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May is National Arthritis Awareness Month. Please join the fight against arthritis by engaging some some advocacy activities. Below are some suggestions

  1. Change your social media avatar. Several are available at this rheumatoidarthritis.net site and one is posted below.
  2. Post a daily arthritis fact on your social media accounts. Several good examples are available at the sites below.
    1. http://www.curearthritis.org/arthritis-facts-tweets/
    2. http://rheumatoidarthritis.net/news/national-awareness-month/
  3. Spread awareness to friends, family, and co-workers by sharing your experiences.
  4. Donate to a non-profit organization such as the Arthritis National Research Foundation (ANRF) or the American Autoimmune Related Diseases Association (AARDA).

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rheumatoid-arthritis-bestFor the 4th year in a row, my blog Living with Rheumatoid Arthritis was named by Healthline as one of the Best RA blogs for 2015. This is quite an honor to be listed amongst the other wonderful bloggers who tirelessly serve as patient advocates for this terrible autoimmune disease. Please take a moment to check out all of the blogs.

Lumpe ANRF photoI am very honored to be named as a Cure Arthritis Ambassador for the Arthritis National Research Foundation (ANRF). The ANRF is a non-profit organization whose mission is to provide initial research funding to brilliant, investigative scientists with new ideas to cure arthritis and related autoimmune diseases. They have been active for 40 years and have the highest possible rating by Charity Navigator.

As an Ambassador, I pledge to the following:

  • – A commitment to arthritis research
  • – A platform to share your efforts
  • – The ability to demonstrate your involvement (Blog, Video, Speaking, etc.)
  • – A personal connection to arthritis
  • – To share in ANRF’s mission
  • – Communication to ANRF about your activities in the fight to Cure Arthritis

Please consider donating and getting involved with this wonderful organization! Plus, they have really cool t-shirts and wristbands.

 

About two years ago I wrote a three part series on the increased risk of cardiovascular disease (CVD), diabetes, and metabolic issues for people with rheumatoid arthritis. The articles are listed below.

Metabolic syndrome involves a set of interconnected risk factors that are related to cardiovascular disease and diabetes (see this excellent overview from the U.S. National Institutes of Health). All of these complex biochemical processes are connected and involve metabolism of food for energy, sugar processing, insulin, insulin resistance, fat/lipids including cholesterols and triglycerides, liver health, food types, excess weight, exercise, and systemic inflammatory responses. Whenever one of the interconnected systems gets out of normal parameters, a cascade of problems may occur which may impact cardiovascular health. In a study published in 2013, it was found that 18-49% of RA patients also had metabolic syndrome that was significantly higher than general populations. These researchers also found that RA patients with higher inflammatory blood markers and those who used corticosteroids were more likely to show signs of metabolic syndrome. Anti-inflammatory treatments for RA including DMARDS and many of the biologicals like anti-TNFs may impact the biochemical pathways involved in metabolism (see this recent study). Cardiovascular risk is one extra-articular manifestation of RA that can have serious and fatal consequences.

According to the U.S. National Institutes of Health,

“Insulin resistance is a condition in which the body produces insulin but does not use it effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes.”

review of research conducted by European rheumatologic researchers (Amaro, et al., 2011) connected insulin resistance to RA. They revealed that insulin resistance was more common in RA patients with higher inflammatory blood markers (c-reactive protein, ESR) and disease activity measured by the DAS28.

A recent study published in the journal Arthritis and Rheumatology focused on insulin resistance and RA. Giles, et al., 2015 stated that the connection between insulin resistance and RA is poorly understood. They examined almost 400 people, 200 RA patients and 200 non-RA patients. They measured variables associated with CVD and insulin resistance. They found that insulin resistance levels were much higher in the RA group and demographic factors did not play a role. Insulin resistance was higher in patients with positive rheumatoid factor (RF) tests for both genders and higher for women who use steroids. They concluded by arguing that while insulin resistance levels were higher in RA patients, it remains unclear how this impacts cardiovascular risks.

More research is needed into this critical area of extra-articular (outside the joint) affect of rheumatoid arthritis.

My Living With Rheumatoid Arthritis blog was featured by the Arthritis National Research Foundation (ANRF). The article also includes my story of fighting the disease. Click for the story.

In an earlier post, I documented some of the new biologic medicines for RA in the development pipeline. There continues to be a constant stream of biologic drugs in research and development. But in the past few years, a new line of research led to the investigation of a set of molecules called kinases that are involved in the complex biological processes of RA. The development of kinase inhibitors is based on the theory that inhibition can slow down the production of inflammatory cytokines thereby controlling the disease processes. These processes are linked to the so-called JAK-STAT pathway that is being studied in numerous diseases.

Currently, there is only one kinase inhibitor approved for RA in the United States. Xeljanz, or tofacitinib, was developed and is marketed by Pfizer. The European Medicines Agency did not approve Xeljanz because of lack of efficacy and safety. Some European and Arab countries including Russia approved it.

Below is a list of some of the Kinase inhibitors currently in the development and trial pipeline. There are many others that died in the development pipeline.

Baricitinib by Eli Lilly and Incyte Corporation. Currently in Phase III clinical trials.

Fostamatinib by Rigel. In Phase II clinical trials. Efficacy is questioned.

CC-292 by Cellgene. In Phase II clinical trials.

PLX5622 by Plexxikon. In Phase I clinical trials.

AB494 by Abbvie. In Phase II clinical trials.

HM71224 by Hanmi. In Phase I clinical trials.

It remains to be seen whether or not JAK-STAT inhibitors will become a fruitful treatment option for those with rheumatoid arthritis.

On March 6, 2015 the Food and Drug Administration (FDA) approved the first biosimilar drug for use by patients in the United States (see FDA press release). The drug called Zarxio (filgrastim-sndz) is produced by Sandoz and is similar to Amgen’s Neupogen (filgrastim). Both are approved to treat certain kinds of cancers and bone marrow transplants.

Biologic medicines come from living organisms. They are different from chemical medicines in that they contain large and delicate biological molecules such as proteins, must be injected or infused since stomach acids would damage the molecules, and are usually much more expensive than chemical medicines due to development and complicated production costs. Given the high development costs associated with biologics, they are given an extended patent length of 12 years in the United States. When a chemical drug looses its patent protection, companies produce generics that are exact chemical matches. Generics are widely used and are much cheaper than the original drug. Given the complexity of biologics, exact chemical matches are replaced with scientific equivalency meaning that the biologic is similar in action but not exactly the same – thus the name “biosimilar” being used for these drugs (Entine, 2012).1

Some of the most popular RA biologic medicines stand to loose patent protection in the United States in next few years.

Read the rest of the article at http://rheumatoidarthritis.net/news/fda-approves-first-biosimilar-drug-whats-next-for-ra/.

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