December 2012 Pain Research Updates
Anti-TNF Rx Fails to Relieve Hand Osteoarthritis Pain
Anti-tumor necrosis factor (anti-TNF) agents failed to improve chronic pain caused by refractory hand osteoarthritis (OA), according to a study presented at the 2012 annual meeting of the American College of Rheumatology.1
“Our research found that 2 injections of anti-TNF failed to improve severe painful hand OA,” reported Xavier Chevalier, MD, PhD, head of the Department of Rheumatology at Hopital Henri Mondor in France and lead investigator of the study. “New trials are needed to find the right target in painful hand OA because this is a disease where we have no real therapy,” he said.
The Digital Osteoarthritis in Refractory Hand OA study (called DORA) compared the effectiveness of adalimumab (Humira) with non-steroidal anti-inflammatory drugs. Seventy-eight patients who received at least one injection were monitored for 26 weeks (37 placebo and 41 adalimumab). After 6 weeks, the researchers found no difference between the two groups in the main outcome—50% improvement in pain scale (35.1% in the adalimumab group versus 27.3% in the placebo group). The only difference recorded was a decrease in the number of swollen joints between week 0 and week 26 in the adalimumab group. No other significant changes or concerns were reported.
Race and Gender Found Key Risk Factors For Osteoarthritis of Knee
African American women appear to be at increased risk of developing osteoarthritis (OA) of the knee, according to a study presented at the 2012 annual meeting of the American College of Rheumatology.2 The study, which looked at the lifetime risk of knee OA for different segments of society, also found that Hispanic women have higher rates than Caucasian women, and all women had higher rates than men of all races.
Using a computer simulation model, Elena Losina, PhD, co-director of the Orthopedic and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital in Boston, and colleagues found that among people age 40 without existing arthritis, the highest lifetime risk of developing painful knee OA is in African American women (17%) and the lowest was in Caucasian men (10%). By age 65, 11.3% of African American women, 10.5% of Hispanic women, and 10% of Caucasian women are expected to develop painful knee OA. The need for a total knee replacement is expected in 6.8% of African American women, but in only 3.8% of Hispanic men.
The higher risk factors seen among African American and Hispanic women are due to higher rates of being overweight or obese, noted Dr. Losina. “We know that obesity increases the risk of osteoarthritis, and weight loss is likely to lower the risk of osteoarthritis and the need for total knee replacement surgery,” she said.