Arthritis Treatment Linked to Liver Problems in Study

HealthDay – 4 hrs ago MONDAY, June 18 (HealthDay News) -- A "medical food" called Limbrel, which doctors prescribe to treat osteoarthritis of the knee, was linked to several cases of liver disease in a small study, but the effects so far seem to be rare and easily reversible.

Still, patients who take Limbrel, also known as flavocoxid, should be aware of the potential for liver problems, said study lead author Dr. Naga Chalasani, director of the division of gastroenterology and hepatology at Indiana University School of Medicine, in Indianapolis.

Patients should not assume that "medical foods," such as Limbrel, are 100 percent safe, he added.

In the United States, medical foods are not subjected to the clinical trials required of prescription drugs before coming to market.

According to Primus Pharmaceuticals, Inc., maker of Limbrel, the main ingredients of the pills are plant elements known as bioflavonoids, specifically baicalin and catechins. The company says Limbrel helps improve mobility and relieve joint discomfort and stiffness related to arthritis.

For the new study, Chalasani and colleagues analyzed 877 cases of liver injury and found four linked with Limbrel. The researchers said it's "highly likely" that the product caused the liver problems in three of the patients and possible in the other one.

Symptoms included nausea, fatigue and yellow skin, Chalasani said. The four patients were women between 57 and 68 years old who showed signs of liver illness between one and three months after taking Limbrel.

They recovered within weeks of discontinuing the drug.

"Our report provides convincing evidence that flavocoxid is capable of causing clinically apparent, acute liver injury," the study authors wrote. They also noted that the pharmaceutical company has discovered 31 possible cases of liver problems among more than 284,000 users since the drug was brought to market in 2004.

It's not clear why Limbrel might cause liver problems, although the researchers suspect one of its chemicals may be at fault, Chalasani said.

According to Dr. Robert Levy, director of clinical development for Primus Pharmaceuticals, "Limbrel is, by far, the safest anti-inflammatory on the market."

Limbrel has an "extraordinary safety profile," he added. He said medical foods must be prescribed and used under the direction of a physician, adding that physicians should monitor the livers of patients who take the drugs.

"Because the liver is the site of metabolism of most drugs and foreign chemicals, a great many drugs, including all anti-inflammatory agents, are known to have some liver toxicity," Levy said.

Painkillers, another common treatment for osteoarthritis, only provide limited relief and are also associated with adverse events, the study authors said.

About 20 million Americans suffer from osteoarthritis, which is the leading cause of disability in the United States, according to the U.S. National Institutes of Health.

Study lead author Chalasani said patients and physicians should be aware that medical food products haven't gone through the same kind of review as regular prescription drugs.

"I'll bet most people who prescribe Limbrel think it's gone through the typical review process," he said. "If a physician chooses to prescribe Limbrel, he or she should be aware that it can cause this toxicity." If patients develop symptoms of liver damage, they should stop taking Limbrel, he added.

The study appears in the June 19 issue of the Annals of Internal Medicine.

The authors of an accompanying journal editorial said that the current policy of allowing medical foods to come to market without rigorous testing may need to be reconsidered, given their popularity and potential for damage.

More information

The U.S. Food and Drug Administration has more about medical foods.

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Research With Dogs Points to Early Test for Arthritis

HealthDay – Fri, May 18, 2012 FRIDAY, May 18 (HealthDay News) -- A new test that can detect and predict osteoarthritis before patients experience symptoms was developed by analyzing the joints of dogs with arthritis.

Osteoarthritis, the most common form of arthritis, affects more than 27 million adults in the United States. Early detection of the disease, which causes pain and swelling in the joints, would allow better treatment options, according to the University of Missouri researchers.

They said their test can be conducted using a single drop of fluid from a patient's joint. The fluid is obtained with a small needle.

"With this biomarker test, we can study the levels of specific proteins that we now know are associated with osteoarthritis," James Cook, a professor of orthopedic surgery and a researcher at the MU College of Veterinary Medicine, said in a university news release.

"Not only does the test have the potential to help predict future arthritis, but it also tells us about the early mechanisms of arthritis, which will lead to better treatments in the future," he explained.

Cook and his colleagues used dogs to develop the test, noting that dog joints operate similarly to the joints of humans and the test is being adapted to human patients. The test has been submitted to the U.S. Food and Drug Administration for approval.

Scientists note, however, that research with animals often fails to provide similar results in humans.

"This test has already shown early usefulness for allowing us to monitor how different treatments affect the arthritic joints in people," Cook said. "With further validation, this test will allow doctors to adjust and fine tune treatments to individual patients. Also, being able to tell patients when they are at a high risk for developing arthritis will give doctors a strong motivational tool to convince patients to take preventive measures including appropriate exercise and diet change."

The research appears in the Journal of Knee Surgery.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about osteoarthritis.

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FDA panel urges approval for Pfizer arthritis drug

"An advisory committee to the US Food and Drug Administration on Wednesday urged US regulators to approve a new treatment for rheumatoid arthritis made by the pharmaceutical giant Pfizer. (AFP Photo/Timothy A. Clary)" title

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Rising Obesity Rates Might Mean More Rheumatoid Arthritis

HealthDay – Fri, May 4, 2012 FRIDAY, May 4 (HealthDay News) -- A new study suggests that severe weight gain might raise the risk for rheumatoid arthritis -- a painful, chronic ailment -- especially among obese women.

The epidemiological research indicated that about half of the increase in rheumatoid arthritis cases in one Minnesota county may be linked to rising obesity rates there over three decades.

"The findings outline yet another disease, or disease group, associated with the current obesity epidemic," said study co-author Dr. Sherine Gabriel. "We are likely to see an increasing incidence of rheumatoid arthritis as a result of the increasing prevalence of obesity if we don't address this health crisis."

Moreover, the research suggested that obesity precedes the onset of rheumatoid arthritis, said Gabriel, a professor of medicine and epidemiology at the Mayo Clinic in Rochester, Minn.

The impact of obesity on rheumatoid arthritis risk appeared greater for women in the study, which may be due to the fact that women get the disease three times more often than men. Men often develop the condition later in life, according to the Arthritis Foundation.

The study, conducted at the Mayo Clinic from 1985 to 2007, appeared online recently in the journal Arthritis Care & Research.

Rheumatoid arthritis affects about 1.3 million Americans, or 1 percent of the U.S. population, according to Arthritis Foundation figures. The autoimmune disorder attacks joint tissues and sometimes organs, causing swelling, inflammation, fever and fatigue. The condition can develop at any time, but it usually develops between the ages of 30 and 60.

The illness is influenced by both genetics and environmental factors, according to background information in the study.

The new research was focused on Olmsted County, Minn., where records of all medical providers have been collected on every resident in one database for decades, Gabriel said.

Adults who developed rheumatoid arthritis were matched with other people based on age, sex and year of diagnosis. Of the 813 people with the disease and another 813 without it, 68 percent were women and about 30 percent were obese. Their average age was 56.

Researchers reported that during the study the incidence of the disease increased by about nine people per 100,000, and 52 percent of the change was attributable to obesity.

Obesity rates in the United States have risen steadily, from about 10 percent of the population in 1980 to almost 36 percent of adults in 2007, according the U.S. Centers for Disease Control and Prevention. About 17 percent of children are obese, the agency's data shows.

Commenting on the new findings, one expert expressed concerns about increasing rates of rheumatoid arthritis fueled by rising obesity rates, but agreed with the study's conclusion that more research was needed because the Minnesota group was not racially diverse. Olmsted County is 90 percent white, according to the study.

"The study was pretty well done," said Dr. Olivia Ghaw, a rheumatologist at Mt. Sinai Medical Center in New York City. But "the population was limited to one county, so I'm not sure the results can be extrapolated to the entire country."

Ghaw said that because rheumatoid arthritis is an inflammatory disease and obesity has been linked to inflammation, a connection between rising rates of both seemed likely.

"The increase in rheumatoid arthritis is troubling," she said. "Obesity confers a greater risk of inflammatory disease" because certain chemicals in fat cells promote inflammation in the body.

Ghaw also cautioned that treating obese patients for rheumatoid arthritis might be more difficult because they may not respond as well to the medications due to "a chronic inflammatory state."

On a positive note, she said the research showed that some patients may be able to prevent the disease by keeping their weight down.

Although the study found an association between obesity rates and rheumatoid arthritis, it did not prove a cause-and-effect relationship.

More information

To learn more about rheumatoid arthritis, visit the Arthritis Foundation.

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THE PARK LANE Health and Vitality Series April Topic Living Well with Arthritis

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2012Save the Date! Monday, April 30th from 3:00 p.m. - 4:00 p.m "Living Well with Arthritis"

Salinas, CA (1888PressRelease) April 18, 2012 - The 2012 Health and Vitality Speaker Series is a community education event held at The PARK LANE's Vista Lounge located at 200 Glenwood Circle in Monterey monthly. The events begin at 3:00 p.m. followed by question and answer s at 4:00 p.m. This series is open to the public and refreshments are provided.

The April presentation is "Living Well with Arthritis" will be held Monday, April 30th from 3:00 p.m. - 4:00 p.m. Guest speakers include Alexandra Fallon, Arthritis Foundation, Brian Ellinoy, Integrative Pharmacistand Joy Colangelo, Occupational Therapist Community Hospital of the Monterey Peninsula. The panel will be discussing the various types of arthritis, treatments and exercises that may help those suffering from one of its many forms. Did you know one in five adults has some form of arthritis?

Special to this event will be the presence of the NOVA Company, makers of the four wheeled rolling walker with handbrakes and seat. NOVA Company will be on site to conduct a "Walker Clinic". Bring in your collapsible aluminum walker, and NOVA Company will replace the tennis balls with new adaptive gliders to make the walker easier to maneuver. There will be no charge for adapting the gliders. In addition to the "Walker Clinic, " Akshai Patel, of AllCare Pharmacy will be bringing assistive devices, arthritis support braces and some of the cr

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Gastro Woes Often Strike Rheumatoid Arthritis Patients

HealthDay – 1 hr 34 mins ago MONDAY, April 9 (HealthDay News) -- People with rheumatoid arthritis are at increased risk for gastrointestinal problems, such as ulcers and bleeding, and also for death related to gastrointestinal issues, a new study says.

The findings highlight the need to develop new ways to prevent and treat gastrointestinal complications in rheumatoid arthritis patients, according to the Mayo Clinic researchers.

They examined data collected from 813 rheumatoid arthritis patients and an equal number of patients without the disease between 1980 and 2008.

During that time, the incidence of upper gastrointestinal problems in rheumatoid arthritis patients declined but was still higher than in people without rheumatoid arthritis: 2.9 vs. 1.7 per 100-person years. Rheumatoid arthritis patients also had a higher rate of lower gastrointestinal problems than people without RA: 2.1 vs. 1.4 per 100-person years.

The researchers also found that 229 of the rheumatoid arthritis patients died and that gastrointestinal problems such as bleeds, perforations and obstructions were significantly associated with their deaths.

"Our findings emphasize that physicians and patients must be vigilant for these complications, which can occur without causing abdominal pain," study co-author Dr. Eric Matteson, chair of the rheumatology department at the Mayo Clinic in Rochester, Minn., said in a Mayo news release.

Quitting smoking and reducing use of corticosteroids may be important ways to cut the risk of gastrointestinal complications in rheumatoid arthritis patients, he added.

The study was published online last week in The Journal of Rheumatology.

More information

The American Academy of Family Physicians has more about rheumatoid arthritis.

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Rheumatoid Arthritis Patients Who Quit Statins May Face Raised Death Risk

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