Health Journal Online

Tag: Arthritis

  • The FDA Just Approved a Powerful Biologic for Children as Young as 6 with Severe Psoriasis or Psoriatic Arthritis

    The FDA Just Approved a Powerful Biologic for Children as Young as 6 with Severe Psoriasis or Psoriatic Arthritis

    Children as young as 6 years old with moderate-to-severe plaque psoriasis or active psoriatic arthritis now have access to one of the most effective biologics in dermatology and rheumatology, following an FDA approval announced June 26, 2026.

    AbbVie announced that the FDA has approved risankizumab (Skyrizi) for children 6 years of age and older with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy, and for active psoriatic arthritis in the same age group. A new 55 mg prefilled syringe was simultaneously approved to support weight-based dosing for patients weighing less than 40 kg, filling a critical gap in pediatric treatment access.

    Risankizumab is now the first and only interleukin-23 (IL-23) inhibitor approved in the United States for pediatric patients 6 years of age and older who weigh less than 40 kg with either plaque psoriasis or psoriatic arthritis.

    Why This Matters

    According to Drug Topics, approximately 30 percent of people who develop psoriasis first experience symptoms before age 18. For these patients, severe psoriatic disease can mean painful, visible skin lesions that affect school participation, social development, and mental health in addition to causing physical discomfort.

    Psoriatic arthritis in children — called juvenile psoriatic arthritis or psoriatic juvenile idiopathic arthritis — causes joint pain, swelling, and stiffness that can impair a child’s ability to walk, write, or participate in normal childhood activities. Before biologics in this class were available for children, treatment options were more limited, and some children were treated off-label with adult formulations in adult doses, which is not ideal from a pharmacokinetic standpoint.

    “Plaque psoriasis and psoriatic arthritis can affect much more than skin and joints — these conditions can shape daily life and disrupt important childhood experiences,” said Roopal Thakkar, MD, executive vice president of research and development at AbbVie.

    What We Know So Far

    Risankizumab is a humanized IgG1 monoclonal antibody that selectively blocks the p19 subunit of IL-23, a cytokine that drives the inflammatory cascade responsible for the skin plaques and joint inflammation in psoriatic disease. It was first approved for adults with moderate-to-severe plaque psoriasis in 2019 and has since received approvals for adult psoriatic arthritis, Crohn’s disease, and ulcerative colitis.

    The pediatric approval is supported by data from the Phase 3 OptIMMize clinical trial program, which enrolled children and adolescents aged 6 through 17. Key findings from the trial:

    In adolescents aged 12 to 17: At week 16, 85.2 percent of risankizumab-treated patients achieved PASI75 (75% reduction in psoriasis severity), comparable to ustekinumab (85.7%). However, PASI100 (complete clearance) favored risankizumab at 40.7% versus 17.9% for ustekinumab.

    In children aged 6 to 11: Response rates at week 16 were high: PASI75 in 86.7%, PASI90 in 76.7%, and PASI100 (complete clearance) in 43.3%. Nearly all patients (90.0%) achieved a physician global assessment score of clear or almost clear.

    Durability: In adolescents who responded and continued treatment through week 52, approximately 95% maintained clear or almost clear skin — a strong durability finding for this age group.

    The safety profile in pediatric patients was consistent with the established adult safety profile, according to AbbVie and Contemporary Pediatrics.

    Who Qualifies for Skyrizi — Children and Dosing

    Age: 6 years and older

    Conditions: Moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy; OR active psoriatic arthritis

    Dosing by weight:

    • Children weighing less than 40 kg: 55 mg subcutaneous injection (new weight-based formulation)
    • Children weighing 40 kg or more: 150 mg subcutaneous injection (same as adult dosing)

    Administration schedule: An initial dose, followed by a dose 4 weeks later, then maintenance dosing every 12 weeks thereafter — the same schedule used in adults.

    The psoriatic arthritis approval for children 6 and older is supported by the OptIMMize psoriasis data plus population pharmacokinetic modeling from well-controlled adult PsA studies.

    What Doctors and Experts Say

    Amy S. Paller, MD, chair of dermatology and professor of pediatrics at Northwestern University Feinberg School of Medicine and a lead OptIMMize study investigator, called the approval significant: “These clinical responses, combined with weight-based dosing for younger patients, may help physicians better support a broad range of children living with these conditions.”

    Medscape’s analysis noted that this is the first IL-23 inhibitor to reach the under-40 kg pediatric population, distinguishing Skyrizi from other biologics in this class that have not yet reached this weight category in children.

    What the Evidence Shows — and What It Does Not

    MedicalDaily Evidence Check

    • Study type: Phase 3 randomized controlled trial (OptIMMize psoriasis program) — active-controlled in adolescents; single-arm open-label in children 6 to 11
    • Participants: Children and adolescents aged 6–17 with moderate-to-severe plaque psoriasis; PsA approval additionally supported by adult data plus PK modeling
    • Published in: Journal of Investigative Dermatology (conference data); FDA review completed June 26, 2026
    • What it found: High rates of PASI75, PASI90, and PASI100 at week 16 with durable responses through week 52
    • Key limitation: The psoriatic arthritis approval for children is partially supported by adult study data extrapolation through PK modeling rather than a dedicated pediatric PsA efficacy trial
    • Safety limitation noted: Detailed pediatric adverse event rates and serious adverse event rates were not publicly released in the press announcement

    What You Can Do Now

    • If your child has moderate-to-severe plaque psoriasis or psoriatic arthritis that has not been adequately controlled with topical therapies, ask your pediatric dermatologist or pediatric rheumatologist about risankizumab at your next appointment.
    • Before starting any biologic, standard screening includes tuberculosis testing, hepatitis B testing, and a review of current infections — discuss these with your child’s specialist.
    • The European Commission approved risankizumab for pediatric plaque psoriasis (ages 6 and up) on June 23, 2026 — just days before the U.S. approval — making this a global regulatory milestone for pediatric psoriatic disease.

    Cost and Access: What Patients Should Know

    Skyrizi is a biologic specialty medication. Insurance coverage and prior authorization requirements vary by plan. AbbVie has a patient support program — myAbbVie Assist — for eligible patients who need help with access or cost. Contact your specialty pharmacy or AbbVie’s patient support team for current assistance program details.

    The Bottom Line

    Skyrizi (risankizumab) is now FDA-approved for children 6 and older with moderate-to-severe plaque psoriasis or active psoriatic arthritis — making it the first and only IL-23 inhibitor available for the under-40 kg pediatric population in the United States. Clinical trial data showed high rates of complete skin clearance in both adolescents and younger children, with durable responses through a year of treatment. Families of children with severe psoriatic disease should ask their pediatric specialist whether risankizumab is appropriate.

    Source link

  • Genicular Artery Embolization Delivered 12 Months of Knee Arthritis Pain Relief without Surgery in Nearly 200 Patients

    Genicular Artery Embolization Delivered 12 Months of Knee Arthritis Pain Relief without Surgery in Nearly 200 Patients

    For millions of people living with knee osteoarthritis, the current treatment ladder has a frustrating middle step that is largely empty. Conservative measures — physical therapy, NSAIDs, corticosteroid injections — provide relief that wanes over months. Full joint replacement surgery is effective but invasive, carries surgical risks, requires weeks of rehabilitation, and comes with a prosthetic lifespan of 15 to 20 years, making it poorly suited for younger or less medically robust patients who face decades of living with arthritis.

    Between those two rungs is a gap that has driven years of research into minimally invasive interventional options. A study published June 16, 2026, in Radiology — the flagship journal of the Radiological Society of North America — now provides the strongest evidence yet that one of those options delivers a full year of meaningful pain relief and functional improvement for appropriately selected patients.

    “For many patients with knee osteoarthritis, there is a real treatment gap today,” said lead author Florian Nima Fleckenstein, M.D., deputy head of Interventional Radiology Campus Mitte at Charité — Universitätsmedizin Berlin. “Conservative measures such as intra-articular injections no longer provide sufficient relief, but joint replacement is not an option for medical or personal reasons.”

    What Genicular Artery Embolization Is — and How It Works

    Genicular artery embolization (GAE) is a minimally invasive procedure performed by interventional radiologists using fluoroscopy (real-time X-ray imaging) and catheter-based techniques. The procedure targets a specific feature of the arthritic knee joint that conventional treatments have largely ignored: abnormal blood vessel formation.

    According to ScienceDaily’s coverage, in a healthy knee, the synovial tissue and supporting structures maintain a normal, controlled blood supply. In osteoarthritis, the chronic inflammation process triggers the growth of abnormal new blood vessels — called neovascularization — in and around the joint. These pathological vessels contribute to sustained inflammation and pain. Standard treatments target the inflammation downstream; GAE targets the vascular supply driving it.

    During GAE, an interventional radiologist threads a thin catheter through a puncture in the femoral artery, navigates it to the genicular arteries supplying the knee, and injects tiny microspheres that block blood flow to the abnormal vessels. By shutting down these pathological vessels, the procedure aims to reduce the vascular contribution to joint inflammation — producing pain relief and functional improvement without cutting, implanting, or removing anything.

    The version studied in the June 2026 Radiology paper uses rapidly resorbable, gelatin-based microspheres — a key distinction from earlier GAE studies that used permanent microspheres. The resorbable particles dissolve in the body over time, potentially reducing risks associated with permanent vascular occlusion in the lower extremity.

    GAE Radiology Study Key Data (June 16, 2026) Detail
    Published in Radiology (RSNA), June 16, 2026
    DOI 10.1148/radiol.253312
    Lead author Florian Nima Fleckenstein, M.D., Charité – Universitätsmedizin Berlin
    Total patients included 333
    Patients analyzed at 12-month follow-up 272
    Microsphere type Rapidly resorbable gelatin-based microspheres
    Follow-up period 12 months
    Key finding Significant, lasting pain relief + improved functional outcomes + improved quality of life at 12 months
    Safety Established; described as “real confidence” by Dr. Fleckenstein
    Procedure type Minimally invasive; image-guided catheter-based; outpatient
    Comparison No randomized placebo control — observational cohort design
    Global OA knee prevalence (WHO) 365 million adults
    U.S. OA prevalence ~32.5 million adults

    What the Study Found — and Why Scale Matters

    According to the Radiology abstract, 333 patients were included in the study, with 272 analyzed at the 12-month follow-up point. “This lets us speak about safety and efficacy with real confidence,” Dr. Fleckenstein told ScienceDaily. The study used validated outcome measures, including patient-reported pain scores and functional assessments, to document improvement.

    The clinical finding was clear: in patients with symptomatic knee osteoarthritis, GAE using rapidly resorbable microspheres provided long-lasting pain relief, improved functional outcomes, and enhanced quality of life across the 12-month observation period.

    According to Applied Radiology’s analysis, Dr. Fleckenstein framed the study’s significance specifically: “This study addresses osteoarthritis, which is a significant public health issue and the leading cause of chronic pain and disability worldwide. With millions of people affected by knee osteoarthritis, particularly in aging populations, finding effective, minimally invasive treatments is critical.”

    “GAE has the potential to reduce the need for more invasive surgeries, lower healthcare costs and significantly improve the quality of life for countless individuals suffering from knee osteoarthritis,” Dr. Fleckenstein added.

    An important technical caveat: this is a prospective observational cohort study, not a randomized controlled trial with a placebo or sham procedure comparison group. The absence of a randomized control arm means the study cannot fully exclude the placebo effect and selection bias as contributors to the observed outcomes. The evidence base for GAE is growing — including prior trials with permanent microspheres that also showed benefit — but the gold-standard randomized trial with a sham control remains an important next step in confirming GAE’s efficacy.

    Who Is an Appropriate Candidate for GAE?

    The procedure is designed for patients who have osteoarthritis-related knee pain that is no longer adequately controlled by conservative measures (physical therapy, NSAIDs, injections) but who are not candidates for or do not wish to pursue joint replacement surgery. This includes:

    • Patients who are too young or too active for joint replacement (where prosthetic lifespan becomes a concern)
    • Patients with medical comorbidities that increase surgical risk
    • Patients on blood thinners or immunosuppressants that complicate surgery
    • Patients who have declined joint replacement for personal reasons
    • Patients for whom prior injections have provided diminishing returns

    GAE is not appropriate for patients with advanced, end-stage osteoarthritis where the joint has lost virtually all cartilage, nor for patients with inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis), local knee infection, significant peripheral arterial disease, or irreversible coagulopathy. Patient selection is performed by the interventional radiologist in consultation with an orthopedic specialist or rheumatologist.

    The procedure is typically performed in an outpatient or same-day surgery setting under conscious sedation. Recovery is significantly less demanding than joint replacement — most patients resume normal activities within days rather than weeks.

    The Road to Widespread Availability

    In the United States, GAE is currently performed primarily at academic medical centers and major hospital systems with active interventional radiology programs. It is not yet widely available at community hospitals. Insurance coverage is variable; Medicare and many private insurers have not universally adopted coverage policies for GAE, though this is an active and rapidly evolving area given the growing evidence base.

    The June 2026 Radiology study’s scale — 333 patients, 272 analyzed at 12 months — represents the largest body of evidence assembled for GAE using rapidly resorbable microspheres, and it is likely to support additional insurance coverage petitions and professional society guidance updates in the coming months.

    Frequently Asked Questions

    What is genicular artery embolization (GAE)?

    GAE is a minimally invasive procedure where an interventional radiologist uses a thin catheter to navigate to the blood vessels supplying an arthritic knee joint and injects small particles that block abnormal (pathological) vessels. By reducing the vascular contribution to joint inflammation, the procedure aims to provide sustained pain relief without surgery.

    How long does the pain relief from GAE last?

    In the June 2026 Radiology study, significant pain relief and improved functional outcomes were sustained at 12-month follow-up in the 272 patients analyzed. Longer-term follow-up data is still being collected.

    Is this better than cortisone injections?

    Cortisone (corticosteroid) injections typically provide relief lasting weeks to a few months. GAE has demonstrated 12-month sustained benefit in this study and prior research, suggesting it offers more durable relief than repeat injections for appropriately selected patients. However, direct head-to-head randomized comparison with injections has not yet been published.

    What does the procedure involve?

    An interventional radiologist makes a small puncture in the femoral artery, threads a catheter to the genicular arteries of the knee, identifies abnormal blood vessels using imaging, and injects tiny resorbable microspheres that block them. The procedure is performed under fluoroscopy guidance, typically with conscious sedation, in an outpatient setting.

    Is GAE covered by insurance?

    Coverage in the U.S. varies by insurer and is still evolving. Medicare and private insurers are reviewing coverage policies as the evidence base grows. Patients should check with their insurer and the interventional radiology team about coverage and prior authorization requirements.

    Source link

  • Why In-Office Infusion Centers Are Changing Arthritis Care

    Why In-Office Infusion Centers Are Changing Arthritis Care

    Infusion therapy is now a vital component in the treatment of autoimmune arthritis, offering timely access to medications in a convenient and controlled setting. In-office infusion centers, commonly found in rheumatology practices, provide a patient-friendly alternative to hospital-based care by combining clinical oversight with convenience. As noted by Jatin Patel, MD, these centers not only enhance the patient experience but also allow physicians to maintain tighter control over treatment adherence and outcomes.

    As the healthcare industry continues to shift toward value-based care models, integrating infusion services into outpatient settings can support cost savings and improve care delivery. Patients benefit from reduced wait times, easier appointment scheduling, and a more familiar environment, while providers gain efficiency and oversight.

    Infusion Therapy and Its Role in Arthritis Treatment

    Infusion therapy has become a cornerstone in managing autoimmune arthritis, particularly in patients who don’t respond well to oral medications alone. Rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis are among the conditions that often require biologic infusions to help control inflammation and slow progression.

    Many of these medications, such as rituximab and tocilizumab, target specific parts of the immune system. Administering them via infusion allows for controlled dosing under medical supervision, which is crucial when dealing with complex autoimmune responses. Patients often report improved mobility and reduced pain after regular treatments, underscoring the importance of maintaining a consistent schedule. During flare-ups, timely infusion can be the difference between regaining function and experiencing prolonged discomfort.

    When these therapies are provided consistently, patients are more likely to experience disease remission or at least a reduction in symptoms. Missed doses or irregular treatment can lead to flare-ups, joint damage, and diminished quality of life. Regular laboratory monitoring and periodic assessments are often coordinated with infusion appointments to ensure safety and therapeutic effectiveness.

    Patient-Centered Benefits

    Receiving infusion therapy in a physician’s office is often more convenient, especially for individuals juggling work, caregiving responsibilities, or mobility issues. Shorter wait times and easier appointment coordination make it simpler to stay on track with treatment, which is often critical in chronic disease care.

    Patients tend to feel more at ease when their infusion sessions occur in the same clinic where they see their rheumatologist. This continuity fosters trust and allows for better communication about how the treatment is working. One person undergoing monthly infusions may feel more confident knowing any concerns can be addressed quickly by a familiar team.

    Beyond the physical comfort, in-office infusion centers often provide a quieter, more personalized environment. Staff are trained to monitor closely for side effects, and patients can relax during infusions, sometimes even catching up on reading or work, making the experience less stressful overall.

    Clinical and Operational Advantages for Providers

    Integrating infusion services directly into a rheumatology practice streamlines care and enhances efficiency. Providers have immediate access to patient records, lab results, and previous infusion notes, which allows for more informed decisions during treatment sessions.

    Physicians can also monitor adherence more closely. When infusions take place in-house, it’s easier to track whether patients are receiving therapy as prescribed. This can be particularly valuable in managing chronic conditions where missing treatments may lead to disease progression or complications.

    Cost and Coverage Considerations

    In-office infusion centers offer a more cost-effective option than hospital-based settings. Insurance companies, including Medicare, have increasingly recognized the value of shifting care to lower-cost environments without compromising quality. Patients may face lower out-of-pocket expenses due to reduced facility fees, which can make it easier to remain consistent with therapy.

    Health systems and payers are also aligning with site-of-care policies that encourage treatment in outpatient or office-based settings. As more patients transition to this model, providers may see fewer administrative hurdles and more streamlined reimbursement processes.

    Source link

  • Can Olive Oil Compete with Arthritis Drugs?

    Can Olive Oil Compete with Arthritis Drugs?

    What happened when topical olive oil was pitted against an ibuprofen-type drug for osteoarthritis and rheumatoid arthritis?

    Fifty million Americans suffer from arthritis, and osteoarthritis of the knee is the most common form, making it a leading cause of disability. There are several inflammatory pathways that underlie the disease’s onset and progression, so various anti-inflammatory foods have been put to the test. Strawberries can decrease circulating blood levels of an inflammatory mediator known as tumor necrosis factor, but that doesn’t necessarily translate into clinical improvement. For example, drinking cherry juice may lower a marker of inflammation known as C-reactive protein, but it failed to help treat pain and other symptoms of knee osteoarthritis. However, researchers claimed it “provided symptom relief.” Yes, it did when comparing symptoms before and after six weeks of drinking cherry juice, but not any better than a placebo, meaning drinking it was essentially no better than doing nothing. Cherries may help with another kind of arthritis called gout, but they failed when it came to osteoarthritis.

    However, strawberries did decrease inflammation. In fact, in a randomized, double-blind, crossover trial, dietary strawberries were indeed found to have a significant analgesic effect, causing a significant decrease in pain. There are tumor necrosis factor inhibitor drugs on the market now available for the low, low cost of only about $40,000 a year. For that kind of money, you’d want some really juicy side effects, and they do not disappoint—like an especially fatal lymphoma. I think I’ll stick with the strawberries.

    One reason we suspected berries might be helpful is that when people consumed the equivalent of a cup of blueberries or two cups of strawberries daily, and their blood was then applied to cells in a petri dish, it significantly reduced inflammation compared to blood from those who consumed placebo berries, as you can see below and at 2:02 in my video Extra Virgin Olive Oil for Arthritis.

    Interestingly, the anti-inflammatory effect increased over time, suggesting that the longer you eat berries, the better. Are there any other foods that have been tested in this way?

    Researchers in France collected cartilage from knee replacement surgeries and then exposed it to blood samples from volunteers who had taken a whopping dose of a grapeseed and olive extract. They saw a significant drop in inflammation, as shown below and at 2:30 in my video.

    There haven’t been any human studies putting grapeseeds to the test for arthritis, but an olive extract was shown to decrease pain and improve daily activities in osteoarthritis sufferers. So, does this mean adding olive oil to one’s diet may help? No, because the researchers used freeze-dried olive vegetation water. That’s basically what’s left over after you extract the oil from olives; it’s all the water-soluble components. In other words, it’s all the stuff that’s in an olive that‘s missing from olive oil.

    If you give people actual olives, a dozen large green olives a day, you may see a drop in an inflammatory mediator. But according to a systematic review and meta-analysis, olive oil—on its own—does not appear to offer any anti-inflammatory benefits. What about papers that ascribe “remarkable anti-inflammatory activity” to extra virgin olive oil? Their evidence is from rodents. In people, extra virgin olive oil may be no better than butter when it comes to inflammation and worse than even coconut oil.

    So, should we just stick to olives? Sadly, a dozen olives could take up nearly half your sodium limit for the entire day, as you can see below and at 3:47 in my video.

    When put to the test, extra virgin olive oil did not appear to help with fibromyalgia symptoms either, but it did work better than canola oil in alleviating symptoms of inflammatory bowel disease. Unfortunately, I couldn’t find any studies putting olive oil intake to the test for arthritis. But why then is this blog entitled “Can Olive Oil Compete with Arthritis Drugs?” Because—are you ready for this?—it appears to work topically.

    Topical virgin olive oil went up against a gel containing an ibuprofen-type drug for osteoarthritis of the knee in a double-blind, randomized, clinical trial. Just a gram of oil, which is less than a quarter teaspoon, three times a day, costing less than three cents a day, worked! Topical olive oil was significantly better than the drug in reducing pain, as you can see below and at 4:37 in my video.

    The study only lasted a month, so is it possible that the olive oil would have continued to work better and better over time?

    Is olive oil effective in controlling morning inflammatory pain in the fingers and knees among women with rheumatoid arthritis? The researchers went all out, comparing the use of extra virgin olive oil to rubbing on nothing and also to rubbing on that ibuprofen-type gel, and, evidently, the decrease in the disease activity score in the olive oil group beat out the others.

    Doctor’s Note

    For more on joint health, see related posts below.

    What about eating olive oil? See Olive Oil and Artery Function.



    Source link

  • Key Autoimmune Arthritis Warning Signals

    Key Autoimmune Arthritis Warning Signals

    Rheumatoid arthritis (RA) is a chronic autoimmune arthritis that affects millions worldwide. Recognizing the early signs and symptoms is crucial for timely treatment and preventing joint damage.

    This article explores the early rheumatoid arthritis symptoms, typical RA signs, how the disease differs from other autoimmune arthritis conditions, and when to see a doctor for evaluation.

    What Is Rheumatoid Arthritis?

    Rheumatoid arthritis is an autoimmune arthritis condition where the immune system mistakenly attacks the body’s own joint tissues. Unlike osteoarthritis, which results from wear and tear, RA causes inflammation inside the joint lining that leads to swelling, pain, stiffness, and eventual joint destruction. It most commonly affects small joints such as those in the hands, wrists, and feet, but it can progress to larger joints as well.

    RA is systemic, meaning it can also affect other organs in the body, including the heart, lungs, and eyes. While the exact cause remains unclear, genetic predisposition and environmental factors like smoking increase the risk of developing this autoimmune disorder.

    What Are the Early Rheumatoid Arthritis Symptoms?

    Identifying early rheumatoid arthritis symptoms is vital as immediate medical attention can slow the disease’s progression. The primary early RA signs include:

    • Joint Pain and Stiffness: Inflammation causes the joints to ache, especially after periods of inactivity. This pain is often symmetrical, affecting joints on both sides of the body.
    • Prolonged Morning Stiffness: One of the classic autoimmune arthritis symptoms is stiffness that lasts for more than an hour in the morning or after resting. This is different from other arthritis types where morning stiffness is typically brief.
    • Joint Swelling and Redness: Inflamed joints often appear swollen, warm, and sometimes red. These signs indicate active inflammation.
    • Fatigue and Malaise: General feelings of tiredness and low energy often accompany the joint symptoms. This systemic symptom is common in RA due to widespread inflammation.
    • Low-grade Fever: Some individuals may experience a mild fever, signaling the autoimmune activity in the body.

    These early symptoms may be subtle, making it important to monitor changes carefully.

    How to Recognize RA Signs in Daily Life

    Early RA signs can interfere with daily activities. People may find it difficult to perform routine tasks such as buttoning shirts, opening jars, or walking comfortably because of joint stiffness, according to the World Health Organization. Noticing symmetrical joint discomfort, for example, pain in both hands or both wrists, can be a key indicator of RA rather than mechanical injury or osteoarthritis.

    The combination of joint symptoms with systemic complaints like fatigue or unexplained low-grade fever should raise suspicion for autoimmune arthritis and prompt medical evaluation.

    Which Joints Are Affected First in Rheumatoid Arthritis?

    RA typically targets the small joints first, particularly those in the hands, wrists, and feet. The joints around the knuckles (metacarpophalangeal joints) and the base of the fingers are commonly involved early. Unlike osteoarthritis, which often affects the thumbs and large weight-bearing joints, RA’s inflammation is characteristically symmetrical and persistent.

    This pattern helps distinguish RA from other arthritis types. Recognizing which joints are affected early on supports faster diagnosis and treatment initiation.

    How Is Early Rheumatoid Arthritis Diagnosed?

    Diagnosing RA in its early stages involves a combination of clinical evaluation, laboratory testing, and imaging. A healthcare provider will assess for RA signs such as swollen, tender joints and review the duration and pattern of joint symptoms, as per the Centers for Disease Control and Prevention.

    Laboratory tests are essential to confirm the diagnosis:

    • Rheumatoid Factor (RF): An antibody present in many but not all RA patients.
    • Anti-Cyclic Citrullinated Peptide (anti-CCP) Antibodies: Highly specific for RA and often present even before symptoms develop.
    • Inflammatory Markers: Elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) indicate active inflammation.

    Imaging techniques such as X-rays can detect joint erosion, but changes may not appear early. Ultrasound and MRI are more sensitive and can identify inflammation and damage before it is visible on X-rays.

    Early diagnosis is critical because starting disease-modifying antirheumatic drugs (DMARDs) early reduces joint damage and improves long-term outcomes.

    What Are the Differences Between Rheumatoid Arthritis and Other Autoimmune Arthritis?

    While RA is a common form of autoimmune arthritis, it is distinct from other autoimmune diseases like lupus or psoriatic arthritis.

    • Lupus: Often affects skin, kidneys, and blood cells with joint symptoms but usually less severe joint erosion.
    • Psoriatic Arthritis: Associated with psoriasis skin lesions and affects joints asymmetrically.

    Some RA signsspecifically include symmetrical joint inflammation, presence of anti-CCP antibodies, and particular patterns of joint involvement.

    Understanding these differences aids in accurate diagnosis and tailored treatment approaches.

    When Should You See a Doctor for Rheumatoid Arthritis Symptoms?

    Prompt medical consultation is recommended when experiencing persistent joint pain, swelling, and stiffness lasting more than six weeks, especially if these symptoms involve multiple joints on both sides of the body.

    Early signs such as prolonged morning stiffness and unexplained fatigue coupled with joint discomfort are also red flags. Since RA can cause irreversible joint damage, early intervention by a rheumatologist significantly improves prognosis.

    How Can Early Rheumatoid Arthritis Be Managed?

    Effective early management focuses on controlling inflammation to prevent joint damage and improve quality of life.

    Disease-Modifying Antirheumatic Drugs (DMARDs): Medications like methotrexate reduce immune system activity and slow progression.

    • Biologic Therapies: Target specific immune system components to suppress inflammation.
    • Physical Therapy: Helps maintain joint flexibility and muscle strength.
    • Lifestyle Adjustments: Regular exercise, balanced diet, and quitting smoking support treatment effectiveness.

    Early, aggressive treatment strategies improve symptoms and reduce long-term disability associated with RA.

    Frequently Asked Questions

    1. Can rheumatoid arthritis affect people of all ages?

    While RA is more common in middle-aged adults, it can affect individuals of any age, including children (known as juvenile idiopathic arthritis) and the elderly. Age does not exclude anyone from developing this autoimmune arthritis.

    2. Are there specific lifestyle factors that can trigger rheumatoid arthritis flare-ups?

    Certain factors like stress, infections, smoking, and poor diet may exacerbate inflammation and trigger RA flare-ups. Managing these triggers alongside medical treatment can help reduce symptom severity.

    3. How do gender and genetics influence the risk of developing RA?

    Women are two to three times more likely to develop rheumatoid arthritis than men, likely due to hormonal and genetic influences. A family history of autoimmune arthritis also increases individual risk.

    4. What role does diet play in managing autoimmune arthritis symptoms?

    While no specific diet cures RA, anti-inflammatory foods such as omega-3 rich fish, fruits, vegetables, and whole grains may help reduce inflammation and support overall joint health when combined with medical treatment.



    Source link

  • Is Arthritis Inevitable With Age? Early Arthritis Symptoms and Proven Treatment Options for Joint Pain at Any Age

    Is Arthritis Inevitable With Age? Early Arthritis Symptoms and Proven Treatment Options for Joint Pain at Any Age

    Arthritis, a condition characterized by joint inflammation and pain, is often associated with aging. However, is it truly inevitable as people grow older? This article explores whether arthritis is a natural part of aging, the early symptoms to watch for, and effective treatment options that can help manage the condition and preserve joint health. Understanding arthritis treatment, arthritis symptoms, and age-related joint pain is crucial for maintaining mobility and quality of life.

    Is Arthritis Inevitable as You Get Older?

    Aging does affect joint health, but arthritis is not an unavoidable consequence of growing older. While many older adults may experience joint pain as part of normal wear and tear, this does not necessarily mean they have arthritis.

    Arthritis is a chronic condition characterized by joint inflammation, which multiple factors, including genetics, injury, autoimmune processes, and lifestyle factors such as obesity can trigger. Normal joint aging may cause some stiffness and discomfort, but persistent inflammation and damage are not guaranteed in every individual. Therefore, arthritis development involves risk factors beyond just age.

    What Are the Early Symptoms of Arthritis?

    Recognizing early arthritis symptoms is key to timely diagnosis and treatment. Common symptoms include joint pain, swelling, stiffness, especially noticeable in the morning or after periods of inactivity, and reduced range of motion. These signs distinguish arthritis-related joint pain from age-related discomfort, which tends to be less persistent and severe. Early detection allows for intervention before significant joint damage occurs, improving treatment outcomes.

    Effective Early Treatment Options for Arthritis

    The primary goals of arthritis treatment are to relieve pain, reduce inflammation, and maintain joint function. Treatment often involves a combination of approaches tailored to the patient’s specific type of arthritis and severity of symptoms.

    • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen help reduce pain and swelling. Acetaminophen can also relieve mild to moderate pain. For inflammatory arthritis, disease-modifying antirheumatic drugs (DMARDs) target the underlying disease process to slow progression. Corticosteroid injections provide quick relief in inflamed joints. Newer options like duloxetine and tramadol may be prescribed for chronic pain management.
    • Physical Therapy and Exercise: Structured exercise programs focusing on strength, flexibility, and aerobic fitness improve joint mobility and reduce symptoms. Physical therapists design customized routines that promote joint stability and function. Low-impact activities like swimming or walking are particularly beneficial.
    • Lifestyle Changes: Weight management reduces mechanical stress on joints; each pound lost can lower knee joint load by about four pounds. An anti-inflammatory diet rich in omega-3 fatty acids and low in processed foods supports joint health. Joint protection techniques and assistive devices can help minimize strain.
    • Alternative and Emerging Therapies: Platelet-rich plasma (PRP) therapy and regenerative treatments aim to promote healing by harnessing the body’s own growth factors. Although promising, these require further validation. Some patients benefit from complementary therapies like massage or shockwave therapy.

    Can Early Treatment Prevent Arthritis Progression?

    Early and consistent management of arthritis can effectively slow disease progression, especially in inflammatory conditions such as rheumatoid arthritis. Non-surgical treatments are most effective when initiated before extensive joint damage, according to the World Health Organization. If symptoms worsen despite these measures, surgical options such as joint replacement or realignment (osteotomy) may be considered to restore function.

    How to Manage Joint Pain Related to Aging

    Joint pain at any age can be managed through various strategies:

    • Using heat or cold therapy for symptomatic relief
    • Taking over-the-counter NSAIDs or acetaminophen as needed
    • Incorporating low-impact exercise to maintain mobility
    • Ensuring proper ergonomics and using braces or orthotics for joint support

    It is essential to understand that some age-related joint pain does not always signal arthritis but should still be addressed to preserve joint health, according to the Centers for Disease Control and Prevention.

    When Should You See a Doctor for Joint Pain?

    Medical evaluation is recommended if joint pain persists for more than a few weeks, is accompanied by swelling, redness, or warmth, limits daily activities, or is accompanied by systemic symptoms such as fever or unexplained weight loss. Doctors use medical history, physical exams, imaging, and laboratory tests to diagnose the specific type of arthritis and recommend a personalized treatment plan.

    This comprehensive overview shows that while joint pain with age is common, arthritis is not an inevitable part of aging, and early treatment options can significantly improve outcomes. Effective arthritis treatment involves a multidisciplinary approach, including medications, physical therapy, lifestyle modifications, and emerging therapies to control symptoms and preserve joint function. Recognizing arthritis symptoms early and consulting healthcare professionals promptly can prevent progression and enhance quality of life at any age.

    Frequently Asked Questions

    1. Can lifestyle changes prevent the onset of arthritis?

    Lifestyle modifications such as maintaining a healthy weight, eating a diet rich in omega-3 fatty acids, and engaging in regular low-impact exercise may reduce the risk of developing certain types of arthritis or delay the onset of symptoms. Avoiding smoking and protecting joints from injury also contribute to prevention efforts.

    2. What types of exercise are best for people at risk of arthritis?

    Low-impact aerobic exercises like walking, swimming, and cycling are recommended to keep joints flexible and strengthen surrounding muscles without overloading the joints. Flexibility exercises such as stretching, yoga, and Pilates help maintain joint mobility and reduce stiffness.

    3. How does weight management influence arthritis symptoms?

    Excess weight increases mechanical stress on weight-bearing joints, such as the knees and hips, accelerating cartilage wear and joint inflammation. Losing even a small percentage of body weight can significantly reduce joint pain and improve function, underscoring the importance of weight management in arthritis treatment and prevention.

    4. Are there ways to protect joints from damage in daily activities?

    Yes, joint protection techniques such as using proper lifting methods, avoiding repetitive strain motions, and using assistive devices when needed can help reduce joint stress and prevent injury. Taking breaks and using ergonomic supports also help preserve joint health over time.



    Source link

  • Does Fasting Help Rheumatoid Arthritis? 

    Does Fasting Help Rheumatoid Arthritis? 

    Fasting, followed by a plant-based diet, is put to the test for autoimmune inflammatory joint disease. 

    Alan Goldhamer is the founder of the TrueNorth Health Center in Santa Rosa, California, where 10,000 individuals have fasted for “a variety of conditions from diabetes and cardiovascular disease to autoimmune diseases.” He noted that “conditions that seemed to be tied to dietary excess tended to respond predictably to the use of fasting followed by a health-promoting diet,” which he describes as one that is “low salt, vegan, high fiber, low fat, low protein, and low sugar.”

    “This approach offers people an option to make lifestyle changes, eliminate the cause of the problem, and stabilize their conditions, to the point where the medication is no longer needed.” It’s in contrast to “conventional medicine, which is more about the suppression of the symptoms associated with the disease, rather than removing the underlying mechanisms by which they are caused.”

    Said Dr. Goldhamer: “If you treat high blood pressure medically, they tell you, ‘You must take these drugs the rest of your life.’ If you have diabetes, they’ll tell you, ‘You’ll be on these medications the rest of your life.’ If you have autoimmune disease, like lupus, rheumatoid arthritis, ulcerative colitis, ankylosing spondylitis, psoriasis, or eczema, you will be told, ‘You must be on medications the rest of your life,’ because medicine guarantees you will never recover. They promise you, if you follow their advice explicitly, you will be sick the rest of your life.”

    Preliminary data suggest that fasting may benefit “metabolic diseases, pain syndromes, hypertension [high blood pressure], chronic inflammatory diseases, atopic [allergic] diseases, and psychosomatic disorders,” but the highest level of evidence we have for the benefits of fasting are in regard to rheumatic diseases—autoimmune inflammatory joint diseases, like rheumatoid arthritis.

    Nearly a century ago, it was written that “diet treatment is not generally recognized by the medical profession…as one of the weapons with which to attack rheumatic conditions.” This attitude persisted until relatively recently, but a systematic review of controlled trials has since shown “a statistically and clinically significant beneficial long-term effect.”

    Rheumatoid arthritis has a well-known genetic component, but the concordance rate—that is, the chance that a pair of identical twins both get it when one has it—is probably less than 30 percent, despite the twins having the same genes. That leaves 70 percent to be explained by nongenetic factors.

    Even if we don’t know exactly what those factors are, “fasting is very similar to rebooting the hard drive in a computer. Sometimes, the computer gets corrupted and you do not know exactly where the problem is. But if you just turn it off and reboot it, a lot of times, that corruption gets cleared out.”

    The evidence base started with case reports of water-only fasting followed by a plant-based diet. There were remarkable reports of years of pain and stiffness that were not only gone within a week but, more importantly, stayed gone on the healthier diet. One after another, just like that. But case reports are merely glorified anecdotes. There have been studies going back decades suggesting that “fasting may represent the most rapid and most available way of inducing relief of arthritic pain and swelling for patients who have RA,” rheumatoid arthritis, but they often failed to control for the placebo effect, which is “particularly important whenever self-reporting systems are used (reports on general well-being, pain, stiffness, tiredness, and the like)”—that is, subjective symptoms. There are objective measures, however, including lab tests of inflammation that don’t appear to be affected by placebos. As shown below and at 3:22 in my video Fasting for Rheumatoid Arthritis is what can be seen in controlled trials, starting immediately and staying down for at least a year. 

    Ten different measures of inflammation decreased significantly after the fasting and subsequent meat- and egg-free diet, whereas none of the parameters budged in those individuals with rheumatoid arthritis who continued to eat their regular diets. What’s more, this squelching of inflammation translated into a significant reduction in pain, morning stiffness, loss of grip strength, and the number of tender and swollen joints, as you can see below and at 3:43 in my video. 

    Even a year after the trial had ended, those who benefited from the diet continued to benefit in terms of less pain, stiffness, and tender and swollen joints, presumably because they stuck with it, as shown here and at 4:00 in my video. 

    “There is little doubt that during the period of fasting both inflammation and pain are reduced in RA patients,” individuals with rheumatoid arthritis. “However, after the normal diet is resumed, inflammation returns unless the fasting period is followed by a vegetarian diet…” Why might that be? It could be due to changes in the microbiome. The improvement in symptoms coincided with a “significant alteration in the intestinal flora” when patients switched from an omnivorous diet. “A diet can change intestinal flora and this may somehow be beneficial in RA,” perhaps by strengthening the gut barrier. We know fasting can decrease the leakiness of the gut in individuals with rheumatoid arthritis, but we don’t yet know what role, if any, this plays in the disease process.

    It could be as simple as eicosanoids, the mediators of inflammation that are formed from arachidonic acid. Arachidonic acid is a long-chain, inflammatory, omega-6 fatty acid found in animal fats. As seen below and at 5:04 in my video, the biggest contributors are chicken and eggs, which together contribute nearly half the intake of Americans. That’s also been suggested as an explanation for why those eating more plant-based appear to have better mental health; they aren’t suffering the “cascade of neuroinflammation” caused by arachidonic acid. It’s also why removing eggs, chicken, and other meats was shown to improve mood in a randomized controlled trial, suggesting the arachidonic acid “may negatively impact mood state.” It may also help explain the impact of more plant-based diets on inflammatory diseases like rheumatoid arthritis. 

    So, all of this may help explain why “maintaining a nutrient-dense, vegan diet of unrefined plant foods”—a plant-based diet—“appears to be necessary after the fast to prevent the recurrence of symptoms and inflammatory activity,” or as one popular press article put it, fasting may just be a tool to get you to radically kickstart a change in the way you eat. 

    For more on fasting, see related posts below.

    This video was originally part of my Fasting for Disease Reversal webinar. If you want to see all of the videos in one place, check them out here.

    Stay tuned for Fasting for Autoimmune Diseases, coming up next.

    For more on rheumatoid arthritis, see Turmeric Curcumin and Rheumatoid Arthritis, Why Do Plant-Based Diets Help Rheumatoid Arthritis?, and Friday Favorites: Fasting for Rheumatoid Arthritis and Autoimmune Diseases.



    Source link