Joints for joints: cannabinoids in the treatment of rheumatoid arthritis
Purpose of review
An increasing number of patients with rheumatoid arthritis (RA) are using cannabis to treat their symptoms, although systematic studies regarding efficacy in RA are lacking. Within this review we will give an overview on the overall effects of cannabinoids in inflammation and why they might be useful in the treatment of RA.
Recent findings
Peripherally, cannabinoids show anti-inflammatory effects by activating cannabinoid type 2 receptors (CB2) which decrease cytokine production and immune cell mobilization. In contrast, cannabinoid type 1 receptor (CB1) activation on immune cells is proinflammatory ...
Source: Current Opinion in Rheumatology - March 29, 2019 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Jon T. Giles Source Type: research
Opioid use in rheumatoid arthritis: trends, efficacy, safety, and best practices
Purpose of review
The opioid epidemic remains prominent in both the medical literature and popular media. Rheumatologists are among the physicians at the forefront of the epidemic because of the prominent role of pain in rheumatoid arthritis (RA) and the limited options for treatment of pain. The purpose of this review is to provide an update on the trends of opioid use among patients with RA, to discuss the various mechanisms of RA pain, review the available evidence for opioid efficacy in RA, and to promote a guideline for best practices in opioid prescribing.
Recent findings
Recent cohort studies have estimated tha...
Source: Current Opinion in Rheumatology - March 29, 2019 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Jon T. Giles Source Type: research
Patient preferences for rheumatoid arthritis treatment
Purpose of review
To provide an overview of recent articles discussing patient preferences for rheumatoid arthritis (RA) treatment.
Recent findings
Recent studies examined patient preferences for RA treatment in several populations, finding that most participants were willing to accept certain risks of adverse effects to gain potential benefits. Perspectives regarding cannabis were studied, with patients describing medical marijuana as an alternative therapy to be used with prescription medications or as means of tapering off these medications. Treatment preferences for different RA therapies were explored using a con...
Source: Current Opinion in Rheumatology - March 29, 2019 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Jon T. Giles Source Type: research
Treatment of neuromyelitis optica spectrum disorders
Purpose of review
This review discusses concepts for diagnosing neuromyelitis optica spectrum disorders (NMOSD), distinguishing NMOSD from other inflammatory diseases of the central nervous system, and highlights recent and forthcoming data on acute and maintenance therapy of NMOSD.
Recent findings
The neurologic manifestations of NMOSD are heterogenous, extending beyond classic presentations of optic neuritis and longitudinally extensive transverse myelitis. NMOSD may be comorbid with rheumatologic diseases, such as systemic lupus erythematosus, but is recognized as a distinct entity. Recent studies of acute treatmen...
Source: Current Opinion in Rheumatology - March 29, 2019 Category: Rheumatology Tags: CLINICAL THERAPEUTICS & HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research
Management of systemic sclerosis-associated interstitial lung disease
Purpose of review
To review the recently published data and provide a practical overview for management of systemic sclerosis-interstitial lung disease (SSc-ILD).
Recent findings
Published evidence shows considerable practitioner variability in screening patients for ILD. Recent published data support use of cyclophosphamide or mycophenolate mofetil as first-line treatment of SSc-ILD. For patients not responding to first-line therapies, consideration is given to rituximab as rescue therapy. Recent trials of hematopoietic autologous stem cell transplantation have demonstrated benefit in patients with progressive SSc-IL...
Source: Current Opinion in Rheumatology - March 29, 2019 Category: Rheumatology Tags: CLINICAL THERAPEUTICS & HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research
