American College of Rheumatology Annual Scientific Meeting, Nov. 6-11, 2007
The 71st annual meeting of the American College of Rheumatology and the 42nd annual meeting of the Association of Rheumatology Health Professionals took place Nov. 6-11 in Boston, and attracted about 14,000 attendees -- including an estimated 11,000 scientific attendees -- from around the world. Highlights included new treatments for rheumatoid arthritis, progress toward individualized medicine in rheumatic diseases, and genetic research that has produced effective treatments for previously intractable conditions such as Cryopyrin-Associated Periodic Syndrome (CAPS). Other topics included the link between rheumatoid arthritis and cardiovascular disease, and the increase in gastrointestinal side effects associated with the withdrawal of COX-2 inhibitors.
"We saw information on several new rheumatoid arthritis drugs that are likely to be part of our arsenal within the next couple of years," said Eric Ruderman, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, and a member of the American College of Rheumatology's communications and marketing committee. "Tocilizumab -- which targets interleukin-6 -- is the closest to being available to clinicians, but several others in the pipeline also show promise."
Josef Smolen, M.D., of the Medical University of Vienna, Austria, presented the results of a 24-week study in which 623 patients were randomly assigned to receive a higher or lower dose of tocilizumab or placebo. During the study, all patients also received weekly doses of methotrexate. Significantly higher percentages of the higher- and lower-dose tocilizumab groups (59 percent and 48 percent, respectively) achieved the primary end-point -- ACR 20 at 24 weeks -- compared to the placebo group (27 percent).
"We're also seeing some additional TNF antagonists such as certolizumab pegol," Ruderman said. "They won't fundamentally change the way we manage rheumatoid arthritis, but they give use new choices and opportunities."
Edward Keystone, M.D., of the University of Toronto, Canada, presented results of a Phase III study involving 982 adult patients who were randomized to receive two different doses of certolizumab pegol or placebo. The researchers found that up to 60 percent of patients on either dose of certolizumab pegol achieved an ACR 20 response at weeks 24 and 52, which was significantly higher than rates observed in the placebo group.
"Two emerging global themes are progressing: better assessment of individual patient outcomes through better assessment tools, and the use of those tools to enhance what ultimately will be individualized medicine in rheumatic diseases," said Eric Matteson, M.D. of the Mayo Clinic in Rochester, Minn., and a member of the American College of Rheumatology's communications and marketing committee. "Many of the presentations here identified subgroups of patients with various diseases that did and didn't respond well to certain therapies."
As an example, Matteson cited a study -- "B-Cell Activity in Synovium Predicts Responsiveness to Rituximab in Patients with Refractory Rheumatoid Arthritis" -- which showed that extra markers on cells predict whether or not a depletion of the B-cells is going to be complete. "If you can understand this in advance, you can predict which patients ought to receive a certain therapy," Matteson said.
In that study, Yoe Kie Onno Teng, M.D. and colleagues from the Leiden University Medical Center in Leiden, the Netherlands, found that rituximab eliminated CD20-plus B cells in the peripheral blood, bone marrow and synovium of rheumatoid arthritis patients.
ACR: Research Paves Way for Targeted Lupus Treatments
MONDAY, Nov. 12 (HealthDay News) -- New understandings in the mechanisms behind atherosclerosis and premature cell death may lead to better treatments for lupus patients who are prone to both complications, according to two studies presented this week at the annual meeting of the American College of Rheumatology Annual Scientific Meeting in Boston.
ACR: Low Vitamin D Linked to Worse Pain in Knee Arthritis
FRIDAY, Nov. 9 (HealthDay News) -- Among patients with knee osteoarthritis, low vitamin D levels are associated with worsened knee pain and more difficulty walking, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Boston.
ACR: Flexible Shoes Reduce Knee Load in Osteoarthritis
FRIDAY, Nov. 9 (HealthDay News) -- Shoes that are flexible and allow natural foot mobility reduce the load on the knee in individuals with osteoarthritis, according to study findings presented this week at the American College of Rheumatology Annual Scientific Meeting in Boston.
ACR: Botox Reduces Shoulder Joint Pain in Osteoarthritis
THURSDAY, Nov. 8 (HealthDay News) -- An injection of Botox into the shoulder joints of patients with osteoarthritis reduces shoulder pain and disability better than placebo, according to a study presented this week at the American College of Rheumatology Annual Scientific Meeting in Boston.
ACR: Surgery Most Effective in Carpal Tunnel Over Long Term
THURSDAY, Nov. 8 (HealthDay News) -- Over the long term, surgical treatment for carpal tunnel syndrome appears to be more effective than local steroid injections, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Boston.
ACR: Rheumatoid Arthritis Ups Risk of Cardiovascular Disease
THURSDAY, Nov. 8 (HealthDay News) -- Newly diagnosed rheumatoid arthritis patients in their 50s and 60s are at substantially greater risk of cardiovascular events than people who don't have rheumatoid arthritis, according to research scheduled to be presented this week at the American College of Rheumatology's Annual Scientific Meeting in Boston.
ACR: Ulcer Risk Increases As Use of COX-2 Inhibitors Declines
THURSDAY, Nov. 8 (HealthDay News) -- Serious gastrointestinal complications have risen sharply among arthritis patients as the use of COX-2 inhibitors has declined, according to a study presented this week at the American College of Rheumatology's Annual Scientific Meeting in Boston.
ACR: Fish Oil Supplements May Be Beneficial in Lupus
THURSDAY, Nov. 8 (HealthDay News) -- Use of dietary supplement-dose omega-3 fish oil appears to reduce disease activity in systemic lupus erythematosus, in addition to potential cardioprotective effects, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Boston.
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