Reduce Joint Pain Research Articles

Exercise for osteoarthritis of the knee.

Exercise for osteoarthritis of the knee.

THE EFFICACY AND SAFETY OF CARMOLIS GEL IN THE COMBINATION THERAPY OF KNEE OSTEOARTHRITIS: RESULTS OF A MULTICENTER CLINICAL TRIAL

Osteoarthritis (OA) is one of the most common rheumatic diseases. Knee OA is particularly frequently encountered among all forms of OA, the prevalence of knee OA being about 25% in the general population. Despite multiple guidelines for the management of knee OA, which have been prepared by the European League Against Rheumatism (EULAR), the American College of Rheumatology (ACR), and the Osteoarthritis Research Society International (OARSI), many problems of its treatment policy remain to be solved. The same holds true for not only the symptomatic and disease-modifying effects of chondroprotectors, but also topical therapy options. Objective : to evaluate the clinical efficacy and safety of Carmolis gel in patients with knee OA. Subjects and methods. The trial included 280 patients with knee OA (a study group consisted of 190 patents; a control group comprised 90 patients). The mean age was 58.3±9.3 years in the study group and 59±10.5 years in the control group. The disease duration was 10.3±5.5 and 10.1±4.1 years, respectively. Carmolis gel was applied to the region of the most painful knee joint up to 4–5 times daily, followed by massage of this skin area. The treatment cycle lasted for 2 weeks. No therapy was performed in the control patients. The clinical efficacy was determined by the changes in joint pains at rest or on movement and palpation, according to a visual analogue scale (VAS), WOMAC questionnaire, the synovitis intensity (assessed by ultrasonography), patient and physician global assessments of disease activity (Likert scale), and the possibility of reducing the daily dosage of nonsteroidal anti-inflammatory drugs (NSAIDs). The onset the therapeutic effect of the gel and the duration of its action were recorded. Results and discussion. The topical application of Carmolis gel caused a statistically significant reduction in joint pain at rest and on movement from 57.7±6.8 to 12±1.8 mm (р < 0.01) and from 52±5.3 to 17±2.7 mm, respectively (р<0.01). The WOMAC showed similar pain changes. In the study group, the WOMAC pain level averaged 210±20.5 mm at baseline and reduced to 101±12.8 mm after the treatment (p < 0.01).The control group also exhibited pain relief, but to a much lesser degree than did the study group. There were no statistically significant differences between the groups in motor and day-to-day activity changes. After treatment, the patients of both groups had reduction in the signs of synovitis; however, no differences were found between the groups. The dose of NSAIDs could be decreased in 99 (52.1%) of the 190 patients in the study group and only in 15 (16.6%) of the 90 patients in the control group (p<0.05). Carmolis gel was well tolerated. No adverse events were observed in 184 patients. Local cutaneous reactions and itch were noted in 6 (3.2%) patients; however, they were short-term and did not required drug discontinuation. Conclusion. The findings suggest that the incorporation of Carmolis gel into the combination therapy of OA ensures a significant reduction in joint pain and allows the dose of NSAIDS to be decreased, making the treatment safer.

Effectiveness of Hot Foot Bath Versus Exercises on Reducing Pain among Patients with Osteoarthritis

Osteoarthritis is a global degenerative joint disease involving the cartilage and many of its surrounding tissues. In arthritis severe joint pain was reported by, at least one in seven adults with arthritis in every state. The aim of present study was to assess the effectiveness of hot foot bath versus exercises on reducing pain among patients with osteoarthritis in selected hospitals at Kanyakumari district. A quasi experimental with pre test post test with control group design was used for the study. A sample of 60 osteoarthritis patients with knee and ankle joint pain in Issac Bone & Joint Specialty hospital, Marthandam was selected by purposive sampling technique. Data were collected using a demographic and clinical variables and visual analogue pain scale from group I and group II before and after administration of hot foot bath and exercises on the first day, third day and fifth day of the treatment. The investigator prepared a information booklet andwas given to the samples on the fifth day. Analysis was done using both descriptive and inferential statistics. Results show that hot foot bath (0.52) had better effect in reduction of joint pain in the knees and ankles than exercises (1.20). There was a significant association between pretest level of pain among patients with age, duration of illness, family history of osteoarthritis, physical mobility and any associated condition present with osteoarthritis.

Freeze-Dried Grape Powder Reduces Joint Pain and Influences Serum Cartilage and Inflammatory Biomarkers in Older Adults with Self-Reported Knee Osteoarthritis

Freeze-Dried Grape Powder Reduces Joint Pain and Influences Serum Cartilage and Inflammatory Biomarkers in Older Adults with Self-Reported Knee Osteoarthritis

Formula food-reducing diets:A new evidence-based addition to the weight management tool box.

The changing pattern of obesity-related disease has created a need for a greater range of weight management options for the increasing number of people for whom weight loss and maintenance cannot be addressed by conventional dietary methods.Formula diet weight loss programmes [very low-calorie diets (VLCDs) (400–800 kcal/day) and low-calorie diets (LCDs) (800–1200 kcal/day)] can deliver weight loss at rates of 1–2 kg/week. This rate of weight loss can result in 10–20 kg weight loss in 8–12 weeks. Many health benefits associated with weight reduction seem to require between 10 and 20 kg weight loss. Formula diet programmes can result in weight loss, reduction of liver volume and reduction of visceral fat before bariatric surgery; weight loss before knee joint replacement surgery has also been shown. The benefit of pre-operative weight loss is still under investigation and such practices before bariatric surgery are variable in surgical units across the UK.Weight loss with formula diet in obesity-associated conditions where inflammation is an important component, such as osteoarthritis and psoriasis, has been demonstrated. Maintenance of about 10% of initial bodyweight loss, with symptom improvement in elderly obese people with knee osteoarthritis, has been shown over a period of 4 years. In obese people with psoriasis, weight loss with skin improvement has been maintained for 1 year.Clinical trials are currently underway to examine the merits of an initial weight loss with formula diet in pre-diabetes, in early type 2 diabetes and in insulin-treated type 2 diabetes.Rapid initial weight loss can result in rapid symptom improvement, such as reduced joint pain in osteoarthritis, improved sleep quality in obstructive sleep apnoea, reduced shortness of breath on exertion, reduced peripheral oedema and rapid improvement in metabolic control in diabetes, all changes that are highly motivating and conducive towards compliance.There is also some evidence for improved vitamin D status and maintained bone health in elderly obese people with osteoarthritis but more research is needed.Rapid initial weight loss was feared to be followed by rapid weight regain. However, provided initial weight loss is delivered in parallel with an intense education programme about nutrition, cooking, shopping and lifestyle for long-term maintenance; and where long-term support is provided, subsequent weight maintenance after VLCDs and LCDs has been shown to be possible. A recent literature review identified high-protein diets, obesity drugs and partial use of formula meal replacements as methods which can result in statistically significantly greater weight maintenance after initial weight loss with VLCDs or LCDs.Anxiety about serious adverse side effects seems to be unfounded although users need to be aware of both minor and more serious, though very infrequent, adverse events, such as gallstones and gallbladder disease.

Exercise for osteoarthritis of the hip.

Current international treatment guidelines recommending therapeutic exercise for people with symptomatic hip osteoarthritis (OA) report are based on limited evidence. To determine whether land-based therapeutic exercise is beneficial for people with hip OA in terms of reduced joint pain and improved physical function and quality of life. We searched five databases from inception up to February 2013. All randomised controlled trials (RCTs) recruiting people with hip OA and comparing some form of land-based therapeutic exercise (as opposed to exercises conducted in water) with a non-exercise group. Four review authors independently selected studies for inclusion. We resolved disagreements through consensus. Two review authors independently extracted data, assessed risk of bias and the quality of the body of evidence for each outcome using the GRADE approach. We conducted analyses on continuous outcomes (pain, physical function and quality of life) and dichotomous outcomes (proportion of study withdrawals). We considered that seven of the 10 included RCTs had a low risk of bias. However, the results may be vulnerable to performance and detection bias as none of the RCTs were able to blind participants to treatment allocation and, while most RCTs reported blinded outcome assessment, pain, physical function and quality of life were participant self reported. One of the 10 RCTs was only reported as a conference abstract and did not provide sufficient data for the evaluation of bias risk.High-quality evidence from nine trials (549 participants) indicated that exercise reduced pain (standardised mean difference (SMD) -0.38, 95% confidence interval (CI) -0.55 to -0.20) and improved physical function (SMD -0.38, 95% CI -0.54 to -0.05) immediately after treatment. Pain and physical function were estimated to be 29 points on a 0- to 100-point scale (0 was no pain or loss of physical function) in the control group; exercise reduced pain by an equivalent of 8 points (95% CI 4 to 11 points; number needed to treat for an additional beneficial outcome (NNTB) 6) and improved physical function by an equivalent of 7 points (95% CI 1 to 12 points; NNTB 6). Only three small studies (183 participants) evaluated quality of life, with overall low quality evidence, with no benefit of exercise demonstrated (SMD -0.07, 95% CI -0.23 to 0.36). Quality of life was estimated to be 50 points on a norm-based mean (standard deviation (SD)) score of 50 (10) in the general population in the control group; exercise improved quality of life by 0 points. Moderate-quality evidence from seven trials (715 participants) indicated an increased likelihood of withdrawal from the exercise allocation (event rate 6%) compared with the control group (event rate 3%), but this difference was not significant (risk difference 1%; 95% CI -1% to 4%). Of the five studies reporting adverse events, each study reported only one or two events and all were related to increased pain attributed to the exercise programme.The reduction in pain was sustained at least three to six months after ceasing monitored treatment (five RCTs, 391 participants): pain (SMD -0.38, 95% CI -0.58 to -0.18). Pain was estimated to be 29 points on a 0- to 100-point scale (0 was no pain) in the control group, the improvement in pain translated to a sustained reduction in pain intensity of 8 points (95% CI 4 to 12 points) compared with the control group (0 to 100 scale). The improvement in physical function was also sustained (five RCTs, 367 participants): physical function (SMD -0.37, 95% CI -0.57 to -0.16). Physical function was estimated to be 24 points on a 0- to 100-point scale (0 was no loss of physical function) in the control group, the improvement translated to a mean of 7 points (95% CI 4 to 13) compared with the control group.Only five of the 10 RCTs exclusively recruited people with symptomatic hip OA (419 participants). There was no significant difference in pain or physical function outcomes compared with five studies recruiting participants with hip or knee OA (130 participants). Pooling the results of these 10 RCTs demonstrated that land-based therapeutic exercise programmes can reduce pain and improve physical function among people with symptomatic hip OA.

Resolvin D1 protects from neutrophil mediated joint destruction in inflammatory arthritis (146.5)

Dietary supplementation with omega‐3 PUFA is efficacious in reducing joint pain, morning stiffness and NSAID usage in rheumatoid arthritis patients. Yet there is an unmet need to determine how they exert beneficial effects. Recent discoveries have determined that omega‐3 PUFA can be enzymatically converted in vivo to novel pro‐resolving bioactive lipid mediators, termed resolvins. We recently showed that resolvin D1 (RvD1) limits PMN recruitment in experimental peritonitis via its receptor ALX (PMID:22499990), yet whether RvD1 exhibits anti‐arthritic effects remains to be determined. In an inflammatory arthritis model; mice were administered veh (0.1% EtOH, i.p.) or treated with 17R‐RvD1 (100ng, i.p. daily) either prophylactically (day 0) or therapeutically (ensuing overt signs of arthritis; day 4), and graded for arthritis severity (max score 12). Prophylactic treatment with RvD1 significantly lowered the clinical score and hind paw oedema, and attenuated leukocyte infiltrate and prostanoids within the paw. Importantly, therapeutic treatment reduced the peak in arthritis severity and shortened the resolution interval. Protective actions of RvD1 were abolished in ALX (fpr2/3) null mice, indicating the crucial role of this GPCR in RvD1 joint protective actions. These studies indicate that the pro‐resolving mediator RvD1 offers a valuable therapeutic approach for inflammatory joint diseases including rheumatoid arthritis.Grant Funding Source: Supported by Arthritis Research UK Fellowship 19909 to LVN and The Wellcome Trust 086867/Z/08/Z

Consumption of whole grape powder reduces joint pain and influences serum biomarkers in individuals with self‐reported knee osteoarthritis (1025.10)

Osteoarthritis (OA) is clinically associated with joint pain and stiffness leading to loss of mobility. There is growing interest in use of natural as opposed to invasive therapies in joint pain management. Consumption of grapes, a rich source of polyphenols may reduce inflammation and influence OA outcomes. We have examined the effect of grape consumption on self‐reported pain, joint range‐of‐motion (ROM) and biochemical markers of inflammation (CRP) and cartilage metabolism (IGF‐1, YKL‐40). Using convenience sampling, 72 men and women with knee OA were recruited and assigned to one of two groups. The treatment group (n =28, 21 female) consumed 47 g of freeze‐dried grape powder (FDGP) daily for 4 months. The placebo group (n=28, 21 female) consumed a comparable placebo. For pain related to activity, the FDGP group had a significant decrease from baseline compared to placebo (‐5.3 vs. ‐2.1, p &lt; .05). At midpoint, both groups had a significant reduction in total knee symptoms, evident in the FDGP group only at the end of study. Further, this effect was greater in females. There was no significant change in overall ROM for either group. FDGP intake led to gender specific changes in IGF‐1 compared to placebo group: male (19.9 vs. 2.0 ng/mL, p &lt;.05) and female (3.2 vs. 8.9 ng/mL, p &gt;.05). Whole grape consumption with its bioactive constituents can be a natural alternative to improving symptoms associated with OA.Grant Funding Source: Supported by California Table Grape Commission

Is radiosynovectomy (RS) effective for joints damaged by haemophilia with articular degeneration in simple radiography (ADSR)?

Radiosynovectomy (RS) is known to be effective in the treatment of chronic haemophiliac synovitis. Its effectiveness may, however, be different when the joint treated shows articular degeneration in simple radiography (ADSR). The purpose of this study was to investigate the effectiveness or otherwise of RS in the presence of ADSR. To this end, the objective improvement in five joint parameters (haemarthrosis, joint pain, range of motion, muscle strength and synovial size) has been analysed with respect to the pre-existence or otherwise of ADSR in the articulation treated. An observational retrospective cohort study was conducted. Between January 1993 and December 2006, RS was performed on 78 people with haemophilia. Their average age was 18 (range 7-51). RS procedures were performed on 104 different joints; some joints required more than one injection (a maximum of 3 were given, with a 6-month interval between them), which we refer to respectively as RS-1, RS-2, RS-3, resulting in a total of 156 procedures. The isotopes used were (90)Y on 107 occasions and (186)Re in 49 injections. RS treatment reduced the frequency of haemarthroses, reduced joint pain and reduced synovial size, and resulted in improved muscle strength and range of motion both in joints with ADSR (N=86) and in those without ADSR (N=18). However, no articulation without ADSR required RS-3. The five parameters studied improved to an equal degree in joints with ADSR and without ADSR. No joint without ADSR required RS-3; this was the only difference our study found between joints without ADSR and those with ADSR at the time of the RS.

Hip joint replacement using monofilament polypropylene surgical mesh: an animal model.

Hip joint dysplasia is a deformation of the articular elements (pelvic acetabulum, head of the femur, and/or ligament of the head of the femur) leading to laxity of the hip components and dislocation of the femoral head from the pelvic acetabulum. Diagnosis is based on symptoms observed during clinical and radiological examinations. There are two treatment options: conservative and surgical. The classic surgical procedures are juvenile pubic symphysiodesis (JPS), triple pelvic osteotomy (TPO), total hip replacement (THR), and femoral head and neck resection (FHNE). The aim of this experiment was to present an original technique of filling the acetabulum with a polypropylene implant, resting the femoral neck directly on the mesh. The experiment was performed on eight sheep. The clinical value of the new surgical technique was evaluated using clinical, radiological, and histological methods. This technique helps decrease the loss of limb length by supporting the femoral neck on the mesh equivalent to the femoral head. It also reduces joint pain and leads to the formation of stable and mobile pseudarthrosis. The mesh manifested osteoprotective properties and enabled the formation of a stiff-elastic connection within the hip joint. The method is very cost-effective and the technique itself is simple to perform.

Enhanced microfracture techniques in cartilage knee surgery: Fact or fiction?

The limited intrinsic healing potential of human articular cartilage is a well-known problem in orthopedic surgery. Thus a variety of surgical techniques have been developed to reduce joint pain, improve joint function and delay the onset of osteoarthritis. Microfractures as a bone marrow stimulation technique present the most common applied articular cartilage repair procedure today. Unfortunately the deficiencies of fibrocartilaginous repair tissue inevitably lead to breakdown under normal joint loading and clinical results deteriorate with time. To overcome the shortcomings of microfracture, an enhanced microfracture technique was developed with an additional collagen I/III membrane (Autologous, Matrix-Induced Chondrogenesis, AMIC(®)). This article reviews the pre-clinical rationale of microfractures and AMIC(®), presents clinical studies and shows the advantages and disadvantages of these widely used techniques. PubMed and the Cochrane database were searched to identify relevant studies. We used a comprehensive search strategy with no date or language restrictions to locate studies that examined the AMIC(®) technique and microfracture. Search keywords included cartilage, microfracture, AMIC(®), knee, Chondro-Gide(®). Besides this, we included our own experiences and study authors were contacted if more and non published data were needed. Both cartilage repair techniques represent an effective and safe method of treating full-thickness chondral defects of the knee in selected cases. While results after microfracture deteriorate with time, mid-term results after AMIC(®) seem to be enduring. Randomized studies with long-term follow-up are needed whether the grafted area will maintain functional improvement and structural integrity over time.

Can natural products serve as potential treatments for osteoarthritis?

Can natural products serve as potential treatments for osteoarthritis?

Abstract P3-08-10: Feasibility and promise of a self-directed walking program to reduce joint pain among older breast cancer patients on adjuvant aromatase inhibitors

Abstract Background: Most breast cancer cases diagnosed among postmenopausal women are hormone receptor positive (HR+); standard adjuvant endocrine treatment usually includes an aromatase inhibitor (AI). Joint pain/stiffness/achiness (arthralgia) is a common AI side-effect, and AI discontinuation due to this side-effect is an estimated 20-32%. There is a need for effective alternative or adjunctive approaches to arthralgia management that enable survivors to remain on AI therapy while optimizing as pain-free a life as possible. This pilot study investigates the feasibility of a highly scalable 6-week self-directed physical activity (PA) program – Walk With Ease (WWE) – among elderly female breast cancer survivors on AIs who report joint pain. WWE goal: minimum of 30 minutes of walking 5 days a week (150 minutes/week). Methods: Recruitment: BC survivors age 65+ were recruited through the oncology clinic of a university-affiliated hospital. Eligibility: age 65+; Stage I-III breast cancer; currently on AI therapy; self-reported joint pain/stiffness; physician permission to engage in PA; English speaking. Measures: (1) walking – number of days per week and number of minutes per walk, (2) visual analog scales (VAS) for joint pain, fatigue and stiffness, and (3) arthritis self-efficacy (ASE) to manage joint pain and fatigue. Statistics: t-test evaluation of changes in mean values. Results: Sample (N = 20) – mean age 71 (65-87), 85% Caucasian, 35% &amp;lt; high school, mean BMI 29. 63% chemotherapy, 61% radiation therapy. 90% completed the 6-week intervention. Compared to baseline, total minutes of walking per week increased from 95 (0-450) to 172 (45-700) (p&amp;lt;.001) and mean joint pain decreased 10% (p = 0.63), fatigue decreased 19% (p = 0.31), and joint stiffness decreased 32% (p = 0.07). Post-intervention, 71% of participants were “fairly” or “extremely” confident they would continue walking; 100% would recommend WWE to other breast cancer survivors experiencing joint pain or stiffness; 100% thought they had learned how joint pain or stiffness could be lessened by physical activity, and how to safely engage in moderate-intensity physical activity; 90% thought WWE had motivated them to become more physically active, and how to overcome physical and mental barriers to walking; and 90% were fairly to extremely confident they would continue walking. Conclusions: A moderate-intensity self-directed walking program is feasible for older breast cancer patients on AI therapy and almost doubled the total time of walking per week over a 6 week period. Joint pain, stiffness, and fatigue decreased, and the walking program was perceived as informative and motivational. These data are promising and the WWE intervention warrants testing in a larger randomized trial of breast cancer survivors on AI therapy. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-08-10.

Exercise intervention in breast cancer patients with aromatase inhibitor-associated arthralgia: a pilot study

Aromatase inhibitors (AIs) block estrogen synthesis and are commonly used as adjuvant treatments for breast cancer patients. A common side effect is joint pain. This was a pilot study to examine implementation of an exercise program in reducing joint pain and improving quality of life (QoL) and functional performance in breast cancer patients treated with AIs. Twenty-six participants completed an 8-week, home-based program that combined upper and lower body resistance exercises with self-selected aerobic exercises. We measured: (1) anthropometry (2) functional performance (grip strength, biceps curl to exhaustion, and sit-to-stand and cardiovascular endurance (3-min step test). Joint pain and QoL were assessed using self-administered surveys. Participants reported a significantly lower number of painful joints, an improvement in QoL and a reduction in depressive symptoms. Significant improvements in grip strength, biceps curl, and sit-to-stand (by 14%, 51% and 15% respectively) were also observed. However, we found no significant changes in cardiovascular endurance or in anthropometric measures. An 8-week, home-based exercise program may provide potential benefit to the breast cancer patients undergoing AI treatment by reducing joint pain, improving functional performance and QoL, and reducing depressive symptoms. Further studies are needed to confirm these results.

Cissus Quadrangularis Reduces Joint Pain in Exercise-Trained Men: A Pilot Study

Background: Strenuous, high-volume exercise is often associated with inflammation and joint pain. Cissus quadrangularis (CQ) has been reported to have anti-inflammatory activity. The purpose of our study was to determine the therapeutic effects of CQ supplementation in healthy, exercise-trained men with joint-specific pain. Methods: Twenty-nine men between the ages of 20 and 46 years, who reportedly experienced chronic joint pain as a result of strenuous exercise, participated in our pilot study. All men received CQ 3200 mg daily for 8 weeks. Before and after the 8-week intervention period, subjects completed a questionnaire to determine their degree of joint pain (Western Ontario and McMaster Universities Index of Osteoarthritis [WOMAC]). Clinical measures (eg, heart rate, blood pressure, blood biomarkers) were also collected for each subject pre- (baseline) and post-intervention. Results: Subject ratings for multiple variables within the WOMAC Index improved (decreased) significantly (P < 0.05), with the subject mean total WOMAC score decreasing from 25.4 ± 2.4 to 17.4 ± 2.1 (∽31%), pre- to post-intervention. No clinical measure was significantly impacted by use of CQ supplementation. Conclusion: An 8-week course of supplementation with CQ reduced joint pain in a sample of 29 young, otherwise healthy, exercise-trained men. Additional study is needed to extend these findings, including comparison with a placebo-controlled cohort, and possibly, examining effects of CQ use in women and older adult subjects.

The effect of healing touch on the pain and mobility of persons with osteoarthritis: A feasibility study

The aims of this pilot study were to investigate the effects of Healing Touch (HT) on the pain level, joint function, mobility, and depression in persons with osteoarthritis (OA) of the knee joint(s). A randomized controlled trial using a repeated measures design was used. Cognitively intact persons (institutionalized and community) with a diagnosis of OA of the knee joint(s) received either HT sessions three times per week for 6 weeks (n = 12) or weekly friendly visits (FV) (n = 7). The HT sessions were delivered by a team of two nurses certified as HT practitioners and the FV was conducted by a nurse. All subjects continued to receive their standard care including the methods they had been using to relieve their joint pain. The two groups were similar regarding demographic variables, number of knees affected, co-morbidities, pain medications used and outcome variables at baseline. Two pain outcome measures (intensity and life interference) produced significant interaction effects. Two joint outcome measures (extension and extensor lag) also produced significant interaction effects. Furthermore, the HT group demonstrated significant improvements in 9 of the 12 outcome variables (75%) while no significant improvements occurred in the FV group. The HT group exhibited sustained effects (3 weeks post treatments) in three outcome variables. The reduction in joint pain and improvement in joint function suggest that biofield therapies could be effective non-pharmacological adjuncts to treatment of OA.

SP0144 The Role of Omega-3 Derived Resolvins in Arthritis

Omega-3 polyunsaturated fatty acids (PUFAs) are beneficial as coadjuvant therapy in Rheumatoid arthritis patients, with indication for efficacy in reducing joint pain, morning stiffness and NSAID usage. It is likely...

Estrogen alone and joint symptoms in the Women’s Health Initiative randomized trial

Although joint symptoms are commonly reported after menopause, observational studies examining exogenous estrogen's influence on joint symptoms provide mixed results. Against this background, estrogen-alone effects on joint symptoms were examined in post hoc analyses in the Women's Health Initiative randomized, placebo-controlled, clinical trial. A total of 10,739 postmenopausal women who have had a hysterectomy were randomized to receive daily oral conjugated equine estrogens (0.625 mg/d) or a matching placebo. The frequency and severity of joint pain and joint swelling were assessed by questionnaire in all participants at entry and on year 1, and in a 9.9% random subsample (n = 1,062) after years 3 and 6. Logistic regression models were used to compare the frequency and severity of symptoms by randomization group. Sensitivity analyses evaluated adherence influence on symptoms. At baseline, joint pain and joint swelling were closely comparable in the randomization groups (about 77% with joint pain and 40% with joint swelling). After 1 year, joint pain frequency was significantly lower in the estrogen-alone group compared with the placebo group (76.3% vs 79.2%, P = 0.001), as was joint pain severity, and the difference in pain between randomization groups persisted through year 3. However, joint swelling frequency was higher in the estrogen-alone group (42.1% vs 39.7%, P = 0.02). Adherence-adjusted analyses strengthen estrogen's association with reduced joint pain but attenuate estrogen's association with increased joint swelling. The current findings suggest that estrogen-alone use in postmenopausal women results in a modest but sustained reduction in the frequency of joint pain.

SAT0333 Inhibitor of Interleukin-1 in the Complex Treatment of Secondary Osteoarthritis of the Knee in Patients with Rheumatoid Arthritis

BackgroundDiseases that cause inflammation such as rheumatoid arthritis (RA) can increase the risk of development of secondary osteoarthritis (OA). In the treatment of patients with RA no attention is paid...

AB0260 Comparison of rheumatoid arthritis (RA) patient parameters at anti-TNF treatment initiation demonstrates wide variability over time in a large real-life cohort treated with infliximab

ObjectivesAnti-tumor necrosis factor alpha (anti-TNFα) agents revolutionized RA treatment by significantly reducing joint pain and inflammation, inhibiting disease progression, and improving patient function and quality of life(1). However, anti-TNFα agents...