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A Rheum Full of Contradictions

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1) There’s “remission” when there’s no remission.

A newly published study says more pain is seen with an older conception of Rheumatoid Arthritis remission than with newer more stringent remission criteria. “Disease remission has become a feasible goal for most Rheumatoid Arthritis (RA) patients; however, patient-reported symptoms, such as pain, may persist despite remission.” Remission is feasible for most patients? What kind of remission still has symptoms?

2) Remission is in the eye of the beholder.

The National Databank for Rheumatic Diseases recently explored why they found an actual 6% remission rate, while trials of drug companies claim 50% remission is achievable.

3) There is pain with “pain relief.”

Although 75% of RA patients studied were currently taking pain-relief medications, 72% still reported experiencing daily pain. Even though nine out of ten mentioned pain in discussions with their physicians, 67% agreed that they constantly look for new ideas to address pain.

4) There can be inflammation when there’s “no inflammation.”

CRP is often called, “the acute phase reactant” and considered as the most objective evidence of RA disease activity by many rheumatologists. However, the use of CRP to rate RA disease activity has so far failed to consider the genetic influences on CRP levels. Genetic studies have consistently shown the genetic influence on CRP. “A difference in 232% in CRP level attributable to genetics alone is not inconsiderable.”

“It is clear that a patient with a genetically determined low CRP level has to have considerable worse disease to read the same DAS28 threshold as a patient with genetically determined high CRP. Considering that in some countries such as the UK, access to biologics therapy is essentially rations on the basis of disease activity score,” some will be denied treatment based on genes.

5) Look at the images click here – there is even swelling when there’s “no swelling.”

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Kelly Young. All rights reserved.

This entry was posted on Tuesday, June 14th, 2011 at 6:00 am and is filed under Reality Check. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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