Pain mechanisms in RA

Pain mechanisms through the natural history of RA.
Mechanisms, impact and management of pain in rheumatoid arthritis
David A. Walsh
Nature Reviews Rheumatology, 27 May 2014


MSCT for refractory SLE

Umbilical cord mesenchymal stem cell transplantation in active and refractory systemic lupus erythematosus: a multicenter clinical study
Dandan Wang, et al. (Beike Biotechnology Co., Ltd.)
Arthritis Research & Therapy 2014, 16:R79

Conclusion: UC-MSCT results in satisfactory clinical response in SLE patients.
However, in our present study, several patients experienced disease relapse after 6 months, indicating the necessity to repeat MSCT after 6 months.

MSCs are multipotent, nonhematopoietic progenitor cells that are currently being explored as a promising new treatment for tissue regeneration. Although their immunomodulatory properties are not yet completely understood, their low immunogenic potential, together with their effects on immune responses, make them a promising therapeutic tool for the treatment of patients with severe and refractory autoimmune diseases.

Stem-Cell Therapy in China Draws Foreign Patients
March 18, 2008

Five Things Physicians Should Question

Five Things Physicians and Patients Should Question
American Academy of Orthopaedic Surgeons

1. Avoid performing routine post-operative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty.

2. Don’t use needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief.

3. Don’t use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.

4. Don’t use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.

5. Don’t use post-operative splinting of the wrist after carpal tunnel release for long-term relief.

Exercise May Help Knees More Than Glucosamine And Chondroitin

Exercise May Help Knees More Than Glucosamine And Chondroitin
October 14, 2013

The vast majority of patients reported no significant difference in pain relief between glucosamine, chondroitin, a combination of the two and placebo.

In all, 60 percent of patients taking the sugar pill said their pain was reduced by about 20 percent, while 66 percent of those taking the supplements reported similar pain reduction.
The results were published in 2006 in the New England Journal of Medicine.

But for a small subset of patients, those with moderate to severe arthritis pain in a knee, there was some benefit.

“About 79 percent had a 20 percent or greater reduction in pain, compared to about 54 percent for placebo,” says Dr. Allen Sawitzke, a rheumatologist at the University of Utah Hospital and Clinics and co-leader of the GAIT study.
“So some patients who have severe pain may get more benefit than somebody who’s got a mild case.”

Because the number of patients in that group was so small, Sawitzke cautions that finding is only preliminary and needs to be confirmed by further study.

Two large studies currently underway, one in Europe and one in Australia, may help answer that question.
They’re expected to wrap up within one year, which Sawitzke says “will either reopen the debate or put an end to it, depending on the results.”

Pretty much any type of exercise seems to reduce pain and increase flexibility, according to Felson.
“There have been a variety of different exercise studies which have tried everything from water aerobics to walking to muscle strengthening, and they all seem to work.”

cited article:
Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis
N Engl J Med 2006; 354:795-808