Information on rhuematoid arthritis

(top of page) Functional Assessment Several questionnaires have been established as validated, reliable research instruments for assessing functional outcomes in patients with arthritis. information on rhuematoid arthritis Exercise arthritis. These include the Lequesne index, the Western Ontario McMaster Arthritis scale (WOMAC), activities of daily living (ADL), etc. Several performance-based tests of function can be done rapidly and easily in the office, however, and may be more sensitive in predicting impending disability than direct questions about disability and impairment. Such measures include grip strength, a timed walk, sequential chair-stands, and others listed below. information on rhuematoid arthritis Arthritis-of-the-hand. . These tests can provide the clinician with valuable information on the patient­s current level of function, as well as serve longitudinally to assess decline in function. (top of page) Future Directions The development of selective COX-2 inhibitors has been an exciting advance in the management of pain and inflammation, as discussed above. information on rhuematoid arthritis Human joints. If the safety profile of the specific COX-2 inhibitors is confirmed in additional long-term studies to be superior to non-selective COX inhibitors, they are likely to replace traditional NSAIDs in the management of arthritis and other painful, inflammatory conditions. It should be kept in mind, however, that no matter what their degree of selectivity, COX inhibitors (NSAIDs) do not alter the natural history of OA and a "disease modifying" agent is still critically needed. One disease modifying strategy is to suppress the progressive degradation of cartilage that occurs in OA. To accomplish this, the ratio of MMP inhibitors to MMP enzymes must be shifted in favor of the former. This could be accomplished by enhancing articular levels of TIMP by recombinant gene therapy or by administration of exogenous TIMP. Studies of exogenous TIMP administration to animals with OA-like disease have had inconclusive results, however, perhaps due to ineffective penetration of this relatively high molecular weight protein into the cartilage matrix. An alternate approach , that has progressed more rapidly, is to develop oral inhibitors of MMPs. In fact, several synthetic small molecular weight inhibitors of MMPs have proven efficacious in animal models of arthritis and are entering Phase III clinical trials in humans. The antibiotic, tetracycline, and its semisynthetic derivatives, doxycycline and minocycline, have modest MMP inhibitory properties and have prompted investigations of these agents in the treatment of both OA and RA. Finally, inhibition of IL-1, via administration of a soluble IL-1 receptor or receptor antagonist, represents another rational strategy for suppressing MMP synthesis, and preliminary studies in RA are also promising. Enhancing the repair of damaged cartilage constitutes another rational strategy for the treatment and/or prevention of OA. Administration of exogenous growth factors, such as IGF and bFGF, to stimulate chondrocyte proliferation and/or matrix synthesis has had beneficial effects in animals models of OA, and TGF-? has the added advantage of suppressing MMP synthesis. The same effect could also be achieved theoretically by transplanting healthy autologous chondrocytes that have been genetically engineered to over-express one or more of these growth factors site.

Information on rhuematoid arthritis



Remedy || Nerve-pain || Arthritis of the eye || Exercise arthritis