Hyderabad- People suffering from arthritis should maintain an active lifestyle as physical exercise reduces inflammation by reducing fat and increasing the production and release of anti-inflammatory molecules, say doctors on World Arthritis Day.
Each year, October 12 is commemorated as World Arthritis Day, and this year, doctors recommend people to take a pledge to enhance awareness about arthritis, its related problems, to stay fit and active, and strive towards reducing the overall arthritis case burden in the country.
Arthritis is an autoimmune condition or a degenerative joint disorder, both causing inflammation in the joints, and these are chronic-cum debilitating problems. At present, there is no specified cure for this ailment, except to live with the problem and manage it from time to time, using steroids. Arthritis can cause severe pain, reduces the quality of life, and decrease people's ability to function.
Doctors warn that more Indians could become victims of arthritis-linked problems due to overweight and obesity. The prevalence of overweight and obesity in India is increasing faster than the world average.
The prevalence of overweight increased from 8.4 percent to 15.5 percent among women between 1998 and 2020, and the prevalence of obesity increased from 2.2 percent to 5.1 percent over the same period. Men are not behind in this problem, and together they are adding to the rising burden of arthritis cases in the country.
"Overweight or obesity along with problems like diabetes, suffering from a traumatic injury to joints, congenital joint deformities, could lead to arthritis problems. While there is a slight difference in osteoarthritis and rheumatoid arthritis, both cause severe damage to human functions. And people who are obese are likely to suffer more than lighter peers after they cross a certain age threshold," said Jagan Mohan Reddy, Consultant Orthopedic Surgeon, SLG Hospitals.
According to K. Saketh, Consultant Orthopedic Surgeon (Sports Surgery & Regenerative Orthopedics), Gleneagles Global Hospital, severe pain in the joints deter arthritis patients from taking up any physical activity due to fear that it could worsen their condition.
"But it is important that individuals suffering from arthritis maintain an active lifestyle. Otherwise, a sedentary lifestyle will further debilitate their ability to do any physical activity, and this could have a severe psychological bearing on the mind. Hence, it is important arthritis patients do not stay immobile and instead motivate themselves to walk or exercise regularly."
Satyanarayana V V, Consultant Orthopedic Surgeon, Aware Gleneagles Global Hospital, pointed out that physical exercise reduces inflammation by reducing fat and increasing the production and release of anti-inflammatory molecules from human muscles.
"Given that inflammation is a primary cause of joint pain in arthritis, exercising will help improve symptoms and will play a crucial role in managing the problem," he said.
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London, July 7 (IANS) Arthritis drugs tocilizumab and sarilumab can reduce the risk of death and the need for mechanical ventilation in patients with Covid-19, finds a study.The results, based on analysis of 27 randomised trials in 28 countries involving nearly 11,000 patients, have also prompted the World Health Organisation (WHO) to recommend its use in patients with severe or critical Covid-19 along with corticosteroids.The study, published in the Journal of the American Medical Association (JAMA), showed that administering one of these drugs in addition to corticosteroids, in hospitalised patients, reduces the risk of death by 17 per cent, compared to the use of corticosteroids alone.In patients not on mechanical ventilation, the risk of mechanical ventilation or death is reduced by 21 per cent, compared to the use of corticosteroids alone.These are the first drugs found to be effective against Covid-19 since corticosteroids were recommended by WHO in September 2020.Patients severely or critically ill with Covid-19 often suffer from an overreaction of the immune system, which can be very harmful to the patient's health. Interleukin-6 blocking drugs -- tocilizumab and sarilumab -- act to suppress this overreaction."These drugs offer hope for patients and families who are suffering from the devastating impact of severe and critical Covid-19. But IL-6 receptor blockers remain inaccessible and unaffordable for the majority of the world," WHO Director General Dr Tedros Adhanom Ghebreyesus said in a statement."The inequitable distribution of vaccines means that people in low- and middle-income countries are most susceptible to severe forms of Covid-19. So, the greatest need for these drugs is in countries that currently have the least access. We must urgently change this."To increase access and affordability of these life-saving products, the WHO called on manufacturers to reduce prices and make supplies available to low- and middle-income countries, especially where Covid-19 is surging.--IANSrvt/vd
Washington, June 26 (IANS) The US Food and Drug Administration (FDA) has issued an emergency use authorization (EUA) for the drug Actemra (tocilizumab) -- used for arthritis -- for the treatment of hospitalised patients with Covid-19.Under the EUA, the drug can be administered only ot hospitalised adults and pediatric patients (2 years of age and older), receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).However, Actemra is not authorised for use in outpatients with Covid-19, the FDA said in a statement.Clinical trials showed that administering Actemra to hospitalised Covid-19, in addition to routine care which included corticosteroid therapy, reduced the risk of death as well as decreased the amount of time patients remained hospitalised.The risk of patients being placed on ventilators or death was also decreased."Although vaccines have been successful in decreasing the number of patients with Covid-19 who require hospitalisation, providing additional therapies for those who do become hospitalised is an important step in combating this pandemic," said Patrizia Cavazzoni, MD, Director of the FDA's Center for Drug Evaluation and Research.Actemra is a monoclonal antibody that reduces inflammation and is given by intravenous infusion that is FDA-approved for multiple inflammatory diseases, including rheumatoid arthritis.In the case of Covid-19 infection, the immune system can become hyperactive, which may result in worsening of disease. But, Actemra does not directly target SARS-COV-2.Based on the FDA's review of the totality of the scientific evidence available, the agency has determined that it is reasonable to believe that Actemra may be effective in treating Covid-19 for the authorised population.The data supporting this EUA for Actemra are based on four clinical trials. All four clinical trials contribute to the FDA's understanding of Actemra for the treatment of Covid-19.Common side effects of Actemra observed in the Covid-19 trials include constipation, anxiety, diarrhoea, insomnia, hypertension and nausea. The EUA was issued to American biotechnology Genentech, a subsidiary of Swiss multinational healthcare Roche, FDA said.--IANSrvt/in
New Delhi, June 20 (IANS) In India, yoga is celebrated as an ancient tradition, which has grown into a global phenomenon. As India gears up for International Yoga Day on June 21, a research paper released by an expert at All India Institute of Medical Sciences (AIIMS) said, yoga can be used as an adjunct therapy in the management of severe arthritis.
Dr Rima Dada, Prof Lab for Molecular Reproduction and Genetics, Department of Anatomy at AIIMS, said, yoga improves clinical outcome in Rheumatoid arthritis (RA), and decreases systemic inflammation by its beneficial effects on psycho-neuro-immune axis and normalization of dysregulated transcripts.
The research paper titled 'yoga impact on autoimmune arthritis' is based on a study done in collaboration with Dr Uma Kumar, Professor and Head of the Department of Rheumatology. Dada emphasized yoga is an integrative health strategy which focusses on both physical and psychological aspects of a disease.
Dada claimed the study on the impact of yoga in 66 RA patients supports adding yoga as an adjunct therapy to treat the chronic debilitating autoimmune disease.
The results of the study suggested that there was a decrease in disease activity after yoga practice, which was associated with a significant reduction in inflammatory cytokines, the elevation of mind-body communicative markers, and normalization of various transcript levels, which improved quality of life. "Despite lack of a cure, the disease may be controlled by yoga-based lifestyle interventions which improves joint flexibility and reduces pain. Yoga significantly improves and reduces the psycho-somatic symptoms, pain perception, disability quotient, joint flexibility, range of motion, posture, muscle strength, coordination, and disease activity", said the study.
Dada emphasized that this mind-body intervention is the need of the hour in the age of super specialization. "Yoga holds the immense potential to be an adjunct therapeutic regimen in RA patient and has tremendous rehabilitative potential", added Dada.
The findings indicated that yoga plays a role in facilitation of mind's capacity to overcome disease and improve physical symptoms via a variety of downstream pathways.
New York, June 17 (IANS) An arthritis drug -- Tofacitinib -- developed by US biopharmaceutical Pfizer has shown to be effective in reducing the risk of death or respiratory failure in hospitalised adult patients with Covid-19 pneumonia who were not on ventilation, according to a study.Tofacitinib belongs to a class of drugs called Janus kinase (JAK) inhibitors. It is approved in the US to treat conditions including rheumatoid arthritis, psoriatic arthritis and ulcerative colitis.The efficacy of Tofacitinib was tested on 289 patients hospitalised with severe Covid across 15 locations in Brazil. Half of these patients received 10 mg twice daily plus standard of care which includes glucocorticoids, while the other half were prescribed placebo twice daily plus standard of care for up to 14 days.The results published in the New England Journal of Medicine showed that after 28 days, tofacitinib lowered the death or respiratory failure by 63 per cent. Among patients on tofacitinib, only 18.1 per cent had the incidence of death or respiratory failure compared to placebo (29 per cent).Deaths in the tofacitinib group occurred in 2.8 per cent of patients and in 5.5 per cent of those in the placebo group.Serious side effects occurred in 14.1 percent in the tofacitinib group and in 12 percent in the placebo group."We are encouraged by the initial findings of our randomized trial of tofacitinib in patients hospitalised with Covid-19 pneumonia," said Otavio Berwanger, Director of the Academic Research Organisation, Hospital Israelita Albert Einstein, which coordinated the trial in collaboration with Pfizer."These results provide new information which indicates that the use of tofacitinib when added to standard of care, which includes glucocorticoids, may further reduce the risk of death or respiratory failure in this patient population," Berwanger added.However, it is important to note that tofacitinib has not been approved or authorised for use by any regulatory authority worldwide for the treatment of Covid-19 and tofacitinib should not be used in patients with an active serious infection, the researchers said.--IANSrvt/vd
Arthritis drug tocilizumab has been found to reduce the risk of death among patients with severe Covid-19 in a phase 3 trial conducted in India.
However, the findings, published in the journal The Lancet Respiratory Medicine, does not support the routine use of tocilizumab in adults with Covid-19.
Explaining the results, the National Lead investigator and Chairman of the Medanta Liver Institute, Arvinder Soin said that this was the first phase 3 study to demonstrate that while routine use of tocilizumab on all hospitalised Covid patients was not warranted, the drug improved survival among patients with severe Covid-19.
Several well known public and private tertiary care hospitals from 10 Indian cities participated in the study.
A total of 180 patients were recruited, 90 of whom received tocilizumab (TCZ) and standard care, whereas the other 90 received only standard care.
Steroids and remdesivir once allowed by the MoHFW, were administered to patients in both groups.
While there was no difference in mortality and need for ventilation among the two groups of patients when moderate and severe categories of patients were considered together, a subgroup analysis of the severe patients in the two groups showed a lower mortality (8/50; 16 per cent) among those who received Tocilizumab compared to those who did not (14/41; 34 per cent) at 28 days.
Tocilizumab was shown to be safe as the reported adverse events did not differ between the tocilizumab and standard care arms, said Soin.
Elaborating on the use of tocilizumab, Soin said given the conflicting results of the previous studies, millions were wasted last year on indiscriminate use of tocilizumab, since the exact stage of the disease in which to use the drug was not clear.
So, this study plugs an important gap in knowledge on Covid treatment and gives a clear direction on the timing of tocilizumab in Covid treatment.
"This research is instrumental in giving the medical fraternity clarity on when to use TCZ in Covid," said Naresh Trehan, Managing Trustee of the Medanta Institute of Education and Research, and Chairman & Managing Director, Medanta.
"We have demonstrated that, even during a pandemic, it is possible to conduct a randomised controlled trial despite the multiple challenges and constraints encountered".
In their paper, the investigators, brought out the difficulties encountered in conducting trials during the pandemic.
They were impeded by challenges such as changing standard care, administration of off-label treatments, rapidly evolving understanding of pathogenesis and treatment, multiple trials competing for participants, media hype, and the publication of non-peer reviewed reports. (IANS)