Latest news with #rheumatoidarthritis
Medscape
20 hours ago
- Health
- Medscape
Wives of Farm Pesticide Applicators at Risk for Incident RA
TOPLINE: Among female spouses of licensed pesticide applicators, the personal use of organochlorine insecticides was associated with an increased risk for rheumatoid arthritis (RA). Among women who did not use specific pesticides personally, the applicator's use of specific pesticides was associated with incident RA. METHODOLOGY: Researchers investigated whether the use of pesticides influenced the risk for RA in a cohort of female spouses of licensed pesticide applicators from North Carolina and Iowa (1993-1997). They included 32,126 female spouses and collected data on their direct pesticide use or indirect exposure, regular farming tasks, and other demographic and lifestyle factors. Cases of incident RA were identified using follow-up questionnaires, medical records, medication use, and claims data. The analysis included 410 participants with probable RA (median age, 51 years) and 21,850 without RA (median age, 45 years), with a median survey follow-up duration of 10 and 19 years and a median of 0.5 and 8 fee-for-service years among those with Medicare data, respectively. A total of 32 specific pesticides were included in the final analysis, and their associations with RA were estimated. TAKEAWAY: Almost half of the participants never used agricultural pesticides. Most reported using them for 20 days or less each year (adjusted odds ratio [aOR], 1.26; 95% CI, 1.01-1.57 vs never use) and for 20 years or less, with no higher odds being observed among those who used them more. The personal use of organochlorine insecticides was associated with a higher likelihood for incident RA (aOR, 1.54; 95% CI, 1.14-2.07), especially with the use of dichlorodiphenyltrichloroethane (aOR, 1.89; 95% CI, 1.30-2.75) and lindane (aOR, 1.97; 95% CI, 1.12-3.47); among the organophosphate insecticides, coumaphos use showed a stronger association (aOR, 2.32; 95% CI, 1.29-4.19). Among spouses who never used specific pesticides themselves, the applicator's use of metribuzin was associated with increased odds of RA (aOR, 1.66; 95% CI, 1.10-2.52). The use of any fungicide was associated with increased odds of RA (aOR, 1.72; 95% CI, 1.24-2.38). Several farming activities, such as cleaning with solvents, driving a gas tractor, grinding feed, painting, applying chemical fertilizer, and planting, were significantly associated with RA. IN PRACTICE: '[The study] findings provide robust evidence that some insecticides may contribute to risk of developing RA in women. While insecticides are an important tool in controlling threats to crops and human health, our results provide evidence of potential risks,' the authors wrote. SOURCE: This study was led by Christine G. Parks, PhD, Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina. It was published online on July 16, 2025, in Arthritis & Rheumatology. LIMITATIONS: Some cases of RA may have been missed by the algorithm, and clinical data and details such as serology of RA were missing. The study had insufficient statistical power to examine differences by risk factors linked to seropositive and seronegative RA. The exposure to pesticides was self-reported, and the frequency or duration of pesticide use in spouses was lacking. DISCLOSURES: This study received support in part from the intramural research program of the National Institutes of Health, the National Institute of Environmental Health Sciences, and the National Cancer Institute. The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
21-07-2025
- Health
- Medscape
C1M Biomarker May Predict Joint Damage in Early Arthritis
TOPLINE: Higher baseline serum levels of C1M, a biochemical marker of type I collagen degradation, were associated with higher odds of progression of total joint damage in patients with early arthritis at 1 and 5 years; however, the C2M marker showed no association with progression. METHODOLOGY: Researchers investigated the association between baseline serum C1M and C2M levels and the radiographic progression of joint damage in a cohort of patients with early undifferentiated inflammatory arthritis and recently developed rheumatoid arthritis (the ESPOIR cohort). They included 813 patients (mean age, 48.1 years; 76% women) having two or more swollen joints, with the swelling lasting more than 6 weeks but less than 6 months, and no previous use of disease-modifying drugs or steroids. Radiographs of the hands, wrists, and feet were obtained and scored according to the van der Heijde-modified Sharp score (mSS), assessing erosion, joint space narrowing, and total radiographic scores for each patient; serum C1M and C2M levels were assessed using biochemical assays. Radiographic progression was defined as an increase from baseline in the mSS score of at least 1 point at 1 year and of at least 5 points at 5 years. TAKEAWAY: Baseline serum levels of C1M were 42% higher in patients who had progression of total joint damage at 1 year than in those without progression (median, 68 ng/mL vs 48 ng/mL; P < .0001). Patients with baseline serum levels of C1M in the highest quartile had increased odds of progression of total joint damage (adjusted odds ratio [aOR], 2.12; P = .03) and bone erosion (aOR, 3.80; P = .005) after adjusting for the Disease Activity Score-28, C-reactive protein levels, and anti-citrullinated protein antibody positivity. Median baseline serum levels of C1M were 33% higher in patients with progression of total joint damage at 5 years than in those without progression (P = .0037); each ng/mL increase in baseline serum levels of C1M was associated with an increased risk for progression after adjusting for age, sex, and BMI (P = .016). No significant associations were found between baseline serum levels of C2M and radiologic progression at either 1 or 5 years. IN PRACTICE: "[The] biological marker [C1M] may be combined with other biomarkers of disease activity to improve the identification of patients with early arthritis at high risk for progression," the authors wrote. SOURCE: This study was led by Patrick Garnero of Inserm, Lyon, France. It was published online on July 10, 2025, in RMD Open. LIMITATIONS: At 5 years, radiologic data were available for only 60% of patients, limiting the robustness of the findings. Relationships of C1M and C2M levels with clinical progression were not analysed using the Disease Activity Score-28. Additionally, the effect of treatment groups during follow-up was not considered. DISCLOSURES: This study received an unrestricted grant from Merck Sharp and Dohme, with additional support from Inserm to support part of the biological database. The ESPOIR cohort study was supported by the French Society of Rheumatology, Pfizer, Abbvie, Lilly, Fresenius, and Biogen. One author disclosed being an employee of and owning stocks in Nordic Biosciences. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
18-07-2025
- Health
- Medscape
Brain Activity May Predict TNF Inhibitor Response in RA
TOPLINE: Adults with rheumatoid arthritis (RA) and high levels of pain activation in their brain responded better to the TNF inhibitor certolizumab pegol in a phase 3 trial. METHODOLOGY: Randomized phase 3 trial at six centers in Germany, Serbia, and Portugal (September 2013 to January 2020) assessed response to a TNF inhibitor in RA based on disease-related central nervous system (CNS) activity. Trial included 139 adults with RA (mean age, 54.3 years; 71% women) who had a disease activity score in 28 joints (DAS28) > 3.2 and an inadequate response to at least one synthetic disease-modifying antirheumatic drug. Patients were stratified by high or low CNS-activated brain volume due to pain and randomly assigned to placebo or 400 mg certolizumab pegol at weeks 0, 2, and 4, then 200 mg every 2 weeks for up to 24 weeks. A placebo group (n = 47) and two certolizumab pegol groups were formed: one with high CNS-activated volume (n = 49) and one with low CNS-activated volume (n = 43). The primary outcome was achieving DAS28 ≤ 3.2 at 12 weeks; a predefined difference in DAS28 of > 0.6 points was required between patients with high CNS-activated volume on certolizumab and patients on placebo. TAKEAWAY: Low disease activity was achieved by 57% and 44% of patients in the certolizumab pegol groups with high and low CNS-activated volumes, respectively, and by 26% of patients in the placebo group. The high CNS-activated volume group showed a better response than the placebo group (P =.0017) and met the predefined difference in DAS28, but the low CNS-activated volume group did not. The mean DAS28 values at week 12 among patients on certolizumab were 3.1 and 3.4 in those with high and low CNS-activated volumes, respectively, and 3.8 for those on placebo. A total of 25 treatment-related adverse events were reported, with 22 in patients who received certolizumab pegol and three in those who received placebo. IN PRACTICE: 'These data highlight the role of subjective patient-related parameters in the response to cytokine inhibition and suggest that a high-volume representation of the disease in the CNS — involving more frontal-associative brain circuits — increases the likelihood to respond to TNF inhibitor, ' the study authors concluded. 'In terms of prediction, this study certainly supports a role for brain-derived data, but, at this stage, it appears the contribution is complementary rather than comprehensive; thus, their integration into multiparametric biomarkers should be considered,' experts wrote in an accompanying comment. SOURCE: This study was led by Andreas Hess, PhD, Institute of Pharmacology and Toxicology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany. It was published online on June 23, 2025, in The Lancet Rheumatology. LIMITATIONS: DAS28-CRP was used for low disease activity assessment; however, the threshold was validated for DAS28-ESR. Functional MRI measurements may be influenced by the mental or circulatory health of the patient or technicalities of image acquisition. DISCLOSURES: This study received support from UCB Biopharma. Additional support was received from the Bundesministerium für Bildung und Forschung. Three authors reported receiving support from the Deutsche Forschungsgemeinschaft. Several authors reported receiving research grants, honoraria, or consulting fees, and having other financial ties with several pharmaceutical companies, including UCB, AbbVie, and Lilly. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medical News Today
16-07-2025
- Health
- Medical News Today
Rituxan for rheumatoid arthritis (RA)
Rituxan (rituximab) is a brand-name intravenous (IV) infusion prescribed for RA. This article covers topics such as side effects, dosage, and how Rituxan works for is a biologic and belongs to a drug class called monoclonal antibodies. The medication is available in several biosimilar on for more information about Rituxan for has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the 'Before receiving Rituxan' section.»Learn more about Rituxan explainedRheumatoid arthritis (RA) is an autoimmune condition that typically affects the RA, your immune system mistakenly attacks healthy tissue in the joints. This can cause symptoms that affect the wrists, hands, knees, ankles, and of RASymptoms of RA may include:joint pain, stiffness, or swellingfatigueskin lumpsWho Rituxan is prescribed forRituxan is prescribed for adults with moderate to severe symptoms of RA. Doctors prescribe Rituxan when tumor necrosis factor (TNF) blocker drugs haven't worked well for managing Rituxan treats RA RA happens when the immune system mistakenly attacks healthy tissue in the works by targeting a protein called CD20, which is found on certain immune cells. This protein is thought to play a role in an overactive immune system. By blocking CD20, Rituxan helps reduce inflammation and ease RA learn more about how Rituxan works, talk with your doctor. How well Rituxan works for RAIn clinical trials, Rituxan was shown to be effective in treating learn more about how the drug performed in clinical trials, refer to Rituxan's prescribing information. You can also talk with your doctor or visit the drug manufacturer's Rituxan for RABelow is information about the dosage of Rituxan for RA in adults. Your doctor will determine the dosage that's suitable for your treating RA, the usual dosage of Rituxan is two doses of 1,000 milligrams (mg) given 2 weeks apart. This is considered one treatment course. You'll typically receive one treatment course of Rituxan every 16 to 24 is prescribed along with methotrexate (Otrexup, Rasuvo, and others) for RA. Your doctor will explain the methotrexate dosage that's right for In addition to treating RA, Rituxan has other uses. Keep in mind that the drug's dosage may differ when treating other conditions. To learn more, talk with your to receive RituxanYour doctor or another healthcare professional will give Rituxan as an IV infusion. An IV infusion is an injection into a vein that's given over a period of time. Rituxan infusions are typically given over several often Rituxan is givenFor RA, you'll receive two infusions of Rituxan 2 weeks apart. This counts as one round of on your treatment plan, you'll receive another round of treatment every 16 to 24 weeks.»Learn more about the dosing protocols for Rituxan. Rituxan side effects The use of Rituxan for RA may cause side effects that are mild or serious. Rituxan is also approved to treat several other conditions. It's important to note that side effects from Rituxan may differ depending on the condition it's used to lists below include some of the main side effects that have been reported with Rituxan. For information about other potential side effects of the drug, talk with your doctor or pharmacist. You can also refer to Rituxan's prescribing After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while receiving Rituxan and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.»Get more information about Riutxan's side side effects of RituxanThese are some mild side effects that may occur with Rituxan for RA:mild infection, such as urinary tract infection (UTI)fever or chillsindigestionitchingjoint painrunny noseThese side effects of Rituxan may be temporary, lasting a few days to weeks. But if they last longer than this, bother you, or become severe, it's important to talk with your doctor or side effects of RituxanBelow are serious side effects that can occur with Rituxan:serious infection, such as shinglesheart problems, such as ventricular fibrillation (a type of irregular heart rhythm)infusion-related reactions*severe reactions affecting the mucous membranes or skin*hepatitis B reactivation*progressive multifocal leukoencephalopathy (PML)*Call your doctor right away if you develop serious side effects while using Rituxan. If the side effects seem life threatening or you think you're having a medical emergency, call 911 or your local emergency number immediately.* Rituxan has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. To learn more, see the 'Before receiving Rituxan' section. ALLERGIC REACTIONFor some people, Rituxan can cause an allergic reaction. In general, symptoms of allergic reaction can be mild or to manageFor mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They'll also let you know whether you should continue treatment with severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care as they can become life threatening. If you've had a serious allergic reaction to Rituxan, your doctor may recommend a different medication receiving RituxanBefore you receive Rituxan, there's some important information to keep in mind. The drug may not be a safe option if you have certain medical conditions or other factors that affect your health. Some of these are mentioned warningsThis drug has several boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA).Infusion-related reactionsRituxan treatment may cause infusion-related reactions during or after your dose. In rare cases, infusion reactions may be of infusion reactions may include:swelling of your face and lipslow blood pressuredifficulty breathingYour doctor may give you medications to help reduce the risk of infusion reactions. These may include acetaminophen (Tylenol) and an antihistamine, such as diphenhydramine (Benadryl).If you have symptoms of an infusion reaction while receiving Rituxan or after, tell your doctor right away. They'll likely pause or stop your Rituxan treatment. Severe reactions affecting the mucous membranes or skinTreatment with Rituxan may cause severe reactions that affect your skin or mucous membranes (lining inside your mouth). These may include life threatening reactions such as Stevens-Johnson syndrome and toxic epidermal of these reactions may include:skin sores or blisterspeelingpain around the affected areaTell your doctor right away if you have symptoms of a mucous membrane or skin reaction. They'll likely stop your Rituxan treatment and manage your symptoms. Hepatitis B reactivation Rituxan may reactivate symptoms of hepatitis B in people who've ever had the hepatitis B virus (HBV). Reactivation of hepatitis B can lead to liver failure or be life of hepatitis B may include:jaundiceabdominal paindark urineDoctors typically test for HBV before and during Rituxan treatment. If the test shows HBV, they may treat it before prescribing Rituxan. Doctors may watch for hepatitis B reactivation for up to 2 years after the final dose of you have symptoms of hepatitis B, contact your doctor right away. They may temporarily stop Rituxan treatment until the infection is Rituxan may increase the risk of PML. This is a rare but serious brain infection that may be fatal in extreme of PML may include:weakness on one side of the bodychanges in memory, personality, or visionconfusiondifficulty speakingIf you have symptoms of PML after receiving Rituxan, tell your doctor right away. They'll likely stop your Rituxan treatment and manage your symptoms. Other warningsIn addition to boxed warnings, Rituxan has other warnings. If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before receiving Rituxan:if you have an infectionif you have a heart problemif you have a lung problemif you have a kidney problemif you're pregnant or breastfeedingif you've had an allergic reaction to Rituxan or any of its ingredientsFrequently asked questionsKeep reading for answers to some frequently asked questions about Rituxan for I receive Rituxan for RA without methotrexate?Not usually, unless your doctor recommends it. Rituxan is typically prescribed together with methotrexate (Otrexup, Rasuvo, others) for RA. If you're unable to take methotrexate for any reason, such as side effects or other health conditions, talk with your doctor. They can recommend whether Rituxan or another treatment option may be better for you. Is there anything I should avoid after a Rituxan infusion for RA?Your doctor can recommend whether to avoid anything specific after a Rituxan people feel tired or have mild body aches within a few hours of the infusion. It may be helpful to plan for rest after your appointment, especially after your first you have other questions about what to expect with Rituxan infusions, talk with your Rituxan chemotherapy or immunotherapy for RA?Rituxan is a type of immunotherapy for RA, but it isn't a works by helping to ease an overactive immune system. Rituxan does this by specifically targeting a protein called CD20 on certain immune can be used with chemotherapy to treat certain cancers. Chemotherapy works by killing all rapidly dividing cells. This includes some healthy cells along with cancer cells, which is why chemotherapy often causes widespread side you have other questions about how Rituxan works, talk with your cost and savingsThe cost of Rituxan is based on several factors. These include your prescribed treatment regimen, your insurance plan, and your location. The price also depends on the cost of the appointment to receive doses of Rituxan from a healthcare is a brand-name drug that's available in the following biosimilar versions: Riabni (rituximab-arrx)Ruxience (rituximab-pvvr)Truxima (rituximab-abbs)Brand-name drugs usually cost more than biosimilars. To learn about this drug's bioimilar versions, talk with your doctor or pharmacist.»Learn more about Rituxan and cost and Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Medical News Today
16-07-2025
- Health
- Medical News Today
Can someone with rheumatoid arthritis donate plasma?
According to the Memorial Sloan Kettering Cancer Center (MSKCC), rheumatoid arthritis (RA) does not generally disqualify a person from donating if a person has severe RA, their doctor may recommend that they do not donate. Other factors unrelated to RA may also stop a person with this condition from being able to example, some factors that may stop a person from donating include:taking aspirin in the past 48 hourstesting positive for HIVcurrent severe allergiestaking antibiotics, excluding antibiotics for acnetaking narcotic pain relieversa current flu or coldhaving routine dental work in the past 24 hourspregnancyweighing below 110 lbsThe MSKCC also states that someone with RA should inform their donor program before donating if they have previously taken or are currently taking upadacitinib (Rinvoq).Upadactinib is a disease-modifying antirheumatic drug (DMARD) that doctors typically use to treat taking immunosuppressive drugs may also be unable to donate blood or plasma, temporarily or permanently. This is due to the increased risk of infection and potential effects on people who will receive the who want to donate plasma may have to undergo medical testing to ensure they are suitable. This may involve testing blood pressure and other health factors. People can speak with a healthcare professional to learn more about this with RA may also want to consider whether the donation process may affect their symptoms or cause discomfort before the needle is in place during plasma donation, a person must recline on a chair and may need to repeatedly squeeze a soft ball. If someone's RA affects their hands or wrists, this action may be entire process of giving plasma may take up to two hours on a person's first time. After this, appointments may range from an hour to an hour and a half. The actual plasma extraction can be up to an hour someone with RA wants to donate plasma, it is generally a good idea to speak with a member of their healthcare team. A healthcare professional can help assess whether they may be a suitable donor and explain the potential for adverse effects or moreEverything to know about rheumatoid arthritisAdvantages and disadvantages of donating bloodFacts about blood plasmaHow does RA affect different parts of the body?
