Breakthroughs in Rheumatology
M3 India Newsdesk Nov 08, 2017
Arthritis is one among the major rheumatic diseases affecting most of the people, statistics say that there are about 50 million adults reported for arthritis, i.e., 1 in every 5 adults.
Among the numerous research updates in rheumatology in 2017, this article briefly describes the significant updates and breakthroughs in this field.
Biosimilars approved for treating rheumatological diseases
According to the new consensus-based recommendations, patients with rheumatological diseases can now be treated with approved biosimilars. A recent study claims that biosimilars of adalimumab, infliximab, rituximab, and etanercept were approved and they possess equivalent efficacy in treating rheumatological diseases. However, biosimilars shouldn’t be used if a patient had any adverse effects or if a patient has not responded to the treatment with biopharmaceuticals.
Use imaging for osteoarthritis- EULAR recommendations
The European League Against Rheumatism (EULAR) recommends the use of imaging for the management of symptomatic peripheral joint osteoarthritis. According to the evidence-based study published by EULAR, it recommends to avoid diagnostic imaging and use conventional radiography as a first-line imaging modality in the patients with typical symptoms.
Romosozumab shows efficacy in postmenopausal osteoporosis
Romosozumab holds potential as a treatment for menopausal osteoporosis to help prevent fractures. When compared with alendronate, romosozumab cause fewer radiographic vertebral fractures in menopausal women during the treatment period. However, the safety of the drugs is yet to be established as the subjects experienced serious cardiovascular events.
Specific exercises more effective at treating shoulder impingement
Impingement is a usual cause of shoulder pain and dysfunction yet the treatment options are limited. A recent study on the nonsurgical interventions for the management of shoulder impingement found that exercises, such as those pertaining to rotator cuff and scapular muscles, are most effective in improving shoulder pain.
Adalimumab for the treatment of uveitis in juvenile idiopathic arthritis
Methotrexate (MTX) along with topical corticosteroids are most commonly used for treating juvenile idiopathic arthritis (JIA) associated uveitis. A recent study claims that addition of adalimumab to the combination of MTX and topical corticosteroids had increased the effectiveness in treating uveitis in adults. The researchers also claim that their results contribute to the support of the usage of adalimumab in children with JIA-associated uveitis when MTX and corticosteroids are inadequate. Nevertheless, more data on the safety and long-term outcomes of adalimumab is required to confirm the use of adalimumab.
Inadequate response to intraarticular glucocorticoids injections to treat knee osteoarthritis (OA)
Intraarticular glucocorticoid injections are widely used for short-term pain relief in the patients with knee OA. However, a recent study found that intraarticular glucocorticoid injections are ineffective in treating knee OA. Moreover, they recommend not to treat knee OA patients with serial glucocorticoid injections as it may result in progressive cartilage damage.
Adverse effects associated with short-term oral glucocorticoid use in adults
Many studies had suggested that chronic use of oral glucocorticoids is responsible for a wide array of side effects. A recent cohort study was conducted in over 300,000 adults to check for the short-term effects of glucocorticoids. Their findings suggested that even short courses of glucocorticoids increased the risk of side effects by two to five-fold. Therefore, it is advised to consider the adverse effects before prescribing oral steroids.
Delaying total knee or hip replacement in young men is beneficial
The lifetime risk of a revision surgery after total hip and knee replacement increases with decreasing age. The risk of revision surgery is highest in men in their early 50s. Therefore, it would be beneficial if the surgery is delayed in younger men who can have symptomatic management with conventional therapies.
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