Science Current Events | Science News | Brightsurf.com
 

Doctors and rheumatoid arthritis patients differ on perception of disease activity

July 18, 2012

RA patients emphasize pain, physicians stress swollen joints to explain change in disease

Researchers from Austria have determined that patients with rheumatoid arthritis (RA) and their doctors differ on perception of RA disease activity. The study now available in Arthritis & Rheumatism, a journal of the American College of Rheumatology (ACR) and published by Wiley, reports that RA patients cite joint pain as the reason for their perception of a change in their disease activity. Rheumatologists, however, stressed joint swelling as the major determinant for their perception of change in RA disease activity.

RA is a systemic rheumatic disease that causes inflammation, pain, tenderness and swelling of the joints, which may limit functional activities and lead to permanent disability. This chronic condition is prevalent in up to 1% of the population worldwide, often striking women between 20 and 40 years of age and those in developed countries according to the World Health Organization (WHO). In the U.S., the ACR reports more than one million adults are affected by RA.

Treatment goals for RA aim to interfere with the inflammatory process and early intervention is recommended by experts. Moreover, the ACR and European League Against Rheumatism (EULAR) recently standardized criteria for measuring disease activity in RA, which were published in Arthritis Care & Research and includes:

- Clinical Disease Activity Index (CDAI)
- Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein) (DAS-28)
- Patient Activity Scale (PAS)
- PAS-II
- Routine Assessment of Patient Index Data with 3 measures (RAPID 3)
- Simplified Disease Activity Index (SDAI)

"Discussion of treatment options by patients and physicians is important in the management of RA," explains lead author Dr. Daniel Aletaha with Medical University Vienna in Austria. "Many times there is a discrepancy between patients' and doctors' views of disease activity, with doctors providing a better rating than the patients." Currently patients may be asked to assess their disease using the patient global assessment (PGA) and rheumatologists typically measure RA disease with the evaluator global assessment (EGA).

Researchers identified 646 RA patients, who began treatment with methotrexate, from an observational patient database. Patients and physicians completed the PGA and EGA assessments, respectively, which the team used to analyze their determinants.

Results indicate that 78% of PGA variability and 67% of EGA variability could be explained by different measures in the RA patients: PGA variation is determined to about 76% by pain, 1.3% by function, and 0.5% by swollen joints. EGA variations were attributed to: 61% by swollen joints, 5% by pain, 0.6% by function, 0.4% by C-reactive protein, and 0.3% by tender joints.

Dr. Aletaha concludes, "Our study shows pain really drives patient perception of disease activity, while physicians mostly rely on the number of swollen joints when they interpret a patient's disease activity. The discrepancy of perception between patient and physician were calculated as PGA minus EGA. Pain levels and joint swelling are again explaining these discrepancies to a great deal." The authors suggest that further understanding of the reasons behind the differing views of disease activity could lead to improved shared decision making between patients and physicians in managing RA.

Wiley


Related Rheumatoid Arthritis Current Events and Rheumatoid Arthritis News Articles


Autism care improved, diagnosis time shortened by new MU program
Wait lists for a specialist to confirm an autism diagnosis can be agonizing and last months. As the prevalence of autism and autism spectrum disorders increase, so does the demand for a health care system that is fully equipped to respond to the complex needs associated with autism.

Human amyloid-beta acts as natural antibiotic in the brains of animal models
A new study from Massachusetts General Hospital (MGH) investigators provides additional evidence that amyloid-beta protein - which is deposited in the form of beta-amyloid plaques in the brains of patients with Alzheimer's disease - is a normal part of the innate immune system, the body's first-line defense against infection.

Study reveals protein that dials immune responses up and down
Research led by scientists at the Sanford Burnham Prebys Medical Discovery Institute (SBP) has identified a new regulator of immune responses.

Harnessing nature's vast array of venoms for drug discovery
Scorpions, snakes, snails, frogs and other creatures are thought to produce tens or even hundreds of millions of distinct venoms. These venoms have been honed to strike specific targets in the body.

Nanoscale Trojan horses treat inflammation
Nanosized Trojan horses created from a patient's own immune cells have successfully treated inflammation by overcoming the body's complex defense mechanisms, perhaps leading to broader applications for treating diseases characterized by inflammation, such as cancer and cardiovascular diseases.

Researchers shed light on pathway from virus to brain disease
Why people on immunosuppressant drugs for autoimmune conditions have a higher incidence of an often-fatal brain disease may be linked to a mutation in a common virus, according to researchers at Penn State College of Medicine.

Cell division and inflammatory disease link revealed
A ground-breaking study by University of Manchester and Liverpool scientists and published in the journal eLife has identified a new link between inflammation and cell division.

Genetic variants may put some soldiers at higher risk of PTSD
In a massive analysis of DNA samples from more than 13,000 U.S. soldiers, scientists have identified two statistically significant genetic variants that may be associated with an increased risk of post-traumatic stress disorder (PTSD), an often serious mental illness linked to earlier exposure to a traumatic event, such as combat and an act of violence.

New study finds asthma patients rely heavily on rescue inhalers, difficult to diagnose
In a new national survey of asthma patients, Health Union, and its new online community Asthma.net, reveals that most were satisfied with the care they received; however, the most frequently used form of treatment, at 89%, is the rescue inhaler.

LJI scientists discover molecular mechanism for generating specific antibody responses
Follicular helper T cells (Tfh cells), a rare type of T cells, are indispensable for the maturation of antibody-producing B cells. They promote the proliferation of B cells that produce highly selective antibodies against invading pathogens while weeding out those that generate potentially harmful ones.
More Rheumatoid Arthritis Current Events and Rheumatoid Arthritis News Articles

The Rheumatoid Arthritis Cookbook: Anti-Inflammatory Recipes to Fight Flares and Fatigue

The Rheumatoid Arthritis Cookbook: Anti-Inflammatory Recipes to Fight Flares and Fatigue
by Caitlin Samson MSACN (Author)


“In The Rheumatoid Arthritis Cookbook, Caitlin skillfully guides you towards improved health with her all-encompassing program that includes valuable, researched information on RA, easy-to-follow meal plans, and delicious, wholesome recipes that will keep you nourished and satisfied.”
―Kate Hope, MS, CNSIf you are one of the 1.3 million people in the US living with rheumatoid arthritis, you’re all too familiar with joint pain, fatigue, and even depression. And if you’ve tried one-size-fits-all anti-inflammatory treatments, you may be disappointed in their side effects or the lack of relief they provide.Though her rheumatoid arthritis symptoms are now under control, author and nutrition expert Caitlin Samson once felt exactly this way. But after many years of frustration and...

The First Year: Rheumatoid Arthritis: An Essential Guide for the Newly Diagnosed

The First Year: Rheumatoid Arthritis: An Essential Guide for the Newly Diagnosed
by M.E.A. McNeil (Author), Kenneth Sack (Foreword)


Rheumatoid arthritis (RA), a disease characterized by inflammation of the joints, is one of the most disabling forms of arthritis and affects over two million people in the United States. Without proper treatment it can lead to long-term joint damage, chronic pain, loss of function, and disability. From the first moment of her diagnosis, author M.E.A. McNeil took charge and educated herself on every aspect of her condition. Now, as a "patient-expert," she guides those newly diagnosed step-by-step through their first year with RA. McNeil provides crucial information about the nature of the disease, treatment options, diet, exercise, social concerns, emotional issues, networking with others, and much more. The First Year—Rheumatoid Arthritis is an essential resource for everyone who wants...

Living with Rheumatoid Arthritis (A Johns Hopkins Press Health Book)

Living with Rheumatoid Arthritis (A Johns Hopkins Press Health Book)
by Tammi L. Shlotzhauer MD (Author)


Rheumatoid arthritis is an autoimmune disease in which inflammation plays a major role in causing joint problems. Warmth and swelling in the joints, along with significant stiffness and pain, can make daily life difficult. Many people with rheumatoid arthritis also experience fatigue, low-grade fever, loss of appetite, depression, and muscle aches.In this, the third edition of Living with Rheumatoid Arthritis, Tammi L. Shlotzhauer describes new findings about causes and treatments, including • New research on risk factors and triggers, including pathologic bacteria in the digestive tract, smoking, and exposure to pollutants and chemicals• Lifestyle and diet modifications that can help avoid potential triggers • How stress contributes to inflammation and other symptoms •...

Rheumatoid Arthritis

Rheumatoid Arthritis
by NetCE


Rheumatoid arthritis ranks among the chronic diseases with the greatest effect on health-related quality of life and the most substantial socioeconomic impact, and the intermittent nature of the disease can make diagnosis and treatment difficult. The purpose of this course is to educate healthcare professionals about the epidemiology, diagnosis, and treatment of rheumatoid arthritis in order to ensure early diagnosis and improvement in patients' quality of life. In addition, members of the public may use this course to enhance their personal knowledge of the subject matter presented.

Upon completion of this course, you should be able to:

1. Describe the epidemiology, demographics, and costs related to rheumatoid arthritis (RA).
2. Analyze the pathophysiology and...

Rheumatoid Arthritis: The Infection Connection {Targeting and Treating the Cause of Chronic Illness}

Rheumatoid Arthritis: The Infection Connection {Targeting and Treating the Cause of Chronic Illness}
by Dr Katherine M Poehlmann PhD (Author), Dr Harold Clark PhD (Introduction), Dr Joseph Mercola DO (Introduction)


Foreword by Dr. Harold Clark, author of "Why Arthritis?" and lab manager for Dr. Thomas McPherson Brown, author of "The Road Back." Appendices by Dr. Joseph Mercola, D.O. (www.mercola.com) and Dr. Garth Nicolson (www.immed.org) IN THIS BOOK YOU WILL DISCOVER: -- Actions of microorganisms that cause RA-mycoplasmas, mycobacteria, molds, spirochetes (e.g., Lyme), viruses, bacteria and their cell wall deficient L-forms;
-- Their role in other chronic illnesses with arthritis-like symptoms such as Fibromyalgia, Lupus, Multiple Sclerosis, and Chronic Fatigue Syndrome;
-- Online authoritative medical information and support organizations;
-- The best Internet sites to research health, drugs, treatments, and disease;
-- What diagnostic tests are available and where to get...

Rheumatoid Arthritis: Rheumatoid Arthritis Guide To Reversing Rheumatoid Arthritis With Diet Strategies For Conquering Rheumatoid Arthritis And Diet Tips ... Pain (Rheumatoid Arthritis Diet Guide)

Rheumatoid Arthritis: Rheumatoid Arthritis Guide To Reversing Rheumatoid Arthritis With Diet Strategies For Conquering Rheumatoid Arthritis And Diet Tips ... Pain (Rheumatoid Arthritis Diet Guide)


Rheumatoid Arthritis Guide To Reversing Rheumatoid Arthritis With Diet Strategies For Conquering Rheumatoid Arthritis And Diet Tips For Reducing Rheumatoid Arthritis Pain
Get this Amazon bestselling book today!
Rheumatoid Arthritis can be devastating to your health but it doesn't have to be. By incorporating the lifestyle tips and diet strategies I share with you in this book you can not only start living a pain free life but begin the process of reversing Rheumatoid Arthritis. In this book you will discover not only how to relieve the pain associated with Rheumatoid Arthritis but also how to send Rheumatoid Arthritis into remission and start regaining the health you once know. I will share with you proven steps and strategies on how healthy eating can help in the management...

Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain

Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain
by Lene Andersen (Author)


Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain is the ultimate guide to living well with this chronic, at times debilitating, autoimmune disease. Lene Andersen has 40+ years of living with RA and is working as Community Leader for HealthCentral.com's RA site. She has amassed an almost encyclopedic knowledge of how to manage the many challenges of life with the disease. Your Life with Rheumatoid Arthritis covers medication and treatment options, questions of opioids and addiction, down-to-earth tips to manage side effects, and techniques to control the pain that is often part and parcel of RA. This is an informative, honest and often very funny book. It offers hope, comfort and help to empower both the newly diagnosed and those who have had the...

Rheumatoid Arthritis: Symptoms of Rheumatoid Arthritis and Things You Can Do

Rheumatoid Arthritis: Symptoms of Rheumatoid Arthritis and Things You Can Do


An excerpt: "...If rheumatoid arthritis is a part of your life, keep a daily diary. A diary can help you to understand the things in life that trigger your arthritis flare ups. It can also help you to understand what helps. You can share this information with your doctor to help him best prescribe treatment options. It is a valuable tool all around.

To use a manual stapler while living with arthritis, press down on the stapler with your forearm. Do this instead of using your wrist. The wrist is one area that can become especially sensitive and painful during an arthritis flare up. Keeping from having to use it during those moments means less pain for you, and the task getting accomplished faster too.

If you have a hard time sleeping because of your arthritis pain,...

A Resilient Life: Learning to thrive, not just survive with rheumatoid arthritis

A Resilient Life: Learning to thrive, not just survive with rheumatoid arthritis
by OTR, Kat Elton (Author)


Too often, people faced with a disease such as rheumatoid arthritis hear words like, "disabling," "progressive," or "tragic." "Tragic" may be what people are saying but the real tragedy is that these often repeated words do nothing but harm to those who hear them. They completely ignore a very real truth: physical issues can absolutely lead to positive transformation, action, challenge, inner strength, deep courage, and compassion. This unique book is written by someone who knows her subject well. Kat Elton, an occupational therapist and woman who's had rheumatoid arthritis since age two, knows that people with RA don't need false hope or to be told what to do. What they do need is to be led toward believing in themselves and improving their reality no matter what it is. Part practical...

Death by Rheumatoid Arthritis: Possible and Preventable

Death by Rheumatoid Arthritis: Possible and Preventable
by Carla Jones (Author)


More than a million Americans suffer from rheumatoid arthritis. The numbers of deaths from this disease continues to climb each year. Late diagnosis and treatment for arthritis related, cervical spine deterioration, is one reason for some of these deaths. Celia Veno, a Bucks County retired woman and mother was one of those fatalities. Celia Veno, a woman in her 70’s, began, experiencing mysterious migraine-like headaches and atrophy. After her general doctor and neurologist failed to determine the cause of these symptoms, a new rheumatologist was called upon. He immediately diagnosed from a previous cervical spine x-ray, that she had advanced spinal cord syndrome. Unfortunately, the findings came critically late. She died two months later. Eighty-six percent of people with rheumatoid...

© 2017 BrightSurf.com