this month.

Comparing the effects of Vitamin D supplementation to a placebo on knee pain, knee cartilage volume, and other structural changes in symptomatic knee osteoarthritis patients with low Vitamin D could shed light on its efficacy.

In an April 2 presentation titled, “Vitamin D Supplementation for the Management of Knee Osteoarthritis: A Randomized Controlled Trial,” Changhai Ding, M.D., from the University of Tasmania in Australia, discussed whether supplementing Vitamin D over two years can lessen knee osteoarthritis symptoms.

“Vitamin D supplementation over two years did not meet either primary endpoint. Secondary analyses suggest modest benefits on knee pain, physical function, bone marrow lesions and effusion-synovitism,” the authors wrote in the abstract.

In a multicenter trial, 413 symptomatic knee osteoarthritis patients – average age 63 and 51 percent women – who also had low 25-hydroxyvitamin D (25OHD) (12.5-to-60 nmol/L) participated in a placebo-controlled study. They either received 50,000 IU Vitamin D3 (n=209) or a placebo (n= 204) for two years. Primary outcomes included a change in tibial cartilage volume on MRI and in pain levels. Secondary outcomes were knee pain, WOMAC function, cartilage defects, bone marrow lesions (BML), and joint effusion-synovitis on MRI.

Vitamin D levels did increase in the 25OHD, and the group did have less cartilage volume loss and more pain reduction, -3.44 percent and -4.23 percent and -49.9 and -35.1, respectively, even though the differences weren’t significant. After a second analysis, the 25OHD group experienced greater knee pain improvement. However, there was no significant difference in tibiofemoral cartilage defect changes or BMLs.

Fewer 25OHD participants had an increase in BMLs, and they had less increase in effusion-synovitis volume than the placebo group (0.26 ml and 2.20 ml). The 25OHD group also had a significantly higher chance of achieving a minimal clinical important improvement in total and suprapatellar effusion-synovitis.

To read the article at its original location: http://www.rheumatologynetwork.com/OARSI2016/only-minimal-pain-relief-vitd-knee-pain



April 13, 2016 Posted by | Healthcare | , , | Leave a comment

OA Pathology Linked to New Biomarkers

Published on the April 5, 2016, Rheumatology Network website

By Whitney L.J. Howell

Spanish researchers have uncovered evidence that may be indicative of solid biomarkers for osteoarthritis (OA). Researchers reported their findings at the OARSI 2016 World Congress held in Amsterdam this month.

To date, no such biomarkers exist, but this group of researchers found six potential biomarkers, with one rising to the top as an early prognostic biomarker in osteoarthritis. Without a reliable biomarker in osteoarthritis, making a diagnosis can be difficult.

“We have defined an interesting panel of six biomarker candidates. Some of them (ITIH1 and C3) can also distinguish between OA patients and patients from other rheumatic diseases. Moreover, we have found S100A6 could be a novel potential early and prognostic biomarker in OA,” researchers wrote in the abstract.

To identify whether reliable protein biomarkers could be found, the research team conducted a large-scale study to pinpoint potential knee osteoarthritis indicators.

In an April 1 presentation titled “Identification of a Serum Protein Biomarker Panel for the Diagnosis of Knee Osteoarthritis,” Luca Lourido from the rheumatology division of Hospital Universitario de A. Coruna in Spain, discussed using broad-scale profiling of protein levels in serum to discover novel osteoarthritis biomarkers.

The team applied antibody suspension bean arrays to profile serum knee osteoarthritis samples with different Kellgren-Lawrence (KL) scores (n=288) and compared them to rheumatoid arthritis (n=288), psoriatic arthritis (PsA) (n=288), and healthy controls (n=96). Protein profiles were obtained using 174 antibodies from the Human Protein Atlas, targeting 78 proteins.

Forty-six proteins were further profiled in a focused-bead array to validate results in an independent cohort of serum samples of osteoarthritis patient (n=196), RA (n=192), PsA (n=192), and healthy controls (n=92). Samples were selected based on previous internal protein profile studies. Protein profiles were adjusted for sex, age, and body mass index.

Compared to healthy controls four proteins had elevated levels in serum: S100 calcium binding protein A6, leptin, Complement 3, and Inter-Alpha-Trypsin Inhibitor Heavy Chain. Healthy controls had two elevated proteins – apolipoprotein A1 and vitamin D-binding protein. S100A6 was also found at high levels in KL scores compared to healthy controls in both sample cohorts.

Through this profiling, researchers identified a panel of six biomarker candidates that allow for distinguishing samples from healthy individuals and those with osteoarthritis or other rheumatic diseases. Alterations of these proteins could provide new serum biomarkers that could expand the knowledge of OA biomarkers and lend a better understanding of osteoarthritis pathology.

To read the article at its original location: http://www.rheumatologynetwork.com/OARSI2016/oa-pathology-linked-new-biomarkers

April 13, 2016 Posted by | Healthcare | , , , , , , , | Leave a comment

Patients with Osteoarthritis Show Improvements after Weight Loss

Published on the Nov. 8, 2015 Rheumatology Network website

By Whitney L.J. Howell

Massive weight loss due to bariatric surgery could greatly improve the quality of life for osteoarthritis patients, according to a small pilot study.

Approximately 27 million Americans have osteoarthritis, a condition of significant public health concern because it directly impacts an affected adult’s functioning. There have been no new treatments within the past two decades, and the most effective therapy remains joint replacement.

In a presentation given on Nov. 8 at the 2015 ACR/ARHP annual meeting in San Francisco, Calif., Cleveland Clinic rheumatologist and immunologist Elaine Husni, MD, discussed the impact of significant weight loss on quality of life, presenting the surgery as a potential strategy for osteoarthritis-symptom reduction. Recent research indicates fat cells could be metabolically active, contributing to inflammatory cytokine development.

“We wanted to see if massive weight loss in patients with osteoarthritis would make a difference beyond reducing the mechanical load on joints,” she said.

Three years post-bariatric surgery, she said, osteoarthritis patients reported, using the SF-36 self-assessment health survey, greater positive feelings about their overall health than those who didn’t undergo surgery. Patients did, however, during the same time, lose some walking and stair-climbing stamina.

Of the 67 study participants, 49 underwent surgery and 18 received medical intervention alone, such as calorie reduction, behavioral modification, or lifestyle changes. Individuals either had physician-documented osteoarthritis; radiographic evidence of degenerative changes in the hip, knee, ankle, foot, or spine; or they met the American College of Rheumatology’s criteria for knee or hip osteoarthritis.

The pilot study is part of the larger STAMPEDE trial – a randomized, controlled trial, evaluating the efficacy of medical therapy alone versus medical therapy combined with bariatric surgery in patients with uncontrolled Type 2 diabetes.

Additional study into activity level, weight-loss maintenance, and metabolic cytokines is needed to understand how to maintain bariatric-surgery impact, she said.

To read the article at its original location: http://www.rheumatologynetwork.com/acr2015-rn/patients-osteoarthritis-show-improvements-after-weight-loss#sthash.tBFdbwMr.dpuf

November 8, 2015 Posted by | Healthcare | , , , | Leave a comment


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