Reports From National Arthritis Meeting
Dr. Shiel Gives Perspectives Of Interest On Osteoarthritis From
Below are perspectives on key reports presented at the national meeting of the American College of Rheumatology:
Osteoarthritis is a type of arthritis that is caused by breakdown of cartilage, with the eventual loss of the cartilage of the joints. Cartilage is a protein substance that serves as a "cushion" between the bones of the joints. Osteoarthritis is also known as degenerative arthritis. Among the over 100 different types of arthritis conditions, osteoarthritis is the most common and affects over 15 million people in the United States. Before age 45, osteoarthritis occurs more frequently in males. After age 55, it occurs more frequently in females. In the United States, all races appear to be equally affected. A higher incidence of osteoarthritis exists in the Japanese population, while South African blacks, East Indians, and southern Chinese have lower rates. Osteoarthritis usually affects the hands, feet, spine, and the large weight-bearing joints, such as the hips and knees.
Valdecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that is being studied for use in the treatment of rheumatoid arthritis and osteoarthritis. It is not yet commercially available. Prostaglandins are chemicals that are important contributors to the inflammation of arthritis, which causes pain, fever, swelling, and tenderness. Valdecoxib blocks the enzyme that makes prostaglandins (specifically, cyclooxygenase 2 or Cox-2), thereby resulting in lower concentrations of prostaglandins. As a consequence, inflammation and its accompanying pain, fever, swelling, and tenderness are reduced. Cox-2 Inhibitors differ from traditional NSAIDs in that they cause less inflammation and ulceration of the stomach and intestine and do not interfere with the clotting of blood.
Valdecoxib was shown to be beneficial in treating
osteoarthritis of the hip.
Etoricoxib is another Cox-2 NSAID that is being investigated for the treatment of rheumatoid arthritis and osteoarthritis (see Valdecoxib above). Previous studies have demonstrated its effectiveness in relieving the signs and symptoms of joint inflammation.
This experimental drug was shown to be effective
in the treatment of osteoarthritis of the knee and hip in over 200
Fewer patients treated with etoricoxib had to
discontinue the medication because of gastrointestinal complications as compared
with the traditional NSAIDs, Voltaren, and Naprosyn.
Complementary and alternative medicines (CAM) are
being used by 33% of osteoarthritis patients. It was also shown that these
patients seem to be more cautious about their health, seeking specialists' care
Glucosamine (a radioactive form that could be
identified in tissues) taken by mouth was found to be incorporated into the
cartilage of Beagle dogs.
September 30, 2004 the Food and Drug Administration (FDA) today acknowledged the voluntary withdrawal from the market of Vioxx (chemical name rofecoxib), a nonsteroidal antiinflammatory drug (NSAID) manufactured by Merck & Co. FDA today also issued a Public Health Advisory to inform patients of this action and to advise them to consult with a physician about alternative medications.