American College of Rheumatology, Nov. 7-11

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The 79th Annual Meeting of the American College of Rheumatology

The annual meeting of the American College of Rheumatology was held from Nov. 7 to 11 in San Francisco and attracted approximately 15,000 participants from around the world, including rheumatology physicians, scientists, and other health professionals. The conference featured presentations focusing on the latest advances in the diagnosis and treatment of arthritis as well as other rheumatic and musculoskeletal diseases.

In one study, Soumya Reddy, M.D., of the New York University School of Medicine in New York City, and colleagues found that patients reported significant improvement in symptoms of psoriasis and psoriatic arthritis after bariatric surgery, and the improvement was more dramatic in patients with more severe disease at baseline. The investigators also found that the amount of weight loss may be associated with the improvement. In addition, older age at the time of diagnosis of psoriasis was associated with improvement of symptoms.

"The majority of patients with psoriasis and psoriatic arthritis experienced symptomatic improvement after bariatric surgery in this retrospective study, highlighting again the link between obesity and psoriatic disease," Reddy said. "This study adds to the growing information that suggests excess weight can impact disease severity and response to treatments. Larger prospective studies with objective measures of improvement are needed to further define the true effect of surgical weight loss on psoriasis and psoriatic arthritis. It is important for rheumatologists and dermatologists to have conversations with their patients regarding the association of obesity and psoriasis and psoriatic arthritis and encourage healthy choices for weight management in obese patients."

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In another study, Douglas C. Wolf, M.D., of Atlanta Gastroenterology Associates, and colleagues found that the practice of non-medical switching of anti-tumor necrosis factor (anti-TNF) therapy leads to decreased quality of care and increased health care utilization and should be avoided. Specifically, the investigators found that changing anti-TNF agents or discontinuing anti-TNF drugs when patients are doing well may lead to a significantly higher rate of flares of rheumatoid arthritis, poorer disease control over the 12 month period after the switch, and significantly higher health care utilization and costs.

"Patients who are on anti-TNF therapy should be maintained on it. Insurance company directives should not require that patients on stable treatment for rheumatoid arthritis change to other anti-TNFs for purported cost saving reasons or tier structure reasons." Wolf said. "These data show that the 'forced switch' policy is a bad one that can have negative impact on quality of care and potentially increase costs due to greater health care resource utilization."

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Allyn Michelle Bove, P.T., D.P.T., of the University of Pittsburgh, and colleagues compared the cost-effectiveness of different combinations of exercise therapy, manual therapy (hands-on techniques such a joint mobilization and stretching), and "booster" physical therapy sessions for people with knee osteoarthritis. Booster sessions were additional physical therapy visits that were scheduled weeks or months after the initial dose of physical therapy, with the intention of maintaining improvements or promoting further improvement in function.

"Taking exercise-based physical therapy and spacing the visits out over a 12-month period using booster sessions is less costly and more effective over a two-year period than strategies that don't utilize booster sessions," Bove said. "If further research continues to support the positive effects and cost-saving potential of booster sessions, we would need to work with insurance companies and other third-party payers to make the implementation of boosters fit into the payment structure for physical therapy."

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ACR: Steroids Little Help, Ozone Injections Promising for Knee OA

WEDNESDAY, Nov. 11, 2015 (HealthDay News) -- Two new studies offer insight into what might -- or might not -- help treat knee osteoarthritis. Both studies were presented this week at the annual meeting of the American College of Rheumatology, held from Nov. 6 to 11 in San Francisco.

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ACR: Tai Chi Offers Similar Benefits to PT for Knee OA

WEDNESDAY, Nov. 11, 2015 (HealthDay News) -- For patients with knee osteoarthritis, Tai Chi and physical therapy (PT) lead to similar improvements in pain and other outcomes, according to a study presented at the annual meeting of the American College of Rheumatology, held from Nov. 6 to 11 in San Francisco.

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ACR: Resistance Training Program Beneficial in Hand Osteoarthritis

TUESDAY, Nov. 10, 2015 (HealthDay News) -- A progressive resistance strength training program can improve some aspects of hand osteoarthritis (OA), such as pain, function, and treatment satisfaction, according to a study presented at the annual meeting of the American College of Rheumatology, held from Nov. 6 to 11 in San Francisco.

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ACR: Chondroitin Sulfate Cuts Cartilage Volume Loss in Knee OA

TUESDAY, Nov. 10, 2015 (HealthDay News) -- For patients with knee osteoarthritis (OA), chondroitin sulfate (CS) is associated with additional benefits in terms of cartilage volume loss (CVL) compared with celecoxib, according to a study presented at the annual meeting of the American College of Rheumatology, held from Nov. 6 to 11 in San Francisco.

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ACR: Studies Explore Link Between Diet and RA

MONDAY, Nov. 9, 2015 (HealthDay News) -- Diet may influence risk of developing rheumatoid arthritis, two new studies suggest. The research was scheduled to be presented at the annual meeting of the American College of Rheumatology, held from Nov. 6 to 11 in San Francisco.

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