Arthritis Treatment: Biosimilars For Rheumatoid Arthritis Treatment

Rheumatoid arthritis (RA) is the most common inflammatory form of arthritis. It is a systemic, chronic, progressive, autoimmune disorder that affects, roughly, two million Americans.

While it preferentially attacks joints, it may affect other organ systems. These other areas include the lungs, heart, peripheral nervous system, skin, bone marrow, and eyes.

Early diagnosis is key. If RA is suspected, a patient should be referred to a rheumatologist (arthritis specialist) as soon as possible.

The current goal of RA therapy is to treat and control disease before any joint damage has occurred. Once the diagnosis is established, aggressive treatment with DMARDS should be started. These DMARDS are usually a combination of standard "old school" DMARDS such as methotrexate along with "new school" DMARDS, called biologics (BDs). These latter medicines are proteins that are used to specifically target the immune abnormalities that characterize rheumatoid arthritis.

Using this approach, it is possible to get the majority of RA patients, seen early, into remission.

BDs are extremely complex proteins that undergo a much different development process compared with standard non-biologic drugs. Unlike standard drugs, BDs are made of living proteins, antibodies or pieces of antibody. As a result they are very expensive, costing in the neighborhood of $20,000 per year.

Nonetheless, since BDs are such precise "laser-targeted" weapons, they are extremely effective. And it's estimated that approximately 40 per cent or more of patients with moderate to severe rheumatoid arthritis take these medicines.

Recently though, various forces including patent expiration as well as healthcare regulations have paved the way for the development of "biosimilar" BDs. These are basically generic versions of the currently available BDs. That's the good news. The bad news is that because the manufacture of biologic protein drugs is so complex, the price is not expected to drop that much with the introduction of biosimilars.

Estimates vary from 60-90 percent of the current biologic price is where biosimilars will fall. Cheaper but no bargain.

Another issue will be how good they will be. Because the manufacturing process is so complicated there can be significant variability so that biosimilars may not work as well as the originals. They may also have unforeseen side effects that also differ from the original drug.

In addition, continuing research into the development of other BDs with different mechanisms of action are expected to create a more competitive environment. An example is the development of some new oral BDs that are expected to have a major impact in RA therapeutics.

Rheumatoid Arthritis Diagnosis - A Review Of 3 Methods Used

Know If You Have It

Rheumatoid arthritis is a special type of arthritis that affects a person's immune system as much as it affects the joints, bones, and muscles. Diagnosing rheumatoid arthritis the moment its symptoms appear is crucial for its treatment and prevention. If not acted on immediately, the chances of lasting joint damages and loss of mobility functions become higher. That means that people with advanced rheumatoid arthritis can become disabled.

This is why rheumatoid arthritis has to be diagnosed as early as possible. You should consider seeing your doctor if you suffer from any of these symptoms:

Thickening of the Joint's Lining. Anytime that you feel the swelling in the joints had subsided but the area doesn't seem to be the same as it used to be, there is a high chance that the lining around the joints have already thickened. If you do have this condition, then you might just have rheumatoid arthritis. It should also be the time you go to a health care specialist for a more accurate diagnosis.

Swelling, Pain, Stiffness, Redness, and a Warm Sensation on the Joints. There are a lot of joints in the body. Following that concept, rheumatoid arthritis can possibly strike anywhere. If you feel any chronic pain on any part of your body, more particularly in the knees, neck, and shoulders, it is possible you have arthritis.

Chronic pain means that the pain recurs from time to time. Arthritis comes in different forms. If you merely suffer from joint pains, what you may have is not rheumatoid arthritis. But it is always best to have it checked so that the symptoms can be properly addressed.

Loss of Movement. Once you feel that your motor skills are affected by the chronic pains you are experiencing, then you must be on the advanced stages of rheumatoid arthritis already. By this time, you should have the right kind of medications prescribed so that every time you feel the pain, you have something to relieve it.

Methods Used For The Diagnosis Of Rheumatoid Arthritis

To diagnose rheumatoid arthritis, the doctor would need to perform a series of test on the patient. Here are the different methods that a health professional would use to determine if a patient does have rheumatoid arthritis.

X-ray. X-ray is the most basic type of medical diagnosis procedure. Doctors normally request this first because it gives them a good image of the body part where arthritis usually strikes. While this method alone cannot confirm the presence of the disease, it can certainly rule out the possibility that the pain is caused by some other diseases. Doctors also use x-rays to compare the progression of the disease on the patient over a certain period of time.

Latex Test. The latex test is the procedure used to specifically diagnose rheumatoid arthritis. This diagnostic process examines the blood and checks it for antibody known as the rheumatoid factor.

Whenever there's an inflammation on the joints and its lining, the body reacts by secreting this type of antibody. Once the rheumatoid factor is detected in the blood, then there would be no doubt that the patient has rheumatoid arthritis.

Sedimentation Rate Testing. After the doctor has rightfully determined that their patients are suffering from rheumatoid arthritis, then the next thing they need to find out would be the blood's sedimentation rate. To do this test, a blood sample is drawn and is made to settle for some time. If the sedimentation rate is high, then it means that the patient is suffering from an active type of inflammation.

We have described the 3 most common methods used for rheumatoid arthritis diagnosis. It's practically a cliche that prevention is better than cure, but it is still true. So if you suspect that you may be suffering from this problem, make sure to see your doctor right away so you can confirm your actual health status.

Dog Arthritis Treatment Options

So your dog has a been diagnosed with dog arthritis. What do you do now? There are many things that can help in the treatment of arthritis. It is important to know all your options first so that you can make an educated decision about what would be best for your dog. There are 5 categories which to consider: Joint Supplements, Pharmaceutical Drugs, Alternative Therapies, Exercise and Weight Management.

In order to completely understand Joint Supplements you need to first understand the two main categories. They are Chondroprotectants ie. Cartilage Protectors and Natural Anti-inflammatories. As for chondroprotectants there are three main natural ingredients to consider. Glucosamine and chondroitin have for a long time been the forerunners when it comes to joint supplement ingredients. The newest molecule that is gaining tremendous popularity is hyaluronic acid. All of these are what is known as glycosaminoglycans. They are the precursors that are responsible for the formation and repair of healthy cartilage. As a dog get older or due to some traumatic damage the bodies own ability to supply adequate amounts of these ingredients is diminished, therefore it can be extremely beneficial to supply these ingredients via oral supplementation. In addition, it has been found that these compound work together therefore, finding a supplement that incorporates all three can prove to be more effective.

As for natural anti-inflammatories the list can be very long, but here a few that have been researched over the years and proven to be effective. MSM (Methylsulfonylmethane), Cetyl-M (Cetyl Myristoleate) and Omega 3 Fatty Acids, predominately fish oils. Though, recent research has shown incredible results with the oils extracted from the green lipped mussels of new zealand. This oil has been shown to be rich in an omega 3 fatty acid called eicosatetranoic acid or ETA and has proven to be an amazing natural anti-inflammatory when it comes to joint inflammation.

The problem often times is that consumers do not realize that not all joint supplements are created equal. The quality of the ingredients can vary dramatically when it comes to these products. Most of the time, the old saying "you get what you pay for" really is true when it comes to selecting the right supplement. Quality ingredient cost more and therefore the end product usually is more expensive.

There are also an number of pharmaceutical drugs that have been very effective in relieving the discomfort associated with dog arthritis. The most common drugs prescribed by veterinarians are class a drugs called the non-steroidal anti-inflammatories (NSAIDs). This class of drugs though very effective have meet some serious scrutiny due to there potential side effects. Most hospitals will check your dogs blood work initially and then at one week after prescription and then 4 weeks after. In addition to there potential life threatening side effects there is also controversy whether or not these drugs are over prescribed within the veterinary community before more natural and safe options are considered.

Another pharmaceutical drug that has been gaining tremendous popularity has been Adequan. This drug is in a class of drugs called disease modifying agents. Developed in the 70's for race horses, adequan has shown that it can be very effective as one form of arthritis treatment for dogs.

Lastly, there are the true neurologic pain medications such as tramadol and gabapentin which can be a true god send for the more severe cases of dog arthritis. These medicationa often give a debilitated dog a new lease on life by allowing them the comfort to get up and move around and therefore maintain vital muscle.

Alternative therapies have also been gaining tremendous popularity in recent years. Canine rehabilitation ie. dog physical therapy in the last 10 years has quickly become a very accepted treatment option amongst the veterinary community for dogs after surgery and for dogs suffering from arthritis, who have lost joint range of motion and muscle mass. Canine rehabilitation specialists utilize many of the same modalities that human physical therapist use such as electrical stimulation, therapeutic ultrasound, cold laser therapy and the very popular underwater treadmill. Acupuncture is another alternative therapy that has proven benefits and gained in popularity. Most recently stem cell therapy has been in the media spotlight.

Once you have established the right oral supplement for your dog and whether you dog needs prescription medication, your focus really needs to turn towards exercise and weight management. The majority of domestic dogs don't get the necessary exercise they need. In addition, the majority of dogs are overweight without the pet owners even knowing that their weight is a problem. It is important to speak with your veterinarian about what the ideal body weight is for your dog and therefore what the proper amount of food per day is ideal. For most pet owners it is shocking to find out how little their dogs daily requirement is. Most of the dog food labels over estimate daily quantities.

Juvenile Arthritis Prognosis

JUVENILE ARTHRITIS PROGNOSIS

According to the American Academy of Orthopaedic Surgeons (AAOS) there are three types of arthritis. Doctors classify juvenile arthritis based on the number of joints affected, the symptoms and the presence of antibodies in the blood.

1- Pauciarticular- is called this way because only one joint is usually affected.
Affect girls under the age of 8
The knee, ankle or wrist are most commonly affected
The fingers and toes are rarely affected
The symptoms are very mild
Occasionally three or four joints may be involved
The eyes have to be checked periodically to prevent blindness due to persistent eye inflammation

2- Polyarticular - four or five joints may be involved
About 30% of children suffer this type of arthritis
Girls are most commonly affected
Children with the IgM antibody have the most severe form of this disease

3- Systemic- a fever of at least a 102 degrees a day during two weeks suggest this type of juvenile arthritis.
Symptoms include joint pain swelling and stiffness
Inflammation of the heart,liver,lymph nodes and spleen
A few children develop adult arthritis

Cause
According to the AAOS juvenile arthritis is an autoimmune disease. No one knows exactly the cause. Juvenile Arthritis is not a hereditary disease.
The joint becomes inflamed
The joint stiffens
The joint's growth is changed

History
The first case of Juvenile Arthritis dates back to 1879 and it's considered a relatively modern disease.

Prognosis
The evolution of Juvenile Arthritis may be good if the following guidelines are followed.
The British Journal of Nutrition in the year 2000 reported a potential link between unhealthy fats and increased pain and stiffness in people with arthritis. They blamed it on a substance called nitrites used to cure and preserve various meats. Saturated fats are found in fatty red meats, dark meat poultry,whole milk,creme, cheese and tropical oils.

Fighting Arthritis Through Nutritional Healing

If your aching joints are giving you enough problems to last you a lifetime, you can be just another victim of arthritis. Of the many forms of arthritis, two forms currently stand out as the most common aggressors besieging the American population - osteoarthritis and rheumatoid arthritis. It was reported that a staggering 15.8 million Americans are afflicted with osteoarthritis while 2.1 millions more are suffering from rheumatoid arthritis. Now, that's quite a large number of people, isn't it?

It is also interesting to note that there are more women who are going through this painful experience - thrice as much for osteoarthritis and twice as much for rheumatoid arthritis cases. And if this doesn't seem enough, even young people are not safe from this disease. In fact, it was recently reported that more than 70,000 American minors, are afflicted with juvenile rheumatoid arthritis!

Being afflicted with arthritis might be downright debilitating and extremely discomforting at times, but you do not need to suffer like that indefinitely. You can do something to fight back and reclaim your life. And one of the most effective strategies in handling arthritis is through nutritional healing. By incorporating herbs, vitamins, minerals and other food supplements, you can definitely break from the chains that bind you with arthritis!

Here are some nutritional healing strategies that you might find especially useful in handling the pain brought about by the many forms of arthritis:

o Bring out the primrose oil. Taking 2 capsules of primrose oil two times a day can help control the pain and inflammation resulting from arthritis. You can also try salmon oil for this purpose - it exerts the same action as primrose oil.

o Ever heard of superoxide dismutase? Superoxide dismutase (SOD) is a proven destroyer of free radicals. It can help in preventing the disease from getting worse.

o Take calcium and magnesium supplements - These minerals are required to prevent further bone loss. For best results, take 2,000 milligrams of calcium and 1,000 milligrams of magnesium daily. It would be advisable to use the chelate form of these supplements - they are by far the most effective.

o Coenzyme Q10 - This has been proven to increase tissue oxygenation and aids in repairing damaged connective tissues.

o Try the power of garlic - Taking 2 capsules of odorless garlic 3 times a day will greatly inhibit the formation of free radicals that wreaks havoc to your joints. A word of caution - take garlic capsules along with your meal to avoid any untoward side effects.

o Don't forget your B vitamins! The B vitamins can be very good for you, especially now that you are suffering from arthritis. Vitamin B3 plus B6 dilates the small arteries thus increasing the blood flow to the affected joints to help reduce the swelling. Vitamin B12 plus folic acid, on the other hand, aids in the production of myelin (the protective covering of the nerves) and prevents nerve damage.

o Never underestimate the power of vitamin C! Vitamin C is one of the most powerful destroyers of free radicals. For best results, take 3,000 to 10,000 milligrams (in divided doses) daily.

o Take vitamin E - A daily supplementation using 400 IU of vitamin E can also bring you great rewards. Vitamin E is another powerful antioxidant that can take care of those damaging free radicals and it may also help in mobilizing your joints.

How Arthritis Cream Can Help You Feel Better

If you suffer from arthritis, chances are that you want to find targeted pain relief. Affected joints can throb and ache especially in weather that is cold or damp. Arthritis cream can be a great way to bring about temporary relief. Because arthritis cream uses medicinal ingredients to provide relief it is important to know about them so that you can avoid drug interactions or allergic reactions.

Arthritis cream is often divided into hot creams and cooling creams. This can be great since different types of arthritis need different care regimens and using the wrong product can make your condition worse.

If you suffer from rheumatoid arthritis, there can be heat and swelling in the joints. This is because the body's immune system is attacking the joints and there can be a lot of inflammation. It is this swelling and inflammation that can lead to pain and stiffness. Rheumatoid arthritis sufferers need to be careful of creams which cause the skin or tissues to heat up. This is because added heat can actually harm joints more.

Osteoarthritis does not cause the same heat and inflammation. This is because osteoarthritis is caused by a breakdown in cartilage. Osteoarthritis usually develops as a result of repeated joint use or advanced age although some athletes may develop arthritis in their joints at an earlier age. Joints may feel better as a result of using creams which heat the joints.

Cooling arthritis creams may use salicylate, a drug related to Aspirin to bring on relief from pain and stiffness. People allergic to aspirin should be careful since the drug can be absorbed through the skin.

Arthritis creams which heat the skin and the joints can be a great relief to people suffering from arthritis. They often used capsaicin, the ingredient which gives chillies their heat, to warm tissues and ease pain.

Heating and cooling creams can help in other ways as well. In order to apply the creams they must be rubbed into the skin. This is true whether it is a cream that is squeezed from a tube or put on with the use of a rolling applicator. When anything is massaged into tissues, there is a therapeutic effect. This is because massage will cause increased blood flow to an area which can help to make those body parts feel much better.

Arthritis sufferers who are on specific drug therapies should always make sure to talk to their doctor or a pharmacist before adding any medicines or products to their care regimen. This is because the skin can absorb medications and you want to make sure that there will not be any bad reactions between your cream and the other medications you are using. Finding a way to ease your pain and discomfort can be a valuable tool to managing your disease.

Traumatic Osteoarthritis

Traumatic osteoarthritis or post-traumatic osteoarthritis as it is better known is mainly caused due to an injury of the joints, followed by a number of physiological and mechanical changes. A patient may develop arthritis in a joint which may have been previously injured. The development of arthritis in that joint though may or may not be related to the injury. The progressive degeneration of the joint after an injury along with the genetic or other natural causes of bone degeneration worsen the condition as the patient grows in age. It is extremely important for the treatment, to know whether or not the condition is a direct consequence of the injury.

There are various factors which can lead to conclude whether or not the patient?s condition is a case of traumatic arthritis. If it is noted that other joints are also suffering from similar symptoms as the traumatized joint then the condition is definitely not one of traumatic osteoarthritis. One must also try to recall whether or not the joint was absolutely normal even before the injury and whether or not any evidence of structural damage was found only within a few days of the injury. Many a times, a closer investigation into the history of the injury also reveals that it was not that bad enough to have caused an internal joint condition like arthritis.

However, if the injury may have caused a dislocation of the bone, a fracture, a torn ligament or anything as serious then it may have led to the present condition of arthritis which can easily be classified as traumatic arthritis. Also, if one realizes that only the previously injured joint is affected then too it is a case of traumatic arthritis. An MRI scan can sufficiently establish the condition.

The disease becomes evident only 2 to 5 years after the injury. However, certain changes which are symptomatic of an osteoarthritic condition maybe visible immediately after the injury.