Many people with autoimmune disorders take tumor necrosis factor inhibitors, also called anti-TNF or TNFis, which are drugs that reduce inflammation by blocking TNF proteins. These medications — which include adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade), among others — help control disease activity, but as with all drugs there are risks and side effects.

Experts have been especially concerned that they might increase the risk of cancer, though research has been mixed. Now a new study, presented at the annual European Congress of Rheumatology (EULAR 2019) in Madrid, largely puts those fears to rest for psoriatic arthritis (PsA) patients, though some questions remain.

The study, an analysis of data on over 8,000 PsA patients from Sweden, Denmark, Iceland, and Finland who had used TNFis, found that there was no overall increase in cancer cases versus what’s expected in the general population. Researchers also determined that PsA patients who used TNFis were no more likely to develop specific cancers including lung, melanoma, pancreatic, brain, endometrial, and breast.

While that’s reassuring, the news isn’t all good: The authors found that PsA patients who used TNFis were significantly more likely to develop lymphoma. They were nearly twice as many cases of lymphoma compared to the number that’s expected in the general population.

This doesn’t necessarily mean that TNF inhibitors cause lymphoma, since other factors — including having an autoimmune disease (in this case, PsA) in the first place — might play an important role in cancer development. More research will be needed to further investigate this association.

“TNF inhibitors have a well-established efficacy and safety profile in patients with psoriatic arthritis and we welcome these data which contribute to our understanding in the complex area of cancer risk,” said Professor Hans Bijlsma, president of EULAR, in a press release.

Keep Reading

• Psoriatic Arthritis Flare-Ups: Exactly What to Do When You Get One
• How Psoriatic Arthritis Affects Your Feet
• Which Medications Best Control Psoriatic Arthritis Symptoms Like Dactylitis?

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If you have psoriatic arthritis (PsA), an inflammatory joint condition that’s often accompanied by skin psoriasis, you may already know that one of the most important lifestyle changes you can make is to maintain a healthy weight or lose weight if you’re overweight. Fat cells release inflammatory substances; plus being overweight may interfere with the effectiveness of drugs that are often used to treat PsA.

Now a new study, presented at the annual European Congress of Rheumatology (EULAR 2019) in Madrid, further confirms that obesity and PsA are a bad combo. While earlier research has shown that people who are overweight or obese are more likely to develop PsA, this new study specifically looked at the impact of weight on disease activity.

Researchers led by Stefan Siebert, a clinical senior lecturer in inflammation and rheumatology at the University of Glasgow in Scotland, analyzed data on 917 PsA patients and found that those with a higher body mass index (BMI) were more apt to have greater disease activity and more PsA-related disability. These associations held up even after the authors adjusted for other factors including age, smoking status, and disease duration.

“Our results highlight the impact of obesity and need for lifestyle-directed approaches to manage weight in psoriatic arthritis in parallel to joint and skin focused treatments,” said Dr. Siebert in a press release.

If you’re currently overweight, following a Mediterranean-style diet — which features fruits and vegetables, whole grains, and fish — might help you slim down and, in turn, possibly improve your PsA symptoms. (At the very least, it’s likely to reduce your heart disease and type 2 diabetes.) But it’s best to talk to your doctor or a registered dietitian and choose an eating plan that works best with your lifestyle. Getting regular, low-impact exercise is also a smart move, both for maintaining your weight and keeping PsA well-controlled.

Keep Reading

• A Healthy Diet Plan for Psoriatic Arthritis
• Smart Weight Loss Tips for People with Inflammatory Arthritis
• Free Download: Get Our Psoriatic Arthritis Patient Guidelines

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Osteoarthritis (OA) in the hands is often painful and can make everyday activities like turning a doorknob, brushing your teeth, or holding a pen challenging. Yet despite how common this condition is in older adults, treatment options are fairly limited. Most patients rely on home remedies (like ice packs and heating pads), over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen and naproxen, and medicated creams.

Now a new study suggests that oral steroids might offer additional relief for osteoarthritis hand pain.

According to the research, which was presented at the annual European Congress of Rheumatology (EULAR 2019) in Madrid, low-dose prednisolone (a type of glucocorticoid) significantly reduced pain and improved functioning in people with hand OA.

Researchers found took 92 patients with painful hand OA and swelling in the lining of the joint (synovial inflammation) and randomly assigned them to two groups: One group took 10 mg of prednisolone daily; the other got a placebo. After six weeks, members of the medication group fared substantially better in terms of pain and functioning.

Prednisolone is already used to treat other types of arthritis, such as rheumatoid arthritis, but research showing that it helps with any type of OA has been limited so far.

The traditional view of hand OA is that it’s a “wear-and-tear” kind of arthritis that results solely from physical stress to the joints over time. But in recent years experts have come to believe that inflammatory processes also play a major role in osteoarthritis. That might explain why a drug such as prednisolone could have a substantial impact.

“Our study provides evidence that local inflammation is a suitable target for drug treatment in hand osteoarthritis,” study author Féline Kroon, of Leiden University Medical Center in The Netherlands, said in a press release.

Keep Reading

• Osteoarthritis Symptoms You Shouldn’t Ignore
• The Clue That Your Hand Osteoarthritis Might Be More Aggressive Than You Think
• 8 Daily Arthritis Hand Exercises that Can Soothe Your Pain

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Maintaining a healthy weight, doing some daily physical activity, and eating nutritious foods is sound wellness advice for everybody. But it’s especially important for people living with arthritis, which can be a chronic and progressive disease that requires medication and lifestyle changes to optimally manage symptoms and keep disease activity in check.

The challenge, though, is that arthritis’s toughest symptoms, such as pain, disability, and fatigue, make it hard to exercise and adopt healthy eating habits. Weight loss needs of arthritis patients can be different from those of people without arthritis. Cooking complicated meals that require 45 minutes of prep or taking high-intensity bootcamp classes are not an option when it’s hard to even get out of bed or chop up a carrot.

It’s important to continue to understand the specific weight loss needs and challenges of people with arthritis so we can develop better resources to help patients succeed in achieving these important disease management goals.

CreakyJoints wanted to understand how factors like peer support and digital tools help promote weight loss and healthy lifestyle changes in people with different kinds of arthritis. In research presented at the 2019 Annual European Congress of Rheumatology (EULAR) meeting in Madrid, Spain, we surveyed 418 patients about these issues. Here’s what we learned.

1. Barriers to weight loss can vary by arthritis type

Our study differentiated people into two general buckets: those with osteoarthritis, which occurs when there is wear and tear on a joint due to cartilage breakdown from age or injury, and inflammatory arthritis, which occurs when the body’s immune system is overactive and attacks your joints, causing inflammation and pain.

People with any kind of arthritis can have similar problems doing certain kinds of exercises or experiencing pain following exercise. A majority of arthritis patients in this study (57 percent) said that difficulty moving was a challenge for losing weight. Nearly half (48 percent) said that sedentary behavior, such as watching TV, was a challenge for losing weight.

But our research also found that there may be certain barriers that are more common among people with osteoarthritis vs. inflammatory arthritis. Depression was a greater barrier to exercise among people with osteoarthritis (47 percent) compared with inflammatory arthritis (34 percent), for example. Disliking exercise was also a more prevalent barrier for OA patients (35 percent) than for those with inflammatory arthritis (21 percent).

2. Preferences for digital weight loss tools may also vary by arthritis type (or age)

Our data showed that people with inflammatory arthritis were more likely to use digital weight loss tools or want to use additional tools in the future compared with patients with osteoarthritis. For example, 35 percent of IA patients said they used an app to help them exercise; only 19 percent of people with OA did. This may have to do with age and comfort using technology, since the average age of osteoarthritis patients in the study was 62 compared with 55 for inflammatory arthritis.

“What this research tells us is that while arthritis patients do have some similar needs when it comes to wellness and weight loss resources and support, osteoarthritis and inflammatory arthritis patients shouldn’t necessarily be treated exactly the same,” says study co-author Kelly Gavigan, MPH, manager of research and data science for CreakyJoints. “When developing resources for patients, whether digital tools, patient support groups, or community-based programs, it’s important to think about the specific needs of the patients involved, based on their age, type of arthritis, and other factors, in order to make these resources as useful and effective as possible.”

3. Being part of an authentic community matters

While 70 percent of the patients surveyed said they would want to participate in a peer support program for weight loss with other arthritis patients, only 10 percent of them said they would want to join such a program that includes people without arthritis.

“It may be important to people that resources are catered to arthritis patients specifically,” says Gavigan.

Keep Reading

• 12 Weight Loss Tips for Arthritis Specifically
• Advice for Losing Weight When You Really Hate Dieting
• Gentle Range-of-Motion Exercises You Can Do Regularly

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