Efficacy and tolerability of Boswellia serrata extract

Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial.

MS Orthopedics, Indira Gandhi Medical College, Nagpur, India.

Osteoarthritis is a common, chronic, progressive, skeletal, degenerative disorder, which commonly affects the knee joint. Boswellia serrata tree is commonly found in India. The therapeutic value of its gum (guggulu) has been known. It posses good anti-inflammatory, anti-arthritic and analgesic activity. A randomized double blind placebo controlled crossover study was conducted to assess the efficacy, safety and tolerability of Boswellia serrata Extract (BSE) in 30 patients of osteoarthritis of knee, 15 each receiving active drug or placebo for eight weeks. After the first intervention, washout was given and then the groups were crossed over to receive the opposite intervention for eight weeks. All patients receiving drug treatment reported decrease in knee pain, increased knee flexion and increased walking distance. The frequency of swelling in the knee joint was decreased. Radiologically there was no change. The observed differences between drug treated and placebo being statistically significant, are clinically relevant. BSE was well tolerated by the subjects except for minor gastrointestinal ADRs. BSE is recommended in the patients of osteoarthritis of the knee with possible therapeutic use in other arthritis.

Blood Clotting Protein Linked To Rheumatoid Arthritis

Researchers at Cincinnati Children's have issued the first study showing that a protein normally involved in blood clotting (fibrin), also plays an important role in the inflammatory response and development of rheumatoid arthritis. Inflammatory joint disease appears to be driven by the engagement of inflammatory cells with fibrin matrices through a specific integrin receptor, aMB2. Writing in the November issue of The Journal of Clinical Investigation, researchers suggest that therapies designed to interrupt the localized interaction of inflammatory cells and fibrin may help arthritis patients.

"Our study establishes that fibrin is a powerful, although context dependent, determinant of inflammatory joint disease," said Jay Degen, Ph.D., a researcher in Developmental Biology at Cincinnati Children's and the study's lead author. "These findings also suggest that pharmacologically interrupting the interaction of fibrin and aMB2 might be efficacious in the treatment of arthritic disease as well as many other inflammatory diseases, such as multiple sclerosis.

"Affecting 2.1 million people in the United States, rheumatoid arthritis is a painful and debilitating disease involving chronic inflammation, tissue degeneration, loss of cartilage and bone and ultimately loss of joint mobility and function, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Although the disease's precise cause is not fully known, activation of specific components in the body's immune system seem to play a major role in its onset and early progression, according to researchers. Fibrin deposits are a prominent feature of arthritic joints and the protein appears to be a link between systems that control inflammation and bleeding within joints. Dr. Degen and his colleagues explained that in arthritic joints, the mesh-like matrices formed by fibrin to create blood clots may control local activity of inflammatory cells as well as support inappropriate tissue reorganization.

The study was conducted by a team that includes researchers from Cincinnati Children's and the University of Cincinnati's College of Medicine using genetically engineered mice with collagen-induced arthritis of the knee and paw. The mice were designed to have selective alterations in the production of fibrinogen, a precursor to fibrin, to allow researchers to evaluate the inflammatory impact of fibrin, especially as it interacts with aMB2.

The study was supported by a grant from the National Institutes of Health and the Arthritis Foundation. Dr. Degen and the research team are continuing their research to determine more definitively how the interruption of fibrin and aMB2 might translate into potential therapeutic treatment for patients.

Cincinnati Children's, one of the top five children's hospitals in the nation according to Child magazine, is a 475 bed institution devoted to bringing the world the joy of healthier kids. Cincinnati Children's is dedicated to providing care that is timely, efficient, effective, family-centered, equitable and safe. For its efforts to transform the way health care is provided, Cincinnati Children's received the 2006 American Hospital Association McKesson Quest for Quality Prize®. Cincinnati Children's ranks second nationally among all pediatric centers in research grants from the National Institutes of Health and is a teaching affiliate of the University of Cincinnati College of Medicine. The Cincinnati Children's vision is to be the leader in improving child health.

Cincinnati Children's Hospital Medical Center3333 Burnet Ave.Cincinnati, OH 45229-3039United States

Disease Management

Today, millions of Americans with arthritis find ways to cope with their condition. And you can manage your arthritis just like them. Here's a few suggestions that may help better your lifestyle:

Consider taking a Yoga class for people with arthritis. Over 75 scientific trials have been published on yoga in major medical journals. These studies have shown that yoga is a safe and effective way to increase physical activity that also has important psychological benefits due to its meditative nature.
Joint pain is strongly associated with your body weight. Being overweight increases the load placed on the joints such as the knee, which increases stress and could possibly hasten the breakdown of cartilage. Consider analyzing your daily intake and cutting back on calories to shed a few pounds.

Exercise can play an important role to your arthritis management approach. Physical activity is essential to optimizing both physical and mental health and can play a vital role in the management of arthritis. Regular physical activity can keep the muscles around affected joints strong, decrease bone loss and may help control joint swelling and pain. Regular activity replenishes lubrication to the cartilage of the joint and reduces stiffness and pain. Exercise also helps to enhance energy and stamina by decreasing fatigue and improving sleep. Exercise can enhance weight loss and promote long-term weight management in those with arthritis who are overweight.

Predicting Cardiovascular Disease Risk For Rheumatoid Arthritis Patients

Predicting Cardiovascular Disease Risk For Rheumatoid Arthritis Patients.

People with rheumatoid arthritis have a higher risk for developing heart disease than the general population; however, it is difficult to identify which patients are at increased risk.

Researchers at Mayo Clinic have developed a simple approach to predict heart disease in these patients within ten years of their initial diagnosis of rheumatoid arthritis.

Previous research by the Mayo Clinic team identified a link between rheumatoid arthritis patients and increased risk for heart disease. A major challenge for physicians is detection and prevention of heart disease in rheumatoid arthritis patients who show no symptoms of heart disease. The goal of this latest study is to find a way to detect the risk of heart disease earlier in patients with rheumatoid arthritis.

"Rheumatoid arthritis sufferers are dealing with significant pain and stress, therefore cardiovascular disease prevention may be delayed," says Hilal Maradit Kremers, M.D., lead study investigator and research associate in the Mayo Clinic Department of Health Sciences Research, "Our findings indicate that evaluation of cardiovascular risk based on risk factor profiles of individual patients can help physicians identify high risk rheumatoid arthritis patients and assist with decisions concerning cardiovascular disease prevention."

Mayo Clinic researchers estimated the 10-year absolute risk of cardiovascular disease in a group of 553 patients diagnosed with rheumatoid arthritis and compared them with 574 patients of the same age and gender who did not have rheumatoid arthritis. The researchers collected detailed information about all study subjects' cardiac events and their traditional cardiovascular risk factors: diabetes, blood pressure, cholesterol, body mass index and smoking.

Using absolute risk analysis methods, researchers discovered that 85 percent of those 60 to 69 year olds who were newly diagnosed with rheumatoid arthritis patients had a 1 in 5 chance of developing a serious cardiovascular event, compared to only 40 percent of patients who did not have rheumatoid arthritis. In each age group, cardiovascular risk in rheumatoid arthritis patients was similar to that of nonrheumatoid arthritis subjects who were 5-10 years older.

"These results emphasize the importance of performing a comprehensive cardiovascular risk assessment for all newly diagnosed rheumatoid arthritis patients," says Sherine Gabriel, M.D., the study's senior author and Mayo Clinic rheumatologist and epidemiologist.

Rheumatoid arthritis is a chronic, autoimmune disease that causes pain, swelling, stiffness and loss of function in multiple joints. Rheumatoid arthritis is a systemic disease and also may affect other organs of the body including the lungs, heart and kidneys. Rheumatoid arthritis affects about 2.1 million Americans, mostly women and generally striking between the ages of 20 and 50.

The findings of this Mayo Clinic research study are being presented at the American College of Rheumatology Annual Scientific Meeting in Boston, Nov. 6-11, 2007.

Members of the Mayo Clinic study team include: Hilal Maradit-Kremers, M.D., Cynthia Crowson, Terry Therneau, Ph.D; Veronique Roger, M.D., and Sherine Gabriel, M.D. Their work was supported by grants from the National Institutes of Health; in particular, the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Adapted from materials provided by Mayo Clinic.

Suggested Rheumatoid Arthritis Treatment

Osteoarthritis

What is it?

Osteoarthritis is one of the oldest and most common forms of arthritis. Known as the “wear-and-tear” kind of arthritis, OA is a chronic condition characterized by the breakdown of the joint’s cartilage. Cartilage is the part of the joint that cushions the ends of the bones and allows easy movement of joints. The breakdown of cartilage causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint. Osteoarthritis is known by many different names, including degenerative joint disease, ostoarthrosis, hypertrophic arthritis and degenerative arthritis.

Suggested Osteoarthritis treatment

What is Arthritis?

Aches and Pains

Arthritis is a term that describes not just one disease but more than 100 different conditions. Arthritis - a combination of the Greek words arth (joint) and itis (inflammation) - means joint inflammation. When a person has arthritis, joints and surrounding tissues, such as muscles or tendons, often become inflamed. Inflammation is the body's reaction to illness or injury, which can cause pain, swelling, redness or heat in certain areas, such as a joint.

Arthritis and related diseases are also are also known as rheumatic diseases. This term describes diseases of the joints, muscles and connective tissues, each having different causes. There are some very serious forms of arthritis that are called autoimmune diseases. In these diseases, the body's immune system malfunctions. The immune system is a term that refers to the body's network of defenses against such disease-causing agents as viruses or bacteria. In forms of arthritis that are autoimmune diseases, such as rheumatoid arthritis, the body's disease-fighting components mistakenly turn against the body itself, causing damage to joints, cartilage, skin, and other organs.

Most forms of arthritis are chronic diseases, which means they will be with you for the rest of your life. The do not go away and cannot, at this time, be 'cured' by a drug or treatment. Chronic diseases differ from acute diseases, such as pneumonia or the flu, which are resolved on their own or are cured by drugs.

Just because arthritis is chronic doesn't mean that a person with the disease constantly experiences such symptoms as pain or inflammation. Arthritis symptoms have periods of flare, when symptoms are active, and remission, when symptoms subside.

Suggested non-prescribed arthritis treatment.