Most health experts recommend that people follow an overall healthy diet — one that’s rich in anti-inflammatory fruits and vegetables, whole grains, and lean protein yet low in saturated and trans fat, refined carbohydrates, and salt — for a wide variety of reasons. People who eat in this manner tend to be slimmer and have a lower risk of health problems, ranging from heart disease to cancer to osteoarthritis.

But can a good diet significantly lower your chances of developing an autoimmune condition like lupus? New research suggests it’s not likely.

Like other autoimmune conditions, lupus is believed to be caused by a combination of genetics and environmental triggers. That means you might inherit genetic mutations that make you more susceptible to developing lupus, but something (or perhaps several things) in your environment have the potential to turn those genes “on” or “off.”

A group of rheumatologists and nutrition experts were hoping that diet might turn out to be one of those key environmental triggers. They used data from the ongoing Nurses’ Health Study, in this instance focusing on 194 participants who developed systemic lupus erythematosus (SLE), the most common form of lupus.

The researchers analyzed those participants’ food questionnaires and calculated a nutrition score for each of them based on four healthy eating patterns: the 2010 Alternative Healthy Eating Index, the modified Mediterranean diet, the Dietary Approach to Stop Hypertension (DASH) diet, and the Empirical Dietary Inflammatory Index.

According to the results, which were published in the journal Arthritis Care & Research, there was no association between nutrition scores and the likelihood of developing SLE. That was true for women who had inherited a predisposition to lupus as well as those who had not.

The researchers did note, however, that women who ate large amounts of nuts and legumes were 41 percent less likely to develop lupus than those who rarely consumed nuts and legumes. They called this finding “hypothesis-generating” and said it “should be pursued in future studies.”

The researchers noted that this analysis shouldn’t be the final word on this topic. They suggested that perhaps diet earlier in life may be more influential in lupus risk than diet later in life (and the youngest dietary assessment in this analysis was at age 27). “Our findings warrant replication in large, prospective, general population cohorts, with younger participants and increased racial/ethnic variation,” the study authors concluded.

Track Your Lupus Symptoms with ArthritisPower

Join CreakyJoints’ patient-centered research registry and track symptoms like fatigue and pain. Learn more and sign up here.

The post Can Eating a Healthy Diet Reduce the Risk of Lupus? Probably Not, a New Study Shows appeared first on CreakyJoints.

People with psoriatic arthritis (PsA) are often prescribed methotrexate, an anti-TNF drug like etanercept (Enbrel), or a combination of both. Which option is most effective?

According to a new study, presented at the 2018 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, etanercept alone may be the best choice.

The study, which was sponsored by etanercept manufacturer Amgen, followed 851 patients with PsA for 48 weeks. The patients were randomly assigned to one of three groups: etanercept injections plus oral methotrexate; etanercept only, along with an oral placebo pill; or methotrexate only, along with a placebo injection.

At week 48, members of the etanercept only group and the combination drug group fared equally well, and both had significantly less disease activity compared to the methotrexate-only group. “These results support the use of [etanercept] as monotherapy for PsA,” the authors concluded. This is good news for patients who are looking to minimize the number of drugs they take (and any potential side effects as a result).

The authors also noted that, “aside from GI events, adverse event rates were similar in the three study arms.”

Learn About More Rheumatology Research Breakthroughs

Follow our latest ACR meeting coverage to read about the research findings that could affect your treatment, lifestyle, and overall health.

Get Involved with Patient-Centered Arthritis Research

If you are diagnosed with psoriatic arthritis or another musculoskeletal health condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can use ArthritisPower to track your disease symptoms, share patterns with your doctor, and participate in voluntary research studies. Learn more here.

The post Psoriatic Arthritis Patients May Do as Well with an Anti-TNF Drug Alone Instead of with Methotrexate appeared first on CreakyJoints.

Research has long shown that depression is often associated with other health conditions, such as heart disease and cancer. It’s also been linked to a number of diseases that cause chronic pain, including rheumatologic ones.

According to a new study, people with psoriatic arthritis (PsA) may be at especially high risk for severe depression.

The study, presented at the 2018 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, relied on data from a community-based rheumatology clinic. The researchers analyzed information on 146 patients who had PsA and 366 who had rheumatoid arthritis (RA), all of whom had experienced some level of depression.

Study authors, led by Surjeet Dheer at Mercy Catholic Medical Center in Philadelphia, examined data from patient visits at the clinic. The data included information about each subject’s rheumatologic and depression symptoms. Clinicians had rated each patient’s depression at a given visit on a scale that indicated how mild or severe the depression was.

Although depression was prevalent in both groups, “patients with PsA were more likely to report higher levels of depression than those with RA,” say the authors. That seemed to hold true regardless of how mild or severe a patient’s physical (PsA or RA) symptoms were at the time.

The authors point out that “causality is yet to be determined,” so it’s not clear whether pain and mobility issues related to PsA and RA are what’s causing the depression or vice versa, or if other factors are at play.

But since depression is so common in people with rheumatologic conditions, it’s wise for both doctors and patients to be on high alert so that both physical and mental health issues can be treated promptly and properly before they worsen.

Learn About More Rheumatology Research Breakthroughs

Follow our latest ACR meeting coverage to read about the research findings that could affect your treatment, lifestyle, and overall health.

Get Involved with Patient-Centered Arthritis Research

If you are diagnosed with rheumatoid arthritis, psoriatic arthritis, or another musculoskeletal health condition, you can track depression symptoms by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first ever patient-led, patient-centered research registry for joint, bone and inflammatory skin conditions. You can use ArthritisPower to track your disease symptoms, share patterns with your doctor, and participate in voluntary research studies. Learn more here.

The post Psoriatic Arthritis Is Linked to More Serious Depression than Other Kinds of Arthritis appeared first on CreakyJoints.

Gout is best-known for causing intense pain, usually in the big toe. But research has shown that this condition may cause much more than discomfort. Gout has been tied to an increased risk of cardiovascular disease and premature death.

Using a “treat-to-target” strategy might be the best way to substantially mitigate that risk, according to new research.

The study, presented at the 2018 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, is a follow up to earlier research that was conducted back in 2014. The older trial followed 700 patients and concluded that a variety of factors — including uric acid levels at baseline and during treatment — might predict who had a higher risk of premature death.

At that time, it wasn’t clear whether people who already had developed severe gout could do anything to change this increased early mortality risk. So the new study, conducted by the same team of scientists from Spain, was designed to determine whether bringing uric acid levels in the blood (serum urate) down to normal (less than 6 mg/dL) would make a difference.

The new trial included data on a much larger group of patients — 1,193 of them who were treated at a gout clinic from 1992 to 2017. Researchers tracked patients’ uric acid levels to figure out whether lowering them to less than 6 mg/dL would translate to a lower mortality risk. It did.

When the study began, the average uric acid level of participants was 9.1 mg/dL. Thanks to treatment, most patients were able to get their levels below 6 mg/dL, but about 16 percent still had too much uric acid in their blood. Researchers determined that participants whose uric acid levels remained elevated were significantly more likely to die during the course of the study.

The authors accounted for other variables that might impact mortality risk, including high BMI, alcohol intake, diabetes, and hypertension. High uric acid levels stood out as an independent risk factor.

“There are two current approaches for [excess uric acid] in gout: treat-to-target interventions… or treat to flare unless severe gout develops,” study co-author Fernando Perez Ruiz, MD, PhD told the American College of Rheumatology in a press release. This new study suggests that treat-to-target — treating gout patients as aggressively as needed to get uric acid down below 6 mg/dL — may be a better option than simply treating someone enough to ease their symptoms.

Learn About More Rheumatology Research Breakthroughs

Follow our latest ACR meeting coverage to read about the research findings that could affect your treatment, lifestyle, and overall health.

Get Involved with Patient-Centered Arthritis Research

If you are diagnosed with gout or another musculoskeletal health condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first ever patient-led, patient-centered research registry for joint, bone and inflammatory skin conditions. You can use ArthritisPower to track your disease symptoms, share patterns with your doctor, and participate in voluntary research studies. Learn more here.

The post This Study Shows Why Lowering Your Uric Acid Levels If You Have Gout Could Save Your Life appeared first on CreakyJoints.

While lupus — an autoimmune disease that causes joint and organ damage — might not seem like it has anything to do with this type of distress, the connecting factor is probably inflammation.

“In prior work, exposure to stress and stress-related disorders… has been associated with increased risk of subsequently developing autoimmune diseases, including lupus,” Candace H. Feldman, MD, ScD, assistant professor at Harvard Medical School and the study’s lead author told the American College of Rheumatology in a press release. “Exposure to adverse childhood experiences has specifically been associated with higher levels of inflammation, as well as with changes in immune function.”

To conduct this new study, researchers used data on 67,434 women who participated in the Nurses’ Health Study between 1989 and 2015. During that time period, 93 of the women were diagnosed with lupus. Thanks to questionnaires the subjects had completed every other year, researchers were also able to determine who had been physically or emotionally abused as well as how severe the abuse was.

After analyzing the data, the authors determined that women who had experienced the most severe level of abuse in childhood were more than twice as likely to be diagnosed with lupus as adults compared to those who had not been abused.

When the researchers accounted for other possible risk factors, such as smoking, BMI, and age of first period, the connection between abuse and lupus diagnosis still held relatively strong.

This study, which was funded by the National Institutes of Health, does not prove that abuse causes lupus.

But it does “suggest that the effects of exposure to physical and emotional abuse during childhood may be more far-reaching than previously appreciated,” Dr. Feldman told ACR. “The strong association observed between childhood abuse and lupus risk suggests the need for further research to understand biological and behavioral changes triggered by stress combined with other environmental exposures.”

Learn About More Rheumatology Research Breakthroughs

Follow our latest ACR meeting coverage to read about the research findings that could affect your treatment, lifestyle, and overall health.

Get Involved with Patient-Centered Arthritis Research

If you are diagnosed with lupus, arthritis, or another musculoskeletal health condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first ever patient-led, patient-centered research registry for joint, bone and inflammatory skin conditions. You can use ArthritisPower to track your disease symptoms, share patterns with your doctor, and participate in voluntary research studies. Learn more here.

The post Women Survivors of Child Abuse Have a Higher Risk of Developing Lupus appeared first on CreakyJoints.

Gout, a painful form of inflammatory arthritis that often causes swelling in the big toe, has long been associated with a number of lifestyle factors, like eating a lot of red meat and being overweight. But can you actually prevent the condition?

A new study, presented at the 2018 American College of Rheumatology Annual Meeting in Chicago, suggests that it may be possible if you focus on five key variables.

The researchers used data from the Health Professionals Follow-Up Study to track nearly 45,000 men between 1986 and 2012. None of the men initially had gout, but 1,687 of them developed it during the study period.

Along the way, researchers collected data about the subjects’ lifestyle habits (including dietary pattern), body mass index (BMI), and medical information. In particular, they homed in on five key modifiable factors that have been previously tied to a lower risk of gout:

• Low BMI
• DASH-style diet
• No alcohol consumption
• Vitamin C supplementation
• No use of diuretics

The researchers found that avoiding obesity was most crucial for avoiding gout, but that each of these factors were independently associated with a significantly lower risk. Put them all together and you might be able to avoid the condition entirely. The authors concluded that these “five modifiable risk factors accounted for 70 percent of incident gout cases.”

(However, once you have gout, research shows that you likely need to treat it with medication, not just diet modifications. Read more about peoples’ misconceptions about gout here.)

The study authors note that their conclusions assume a “causal relationship,” meaning they believe — but didn’t actually prove — that these five factors determine whether or not most people develop gout. But given the large size of this study and the fact that there are so many other good reasons to maintain a healthy weight, eat a produce-rich diet, and limit alcohol, adopting some healthier habits seems like a worthwhile move.

Learn About More Rheumatology Research Breakthroughs

Follow our latest ACR meeting coverage to read about the research findings that could affect your treatment, lifestyle, and overall health.

Get Involved with Patient-Centered Arthritis Research

If you are diagnosed with gout or another musculoskeletal health condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first ever patient-led, patient-centered research registry for joint, bone and inflammatory skin conditions. You can use ArthritisPower to track your disease symptoms, share patterns with your doctor, and participate in voluntary research studies. Learn more here.

The post These Are the 5 Risk Factors That Account for About 70 Percent of Gout Cases appeared first on CreakyJoints.

But with many diseases, dietary modifications can only take you so far — and putting too much faith in diet at the expense of heeding your doctor’s recommended treatment plan can put your health at risk.

This may be the case with gout, in particular, according to a recent study presented at the 2018 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago. Researchers, including those from our nonprofit organization, the Global Healthy Living Foundation, surveyed 178 people with gout about their knowledge of the condition. Of those, 53 percent were male. The average age of people in the survey was 52.

“Only about half of people with gout are adherent to their medications, and we wanted to understand more about why this is the case,” says study coauthor Kelly Gavigan, MPH, data scientist at GHLF. “It may be that patients lack adequate understanding about their condition, which in turn affects how well they treat it.”

Here’s what we learned.

Treating Gout with Diet: A Big Misconception

The good news is that 85 percent of people in the survey correctly knew that high levels of uric acid cause gout attacks. But only about half of people said they believe that uric acid-controlling medication such as allopurinol manages gout. Instead, more than 80 percent of respondents said they believed gout is best managed by diet changes, such as limiting consumption of certain foods like red meat, organ meats, and seafood.

It’s important to note that research shows diet changes overall have very little impact on gout management, says Gavigan. “Uric acid cannot be controlled or lowered to an appropriate level by diet changes alone, ” she says. “Medication is most effective at lowering uric acid levels to control gout.”

How Gout Flares Affect Your Knowledge Base

Interestingly, whether or not the patients surveyed were experiencing a gout flare affected some of their beliefs about gout management. For example, patients experiencing a gout flare at the time of the survey were more likely to believe gout is best managed with corticosteroids than those not experiencing a flare.

Corticosteroids can effectively and quickly reduce inflammation in a gout attack, but they should not be used as a long-term treatment because of the risk of side effects. People who believe gout is best managed with corticosteroids may not be aware of the importance of taking uric acid-lowering medication on an ongoing basis.

Getting Treatment from a Rheumatologist: Why It Matters

People with gout may first seek treatment from a primary care doctor, but hard-to-treat, or refractory, cases likely need to be seen by a rheumatologist.

However, the participants surveyed sought information about gout from their rheumatologist (24 percent) at a much lower rate than from online health education sites and their primary care physician (61% and 56%, respectively).

Men were more likely to seek gout information from their rheumatologist than were women (33 percent vs 15 percent).

“While many patients prefer to access information online, there is still an underutilization of rheumatologists for information about managing gout,” says Gavigan.

Get Involved in Arthritis Research

If you are diagnosed with RA or another musculoskeletal health condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first ever patient-led, patient-centered research registry for joint, bone and inflammatory skin conditions.

Keep Reading

• Download Our Patient Guidelines for Managing Gout
• Watch This Webinar: Gout Fact vs. Fiction
• Gout Home Remedies: Here’s What You Can (and Can’t) Do to Relieve Gout Pain Fast

The post 82% of People with Gout Think It’s Best Managed with Diet Changes (But That’s Wrong) appeared first on CreakyJoints.

But few real-world studies have examined the impact of AS — a chronic, systemic, inflammatory disease that primarily affects the sacroiliac joints and spine — on health-related quality of life with regard to work and relationships.

Studying the quality of life of people with AS can be complex due to the slow progression and invisible nature of the disease.

In a recent study presented at the 2018 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, researchers, including those from our nonprofit organization the Global Healthy Living Foundation, surveyed 235 ankylosing spondylitis patients through our ArthritisPower research registry.

Of those, 74 percent were female, which is unique considering that AS is historically known as a more male-dominant condition. More than two-thirds of respondents reported high disease severity as assessed by the RAPID3. Overall, the study found that adults with ankylosing spondylitis experienced high unemployment and a significant impact on their personal relationships.

Here are more details on what we learned.

How Ankylosing Spondylitis Affects Personal Relationships

The most common impacts of AS on relationships were difficulty spending time with friends (63 percent), lack of understanding from friends and family about AS (54 percent), and difficulty spending time with family (47 percent).

In nearly all cases, women reported that AS took a greater toll on their relationships than men did. For example, while 45 percent of women said that AS caused difficulty maintaining friendships, only 25 percent of men did.

Some participants (8 percent of men and 6 percent of women) said that AS even resulted in separation or divorce.

How Ankylosing Spondylitis Affects Your Ability to Work

Half of respondents in the study reported being unemployed; the vast majority of those (91 percent) reported that this was due to AS.

Among the people who were still working, AS affected many aspects of their daily work lives.
People reported difficulty sitting or standing for long hours (72 percent), missing work (47 percent), difficulty doing physical tasks (42 percent), and loss of productivity (41 percent).

Here, too, in many cases, women reported that AS affected their ability to function well at work more than men. Twenty nine percent of women said they were frequently late to work compared with 12 percent of men, for example. And 24 percent of women said they even had to switch their job as a result of AS, while only 15 percent of men said the same.

Talking About Ankylosing Spondylitis with the Doctor

Despite the major ways AS seems to affect patients’ personal and work lives, very few people with AS in the study discussed with their rheumatologist the impact of the disease on their relationships (17 percent), or its effect on work or school (26 percent).

People were much more likely to talk to their doctor about their AS symptoms and how they’re changing over time, how they’re generally feeling, and side effects from treatment.

It makes sense that during a time-crunched doctor visit you’d be likelier to talk about those subjects than how AS is affecting, say, your marriage or career path, but it’s important to let your doctor know what’s happening in other areas of your life. It may be that you could benefit from seeing another specialist, like an occupational or physical therapist or a mental health professional.

Sharing more information with your rheumatologist about the impact of AS on your life using an app like ArthritisPower may be beneficial to you both. It can help your rheumatologist consider whether or how to adjust your treatment or flag when it may be appropriate to connect you with other health care providers.

Getting the Right Info to Manage AS

Another study finding was that people with AS feel they don’t have all the info they need to live well with their disease. Overall, 149 respondents (63 percent) reported that they did not have access to information on how to manage their fatigue. Only 42 respondents (18 percent) said that they had access to all the information they needed about their AS.

People also craved more information on how to manage symptoms on their own and how to find patient support or advocacy groups.

“This data shows us that AS has a huge impact on peoples’ daily quality of life, but AS patients don’t always discuss the burden with their doctors, friends, and families,” says study coauthor W. Benjamin Nowell, PhD, director of Patient-Centered Research at the Global Healthy Living Foundation.

Notably, 62 percent of people in the study reported having depression and 54 percent reported having anxiety. It can be difficult with a disease like AS, which often goes undiagnosed for so long, to feel like the people in your life can really understand what you’re going through and how the disease affects you.

“But it’s so important to share how you feel, both physically and emotionally, with your loved ones,” says Dr. Nowell. Your friends and family might assume no news is good news. They may have no idea what you’re going through unless you let them know.

“This research also highlights an increased need for discussions between patients and their rheumatologists regarding various impacts of AS,” says Dr. Nowell.

This study was done with support from Novartis Pharmaceuticals Corporation.

Keep Reading

• Download Our Free Ankylosing Spondylitis Patient Guidelines
• Become a Patient Advocate in Our 50-State Network
• ‘Modeling Is My Medicine’: Why This Woman’s Ankylosing Spondylitis Diagnosis Makes Her Want to Walk the Runway

The post Ankylosing Spondylitis Is Probably Hurting Your Relationships and Ability to Work, But Too Few Patients Tell Their Doctors About It appeared first on CreakyJoints.

Although ankylosing spondylitis (AS) runs in families, figuring out who has it isn’t easy. This autoimmune disorder causes chronic back pain, but so do many other problems. It typically takes eight to 10 years from the time symptoms start to get diagnosed.

Using a genetic risk score may change that, according to a new study from Queensland University of Technology in Australia.

The new study, presented at the 2018 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, involved the development of two genetic risk scores, which take a combination of many different gene mutations into account.

While some diseases are strongly linked to a single mutation, more often there are many mutations that have been tied to a slight increased risk of a specific disease. Put them all together in a genetic risk score and you get a much better indication of who has or will eventually develop a condition.

For this particular study, scientists created one genetic risk score model based on samples of AS patients who were of European descent. The other model was based on people with AS who were of East Asian descent. Each one factored in thousands of gene variants. The researchers then ran the European test on nearly 8,000 AS patients and more than 14,500 control subjects; the East Asian test was used for another 6,000 AS patients and nearly 5,000 controls.

If a test can perfectly figure out who has a disease and who does not, the “area under the curve” (AUC) would be 1. The AUC for the genetic risk score model found to be 0.92 for the European model and 0.95 for the East Asian one.

Both fared better than then current blood test often used for identifying people with AS (the HLA-B27 test, which had an AUC of 0.87).

“In early disease, MRI imaging is the current gold standard for diagnosis, but it is very expensive, and many patients with early changes on an MRI scan don’t go on to get AS,” study co-author Zhixiu Li, PhD, told the American College of Rheumatology in a press release. “Our findings show that [genetic risk score] has high discriminatory capacity and could be of clinical utility in early diagnosis at lower cost than MRI… [It] could also be applied to identify individuals with high risk of developing AS before major symptoms appear.”

Learn About More Rheumatology Research Breakthroughs

Follow our latest ACR meeting coverage to read about the research findings that could affect your treatment, lifestyle, and overall health.

Get Involved with Patient-Centered Arthritis Research

If you are diagnosed with ankylosing spondylitis or another musculoskeletal health condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can use ArthritisPower to track your disease symptoms, share patterns with your doctor, and participate in voluntary research studies. Learn more here.

The post A New Genetic Test Can Predict Who’s Likely to Get Ankylosing Spondylitis (and Make It Much Easier to Get Diagnosed Quickly) appeared first on CreakyJoints.