Rheumatoid Arthritis News, Vol.5: Men & Mortality, Vitamin D Research, New RA Meds

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Here are a couple of the Rheumatoid Arthritis news articles that have caught my eye recently or, in some cases, caused me to roll my eyes.

More Rheumatoid Arthritis news worth mentioning

1) Big news w/Rheumatoid Arthritis in men:methotrexate fights mortality

A study published last month found “men with rheumatoid arthritis were more than twice as likely to die over a seven-year period as their counterparts in the general population, researchers found. During 2,314 patient-years of follow-up, there were 138 deaths, for a crude mortality rate of 5.9 deaths per 100 patient-years…”

What is associated with mortality in men with Rheumatoid Arthritis?

  • Low body weight, as we’ve noted before, is often significant of severe Rheumatoid disease: “Low body mass index (BMI) also was associated with increased mortality, with a standardized mortality ratio of 5.15 (95% CI 3.29 to 8.08) among those whose BMI was below 20.”
  • Loss of muscle mass due to disease activity (Rheumatoid cachexia): “This may have been related to cachexia and anorexia associated with uncontrolled inflammation, the researchers explained.”
  • Methotrexate is negatively associated; it helps men fight RA: “In contrast, the use of methotrexate was associated with a 40% decreased mortality risk (HR 0.63, 95% CI 0.42 to 0.96).”

Read more about mortality in men with Rheumatoid Arthritis.

2) News on Rheumatoid Arthritis and higher Vitamin D doses

In a study published at the ACR meeting in November, it was concluded that vitamin D was not useful in reducing the incidence of RA:

“Calcium and vitamin D intake as a dietary supplement did not have a statistically significant effect on the incidence of RA in the WHI randomized CaD trial. These results suggest that calcium and low dose vitamin D replacement had no effect on the development of RA in post-menopausal women. Further research is needed to assess the effect of supplementation with higher doses of vitamin D on the incidence of RA.”

However, another study may demonstrate that very few patients get a high enough dose of vitamin D to make a difference:

camping with bears“In this study we found that in RA, patients’ vitamin D deficiency is quite common, but not more common than in age-matched control women representative of the general population. 25(OH)D levels were strongly inverse related to disease activity and disability scores. The causality of these associations remain to be assessed… The inverse relationships between vitamin D levels and disease activity or functional impairment are of interest but not of obvious interpretation.”

“From a careful analysis of a large number of epidemiological studies it was recently found that the optimal 25(OH)D concentrations for bone health and extra-skeletal benefits are between 36 to 40 ng/ml%. These levels were achieved only by 9% of our patients and this indicates that, at least in RA patients, in order to achieve 25(OH)D levels above 38 ng/ml in more than 90% of the population, the daily dose of vitamin D should be substantially higher than 800 U per day.”

Read the whole study about Rheumatoid Arthritis and vitamin D complete with charts and references.

3) Rheumatoid Arthritis medicine news

I’m not sure why this was just posted, but it was recorded at the ACR meeting in November. Dr. Jonathan Kay with Medscape interviewed Dr. Stephen Paget about new types of Rheumatoid Arthritis medicines in the “pipeline.” The video is 15 minutes of informative discussion about new types of RA medicines that we heard about at ACR. I was thinking you’d enjoy watching it as a good report of new RA medicines that we may see soon.

Watch the video or read the transcript of news on Rheumatoid Arthritis meds.

Sadly mistaken

However, there were two regrettable comments: Dr. Kay said, “We have an embarrassment of riches where we can choose between very effective (RA) therapies.” My daughter called across the room, “Who are you listening to?!” Whatever Dr. Kay meant, it seemed inappropriate and inaccurate. As Dr. Paget had already pointed out, at least half of RA patients have inadequate or too short-lived responses to the new “embarrassingly” wonderful medicines. The status quo is so dissimilar that I feel like saying, “If Dr. Kay ever leaves Medscape, Woman’s Day would be glad to have him.”  But, I’ve never ever said anything like that before. There are about 900 pages on this site including comments’ pages which refute that depiction of the current state of treatment with RA.

Another error

This one is more concerning statement since we need the researchers to understand the disease. Immediately afterward, Dr. Paget said, “I would imagine swelling begets erosions; no swelling means no erosions.” I have personally heard from hundreds of patients with erosions and other RA damage without swelling. If this is something that you are unaware of, please read this post and its 200 comments about RA swelling.

Recommended reading:

NOTE: Your comments are an important resource for future readers of this post in the months to come. Please find the comment link below each post.

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Kelly Young. All rights reserved.

This entry was posted on Thursday, February 3rd, 2011 at 6:00 am and is filed under RA Education, Reality Check. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

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