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Therapeutic Advances in Musculoskeletal Disease

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https://www.readbyqxmd.com/read/28620423/vitamin-d-in-pregnancy-current-perspectives-and-future-directions
#1
REVIEW
Mairead Kiely, Andrea Hemmingway, Karen M O'Callaghan
As neonatal vitamin D status is determined by circulating maternal 25-hydroxyvitamin D [25(OH)D] concentrations, prevention of maternal vitamin D deficiency during pregnancy is essential for the avoidance of neonatal deficiency. However, a high prevalence of vitamin D deficiency has been extensively reported among gravidae and neonates from ethnic minorities and white populations resident at high latitude. Currently, regulatory authorities recommend vitamin D intakes for pregnant women that are similar to non-pregnant adults of the same age, at 10-15 µg/day (400-600 IU), to meet 25(OH)D thresholds of 25-50 nmol/liter...
June 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28620422/special-considerations-for-vitamin-d-in-the-south-asian-population-in-the-uk
#2
REVIEW
Nicola M Lowe, Issak Bhojani
The human requirement for vitamin D is achieved primarily through the synthesis of this prehormone in the skin during exposure to ultraviolet B (UVB) radiation, with only a minor contribution from the diet, year round. Achieving optimal vitamin D status is therefore largely dependent upon adequate exposure of the skin to sunlight, however, the length of exposure required varies with latitude and season, and is also dependent upon skin pigmentation, with darker skin requiring greater exposure than fair skin due to the protective effects of melanin against UVB radiation...
June 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28620421/is-there-role-for-vitamin-d-in-the-treatment-of-chronic-pain
#3
REVIEW
Kathryn R Martin, David M Reid
Chronic pain is highly prevalent in the developed world, and levels of vitamin D are often lower among those with chronic pain conditions than those without. Supplementation of vitamin D has been investigated as a potential independent treatment for chronic pain. This paper presents an overview of the scientific evidence and provides recommendations for use of vitamin D in clinical practice with chronic pain patients.
June 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28458723/controversies-and-challenges-in-fibromyalgia-a-review-and-a-proposal
#4
REVIEW
Helen Cohen
Fibromyalgia (FM) is the most commonly encountered chronic widespread pain (CWP) condition in rheumatology. In comparison to inflammatory arthritis (IA), it can seem ill defined with no clear understanding of the pathology and therefore no specific targeted treatment. This inevitably raises controversies and challenges. However, this is an outdated view perpetuated by poor teaching of pain at undergraduate and postgraduate levels, and the perennial problem of advances in relevant cross-speciality knowledge penetrating speciality silos...
May 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28458722/the-calcium-and-vitamin-d-controversy
#5
REVIEW
Bo Abrahamsen
Areas of the world where vitamin D levels are low for months of the year and intakes of calcium are high have a high prevalence of osteoporosis and cardiovascular disease. This suggests a public health message of avoiding calcium supplements and increasing vitamin D intake. No message could be more welcome as vitamin D can be given as a bolus while calcium must be taken daily and may be poorly tolerated. This approach is based on no evidence from intervention studies. Randomized controlled trials (RCTs) suggest that vitamin D given with calcium elicits a small reduction in fracture risk and deaths...
May 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28382113/analytical-considerations-for-the-biochemical-assessment-of-vitamin-d-status
#6
REVIEW
Lewis Couchman, Cajetan F Moniz
The most widely used and clinically accepted biochemical marker for assessing vitamin D status is the total serum 25-hydroxyvitamin D [25(OH)D] concentration. Despite the analysis of 25(OH)D dating back to the early 1970s, modern analytical techniques still exhibit significant interassay variability due to varying concentrations of other related vitamin D metabolites and sample-to-sample matrix differences. It is important for clinicians requesting 25(OH)D analyses to understand these issues and limitations, and where necessary to confront laboratories for details of analytical methods used...
April 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28382112/the-role-of-vitamin-d-in-maintaining-bone-health-in-older-people
#7
REVIEW
Thomas R Hill, Terry J Aspray
This review summarises aspects of vitamin D metabolism, the consequences of vitamin D deficiency, and the impact of vitamin D supplementation on musculoskeletal health in older age. With age, changes in vitamin D exposure, cutaneous vitamin D synthesis and behavioural factors (including physical activity, diet and sun exposure) are compounded by changes in calcium and vitamin D pathophysiology with altered calcium absorption, decreased 25-OH vitamin D [25(OH)D] hydroxylation, lower renal fractional calcium reabsorption and a rise in parathyroid hormone...
April 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28344669/belimumab-in-systemic-lupus-erythematosus-sle-evidence-to-date-and-clinical-usefulness
#8
REVIEW
Sara Guerreiro Castro, David A Isenberg
Systemic lupus erythematosus (SLE) is a complex autoimmune rheumatic disease with multiple presentations, whose management presents many challenges. Many disease modifying or immunosuppressive drugs have been used with limited success, especially in patients with more severe disease activity. Belimumab is the first drug to be approved specifically for the treatment of SLE in more than 50 years. By blocking the B-cell activating factor, it interferes in B-cell differentiation and survival. Here we consider the results of the clinical trials that led to its approval, as well as the post-hoc analyses, follow-up studies and the current trials...
March 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28344668/diabetes-and-bone-health-latest-evidence-and-clinical-implications
#9
REVIEW
Vikram Sundararaghavan, Matthew M Mazur, Brad Evans, Jiayong Liu, Nabil A Ebraheim
As the prevalence of diabetes is increasing worldwide, research on some of the lesser-known effects, including impaired bone health, are gaining a lot of attention. The two most common forms of diabetes are type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). These two differ in their physiology, with T1DM stemming from an inability to produce insulin, and T2DM involving an insufficient response to the insulin that is produced. This review aims to highlight the most current information regarding diabetes as it relates to bone health...
March 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28255339/use-of-febuxostat-in-the-management-of-gout-in-the-united-kingdom
#10
REVIEW
Arabella Waller, Kelsey M Jordan
Gout is the most common cause of inflammatory arthritis worldwide. Despite clinical cure being achievable and multiple evidence-based guidelines having been published, the incidence and prevalence continues to increase and the condition remains undertreated. Concerns regarding allopurinol have limited its use in those with renal impairment. Febuxostat, a novel xanthine oxidase inhibitor requiring no dose adjustment in mild-moderate renal impairment was launched in the United Kingdom (UK) in 2010. We review published data on the efficacy, safety and tolerability of febuxostat and provide an opinion on its place in the management of gout in the UK in the context of other published guidelines...
February 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28255338/apremilast-in-the-treatment-of-psoriatic-arthritis-a-perspective-review
#11
REVIEW
Michael Reed, David Crosbie
Apremilast is an orally-active small molecule which inhibits phosphodiesterase-4 (PDE4). Clinical trials have demonstrated its efficacy and safety in psoriatic arthritis (PsA) and psoriasis. Established therapeutic options have variable effectiveness across the different domains of psoriatic disease. Whilst biologic therapies have proven to be of significant benefit to many patients, not all patients respond, and others are not eligible or do not tolerate biologic therapy. We review the mechanism of action, pharmacokinetics and clinical trial data with regards to both efficacy and safety for apremilast and consider where this new treatment may be positioned in the treatment of PsA...
February 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28255337/baricitinib-in-rheumatoid-arthritis-evidence-to-date-and-clinical-potential
#12
REVIEW
Bindee Kuriya, Marc D Cohen, Ed Keystone
Biologics have changed expectation and outcomes for rheumatoid arthritis (RA). However, the optimal duration and sequence of therapy for this disease has yet to be determined. Also, a significant number of patients do not satisfactorily respond to currently available therapies. The Janus kinase (JAK) inhibitors represent a new class of therapies for RA. These drugs work uniquely by inhibiting intracellular pathways thought to be important in the pathogenesis of RA. They are available as oral agents, which is also different from the currently available biologics...
February 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28101146/bone-health-in-hiv-and-hepatitis-b-or-c-infections
#13
REVIEW
Emmanuel Biver, Alexandra Calmy, René Rizzoli
Chronic infections with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) add to age-dependent bone loss and may contribute to lower bone strength in the elderly. In this review, we report recent highlights on the epidemiology of bone fragility in chronic viral infections with HIV, HCV and HBV, its physiopathology and discuss the interference of antiviral therapies with bone metabolism. Chronic infections influence bone through the interactions between risk factors for bone fragility and falls (which are highly prevalent in infected patients), virus activity and antiviral drugs...
January 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28101145/impact-of-physical-activity-and-mechanical-loading-on-biomarkers-typically-used-in-osteoarthritis-assessment-current-concepts-and-knowledge-gaps
#14
REVIEW
Nicole M Cattano, Jeffrey B Driban, Kenneth L Cameron, Michael R Sitler
There is an ongoing need to develop prognostic and diagnostic biomarkers for osteoarthritis (OA). Understanding how biomarkers change in response to physical activity may be vital for understanding if a patient has a joint that is failing to adapt to a given loading stimulus. The purpose of this review is to describe how biomarker changes after joint loading may help detect early OA and determine prognosis. This may help to inform and more specifically target interventions and clinical trials. We conducted a critical review of the relevant literature that was published to January 2016...
January 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28101144/histopathological-findings-in-systemic-sclerosis-related-myopathy-fibrosis-and-microangiopathy-with-lack-of-cellular-inflammation
#15
Claudio Corallo, Maurizio Cutolo, Nila Volpi, Daniela Franci, Margherita Aglianò, Antonio Montella, Chiara Chirico, Stefano Gonnelli, Ranuccio Nuti, Nicola Giordano
OBJECTIVES: The objective of this study was to identify specific histopathological features of skeletal muscle involvement in systemic sclerosis (SSc) patients. METHODS: A total of 35 out of 112 SSc-patients (32%, including 81% female and 68% diffuse scleroderma) presenting clinical, biological and electromyographic (EMG) features of muscle weakness, were included. Patients underwent vastus lateralis biopsy, assessed for individual pathologic features including fibrosis [type I collagen (Coll-I), transforming growth factor β (TGF-β)], microangiopathy [cluster of differentiation 31 (CD31), pro-angiogenic vascular endothelial growth factor A (VEGF-A), anti-angiogenic VEGF-A165b], immune/ inflammatory response [CD4, CD8, CD20, human leucocyte antigens ABC (HLA-ABC)], and membranolytic attack complex (MAC)...
January 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28321269/exploratory-analysis-of-osteoarthritis-progression-among-medication-users-data-from-the-osteoarthritis-initiative
#16
Jeffrey B Driban, Grace H Lo, Charles B Eaton, Kate L Lapane, Michael Nevitt, William F Harvey, Charles E McCulloch, Timothy E McAlindon
BACKGROUND: We conducted an exploratory analysis of osteoarthritis progression among medication users in the Osteoarthritis Initiative to identify interventions or pathways that may be associated with disease modification and therefore of interest for future clinical trials. METHODS: We used participants from the Osteoarthritis Initiative with annual medication inventory data between the baseline and 36-month follow-up visit (n = 2938). Consistent medication users were defined for each medication classification as a participant reporting at all four annual visits that they were regularly using an oral prescription medication at the time of the visit...
December 2016: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28255336/bone-modeling-and-remodeling-potential-as-therapeutic-targets-for-the-treatment-of-osteoporosis
#17
REVIEW
Bente Langdahl, Serge Ferrari, David W Dempster
The adult skeleton is renewed by remodeling throughout life. Bone remodeling is a process where osteoclasts and osteoblasts work sequentially in the same bone remodeling unit. After the attainment of peak bone mass, bone remodeling is balanced and bone mass is stable for one or two decades until age-related bone loss begins. Age-related bone loss is caused by increases in resorptive activity and reduced bone formation. The relative importance of cortical remodeling increases with age as cancellous bone is lost and remodeling activity in both compartments increases...
December 2016: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28255335/the-clinical-characteristics-of-sarcoid-arthropathy-based-on-a-prospective-cohort-study
#18
Senol Kobak, Fidan Sever, Ozan Usluer, Tuncay Goksel, Mehmet Orman
BACKGROUND: Sarcoidosis is known as a Th1-mediated disease, which can mimic many primary rheumatologic diseases or sometimes co-exist with them. Clinical characteristics of sarcoid arthropathy are not well described and the studies reported in the literature so far are mostly based on data from referrals. The aim of this study was to evaluate the incidence and clinical characteristics of sarcoid arthropathy. METHODS: All our patients were prospectively evaluated in our rheumatology outpatient center from 2011 to 2015...
December 2016: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/27721905/combination-therapy-with-biologic-agents-in-rheumatic-diseases-current-and-future-prospects
#19
REVIEW
Kentaro Inui, Tatsuya Koike
Strategies in rheumatoid arthritis (RA) based on 'treat to target' aim to control disease activity, minimize structural damage, and promote longer life. Several disease-modifying antirheumatic drugs (DMARDs) have been shown to be effective including biological DMARDs (bDMARDs). Treatment guidelines and recommendations for RA have also been published. According to those guidelines, conventional synthetic DMARDs (csDMARDs), as monotherapy or combination therapy, should be used in DMARD-naïve patients, irrespective of the addition of glucocorticoids (GCs)...
October 2016: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/27721904/managing-cardiovascular-risk-in-patients-with-inflammatory-arthritis-practical-considerations
#20
REVIEW
Anne Tournadre, Sylvain Mathieu, Martin Soubrier
Patients with inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis, have higher rates of cardiovascular mortality. While the increased cardiovascular risk is only explained to some extent, a lot of research is currently conducted to improve our understanding of its pathogenesis, risk stratification, and optimal cardiovascular risk management. This review sought to report epidemiological data pertaining to the cardiovascular disease burden in patients with inflammatory arthritis, underlying mechanisms accounting for excessive cardiovascular risk, along with recommendations regarding risk assessment and management in this patient population...
October 2016: Therapeutic Advances in Musculoskeletal Disease
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