Arthritis and rheumatism
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Arthritis and rheumatism · Feb 2008
Randomized Controlled TrialA six-month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia.
A subset of fibromyalgia (FM) patients have a dysfunctional hypothalamic-pituitary-insulin-like growth factor 1 (IGF-1) axis, as evidenced by low serum levels of IGF-1 and a reduced growth hormone (GH) response to physiologic stimuli. There is evidence that pyridostigmine (PYD) improves the acute response of GH to exercise in FM patients. The purpose of this study was to evaluate the clinical effectiveness of 6 months of PYD and group exercise on FM symptoms. ⋯ Neither the combination of PYD plus supervised exercise nor either treatment alone yielded improvement in most FM symptoms. However, PYD did improve anxiety and sleep, and exercise improved fatigue and fitness. We speculate that PYD may have improved vagal tone, thus benefiting sleep and anxiety; this notion warrants further study.
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Arthritis and rheumatism · Dec 2007
Randomized Controlled TrialCase management of arthritis patients in primary care: a cluster-randomized controlled trial.
To assess whether providing information on arthritis self-management through general practitioners (GPs) increases the quality of life in patients with osteoarthritis and whether additional case management provided by practice nurses shows better results. ⋯ Improving the quality of life in patients with arthritis using arthritis self-management seems challenging. Simply providing this information through GPs is not sufficient but combining it with case management seems to be a promising approach.
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Arthritis and rheumatism · Dec 2007
Randomized Controlled Trial Multicenter StudyDisease remission and sustained halting of radiographic progression with combination etanercept and methotrexate in patients with rheumatoid arthritis.
The Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes (TEMPO) is a 3-year, double-blind, multicenter study evaluating the efficacy and safety of etanercept, methotrexate, and the combination of etanercept plus methotrexate in patients with active rheumatoid arthritis (RA). The results after 1 and 2 years of the study have been previously reported. Here we provide the 3-year clinical and radiographic outcomes and safety of etanercept, methotrexate, and the combination in patients with RA. ⋯ Etanercept plus methotrexate showed sustained efficacy through 3 years and remained more effective than either monotherapy, even after adjustment for patient withdrawal. Combination therapy for 3 years led to disease remission and inhibition of radiographic progression, 2 key goals for treatment of patients with RA.
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Arthritis and rheumatism · Dec 2007
Randomized Controlled Trial Multicenter StudyThe efficacy and safety of diacerein in the treatment of painful osteoarthritis of the knee: a randomized, multicenter, double-blind, placebo-controlled study with primary end points at two months after the end of a three-month treatment period.
To determine whether the efficacy of diacerein persists at 2 months after the end of a 3-month treatment period, compared with placebo, in patients with painful knee osteoarthritis (OA). ⋯ This is the first published study of a symptomatic slow-acting OA drug in which the time of assessment of the primary outcome end points was 2 months after the end of a 3-month treatment period. The results show that diacerein is safe and effective for the treatment of knee OA and has a long carryover effect.
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Arthritis and rheumatism · Oct 2007
Randomized Controlled Trial Multicenter StudyEconomic evaluation of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain.
To conduct an economic evaluation of the Enabling Self-Management and Coping with Arthritic Knee Pain through Exercise (ESCAPE-knee pain) program. ⋯ Provision of ESCAPE-knee pain had small cost implications, but it was more likely to be cost-effective in improving function than usual primary care. Group rehabilitation reduces costs without compromising clinical effectiveness, increasing probability of cost-effectiveness.