Dieting and exercise improve osteoarthritis

A combination of weight loss and exercise provides functional improvements in overweight patients with osteoarthritis, a new study shows.

Research published in Arthritis and Rheumatism involved 316 older adults with knee osteoarthritis and a BMI of at least 28 who were randomized to receive a dietary intervention, an exercise intervention, both, or usual care. Of these subjects, 252 completed the study.

The exercise programme involved thrice weekly hour-long sessions that focused on aerobics and resistance training.

The dietary intervention incorporated group dynamics theory and social cognitive theory into a staged program with a goal of maintaining an average weight loss of 5% during the 18-month period.

Subjects in the diet-plus-exercise group experienced a significant improvement in self-reported physical function, 6-minute walk distance, stair-climb time, and knee pain.

The diet-only intervention appeared to offer no functional benefits over usual care but patients in the dietary intervention groups lost significantly more weight than those in the usual care group.

“The results of the study are important for clinicians and patients, because they provide evidence for significant, although modest, treatment effects of a dietary weight loss programme combined with regular exercise classes for sedentary, overweight and obese individuals with knee osteoarthritis,” Dr. Marlene Fransen, from the University of Sydney in New South Wales, Australia, notes in a related editorial.

Reference: Messier S et al (2004) Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: The arthritis, diet, and activity promotion trial Arthritis Rheum 50 (5) 1501-1510

From: Nursing Times Online

Turning The Tide Of Dementia, Hope Is In Prevention, Research

With the prevalence of dementia expected to reach 1.1 million Canadians within a generation, taking care of your brain health has never been more important.

This Brain Awareness Week, March 15 to 21, the Alzheimer Society is calling on Canadians coast to coast to take action today. This means doing everything you can to reduce your risk of developing dementia, including adopting a healthy lifestyle through diet and exercise, staying mentally and socially active , and protecting your head from injury.

“If nothing changes, by 2038 there will be a new case of dementia in Canada every two minutes,” says Dr. Jack Diamond, Scientific Director for the Alzheimer Society of Canada. “We may not be able to control all the risk factors, but more and more, research is telling us that a healthy diet, modest exercise, and ongoing mental stimulation, can provide significant protection for our brains, and reduce the risk of developing dementia.”

According to the Alzheimer Society’s new study, Rising Tide: The Impact of Dementia on Canadian Society, risk reduction is also key to lessening the social and economic impacts of dementia.

“The research in Rising Tide tells us that exercise, along with other risk reduction strategies, is one of the most promising ways to reduce the massive $872 billion dementia is expected to cost Canadians over the next 30 years,” says Kelly Duffin, CEO of the Alzheimer Society of Canada.

A further investment into research is also critical if we are to turn the tide of dementia. This includes research into learning more about the benefits of prevention as well as to find more effective treatments and eventually a cure.

This Brain Awareness Week – the Alzheimer Society invites media to interview leading dementia experts in the field of prevention and risk reduction to help Canadians learn about achieving good brain health. For more information, please contact Patricia Wilkinson at 416-669-5715.

About Brain Awareness Week

Brain Awareness Week is an international campaign, coordinated by the Dana Alliance for Brain Initiatives, to increase public awareness of the progress and benefits of brain research. Brain Awareness Week is a unique international partnership of more than 2,100 organizations in 69 countries, and is celebrating its 15th anniversary campaign in 2010.

Alzheimer Society

Bungee-Powered Backpack Can Reduce Strain on Back

Old Saint Nick might very well be able to run from rooftop to rooftop without reindeer this year, if only he carried toys in a backpack like the one developed by biologists at the University of Pennsylvania.

In this week’s edition of the journal Nature, Penn researchers have announced details for a suspended-load ergonomic backpack that reduces the force of a backpack’s load on the wearer by 86%, allowing wearers to run far more comfortably with heavy loads.

While it might be useful for Santa, the backpack was created with soldiers and emergency workers in mind and could prevent the sort of muscle and joint injuries associated with running while carrying heavy items. The Penn researchers also point out that the backpack will also benefit schoolchildren, since heavy book bags have been linked to muscle and orthopedic injury.

“For the same energetic cost, you can either carry 48 pounds in a normal backpack or 60 pounds in a suspended-load ergonomic backpack,” Larry Rome, a professor in Penn’s Department of Biology, said. “It is like carrying an extra 12 pounds for ???free.’”

The backpack is based on a rigid frame pack, much like the type familiar to hikers everywhere; however, rather than being rigidly attached to the frame, the sack carrying the load is suspended from the frame by bungee cords.

Last year, Rome, an expert in the physics of muscle movement, introduced a power-generating backpack that converts mechanical energy from walking into as much as 7.4 watts of electricity, more than enough energy to power a number of portable electronic devices at once. His findings were published in Science.

The suspended-load ergonomic backpack has a similar sliding motion as the electricity generating-backpack, but it is tuned differently. Rather than having stiff springs, the load is suspended by very compliant bungee cords.

“The ergonomic backpack reduces the force of the load on the wearer by reducing the effect of the load as it shifts up and down,” Rome said. “What is striking is that you can feel the 86% reduction in force with every step.”

With a normal backpack, the peak force exerted by the load on the body during walking is twice as high as the static force, and during running it’s three times as large, exerting extreme forces on the joints.

The backpack shifts the timing of how force is applied as the wearer takes a step.

“Essentially, the bungee cords permit the load to stay at nearly constant height from the ground while the wearer walks or runs around it,” Rome said. “The pack actually reduces the metabolic cost of walking from one point to another by about 40 watts, or the equivalent of carrying 12 extra pounds.

Penn researchers involved in development and testing of the Suspended-load Backpack at the Rome laboratory at Penn are Louis Flynn, an engineer, and postdoctoral fellow Taeseung D. Yoo. Funding for this research comes from the National Institutes of Health and the Office of Naval Research.

Contact: Greg Lester

University of Pennsylvania

New “Generation Alzheimer’s” Report Calls Alzheimer’s Defining Disease Of The Baby Boomers

Starting this year, more than 10,000 baby boomers a day will turn 65. As these baby boomers age, one of out of eight of them will develop Alzheimer’s – a devastating, costly, heartbreaking disease. Increasingly for these Baby Boomers, it will no longer be their grandparents and parents who have Alzheimer’s – it will be them.

“Alzheimer’s is a tragic epidemic that has no survivors. Not a single one,” said Harry Johns, president and CEO of the Alzheimer’s Association. “It is as much a thief as a killer. Alzheimer’s will darken the long-awaited retirement years of the one out of eight baby boomers who will develop it. Those who will care for these loved ones will witness, day by day, the progressive and relentless realities of this fatal disease. But we can still change that if we act now.”

According to the new Alzheimer’s Association report, Generation Alzheimer’s, it is expected that 10 million baby boomers will either die with or from Alzheimer’s, the only one of the top 10 causes of death in America without a way to prevent, cure or even slow its progression. But, while Alzheimer’s kills, it does so only after taking everything away, slowly stripping an individual’s autonomy and independence. Even beyond the cruel impact Alzheimer’s has on the individuals with the disease, Generation Alzheimer’s also details the negative cascading effects the disease places on millions of caregivers. Caregivers and families go through the agony of losing a loved one twice: first to the ravaging effects of the disease and then, ultimately, to actual death.

“Most people survive an average of four to six years after a diagnosis of Alzheimer’s disease, but many can live as long as 20 years with the disease. As the disease progresses, the person with dementia requires more and more assistance with everyday tasks like bathing, dressing, eating and household activities,” said Beth Kallmyer, senior director of constituent relations for the Alzheimer’s Association. “This long duration often places increasingly intensive care demands on 11 million family members and friends who provide unpaid care, and it negatively affects their health, employment, income and financial security.”

The report also offers very personal glimpses into the lives of families who are in the throes of caring for a loved one with Alzheimer’s disease, including a son who struggles to change the diapers of the mother who changed his as an infant, and a husband who watches his wife’s fascination with the “lady in the mirror,” not realizing the lady in the mirror is her.

In addition to the human toll, over the next 40 years Alzheimer’s will cost the nation $20 trillion, enough to pay off the national debt and still send a $20,000 check to every man, woman and
child in America. And while every 70 seconds someone in America develops Alzheimer’s disease today, by 2050 someone will develop the disease every 33 seconds – unless the federal government commits to changing the Alzheimer trajectory.

“Alzheimer’s – with its broad ranging impact on individuals, families, Medicare and Medicaid – has the power to bring the country to its financial knees,” said Robert J. Egge, vice president of public policy of the Alzheimer’s Association. “But when the federal government has been focused, committed and willing to put the necessary resources to work to confront a disease that poses a real public health threat to the nation – there has been great success. In order to see the day where Alzheimer’s is no longer a death sentence, we need to see that type of commitment with Alzheimer’s.”

The full text of the Alzheimer’s Association’s Generation Alzheimer’s report can be viewed here.


Alzheimer’s Association

FDA Regulations On Ozone Depleting Drugs Will Impact Availability Of Combivent

The Environmental Protection Agency (EPA) and the Food and Drug Administration (FDA) have jurisdiction over lessening the use of ozone-depleting substances (ODS) in pressurized containers called chlorofluorocarbon (CFC) propellants. The Montreal Protocol and the Clean Air Act aim to transition away from all CFC containing products because of public health concerns.

The FDA is reviewing the “essential use” designation for seven Metered Dose Inhaler (MDI) drugs which they suggest should be phased out by December of 2009. One of the medications is recommended for removal from the essential list is Combivent. There is no equivalent substitute for Combivent at this time (but there should be by 2010, but not 2009 ).

By removing Combivent from the essential use designation, approximately 2,000,000 COPD patients would be forced to obtain drugs in two separate prescriptions, and perhaps make two co-payments to purchase, and use, two different delivery devices containing one medication each to achieve the same clinical result as with Combivent.

The AARC supports the provisions of the Montreal Protocols and the Clean Air Act, and we support the phase out of ozone depleting drugs, but only when there is a true substitute that will not impact the patient. The AARC submitted comments to the FDA on this issue.

American Association for Respiratory Care

Window Of Opportunity For Successful Autism Therapy

“The biggest surprise to me was that we could rescue the autistic phenotype [in the human cells] to something close to normal,” said Alysson Muotri of the University of California San Diego.

The researchers made the discovery by first transforming adult cells taken from patients with Rett Syndrome into induced pluripotent stem cells (iPS cells) using an established cocktail. iPS cells look and act very much like embryonic stem cells.

Those stem cells were able to form functional neurons in cell culture. However, neurons derived from Rett Syndrome patients exhibited some abnormalities when compared to those derived in the same way from healthy individuals.

The first thing the researchers noticed was that the cells were smaller than healthy neurons. They also had fewer synapses and displayed other signs of a failure to communicate properly, including altered calcium signaling and electrophysiological defects.

When the cells were treated with drugs that had shown promise for correcting autism symptoms in mice, those abnormalities were reversed. In fact, depending on the dose, Muotri said it appeared that the cellular defects could actually be “overcorrected.”

The findings are especially notable because symptoms of Rett Syndrome typically don’t set in until children are 6 to 18 months old, suggesting that the gene responsible isn’t essential for early wiring of the nervous system, Muotri explained. The fact that newborn neurons derived in the laboratory already show signs of the disease suggests that there may still be underlying aberrations at the earliest stages of development, and that may have important clinical implications.

“Our data provide evidence of an unexplored developmental window, before disease onset, in Rett syndrome where potential therapies could be successfully employed,” the researchers write.

Muotri says there is a need to search for better, more specific drugs than the ones applied in the study. That will require the development of methods to create iPS cells from human cells in large quantities, allowing for high-throughput screens for drug candidates.

His team is now working to derive iPS cells and neurons from children with sporadic autism, in which the causes are completely unknown. He suspects that at least some of their cells will show something similar to what has been observed in the case of Rett syndrome.

More generally, Muotri says he hopes that as this study and others shed more light on the biology of autism and other neuropsychiatric diseases, it will help to lift the stigma that is sometimes associated with them.

“There is a real, basic biology behind these diseases,” he said. “We can see it in a culture dish.”

Elisabeth N. Lyons
Cell Press

Amira Pharmaceuticals Announces Initiation Of Phase I Clinical Trial For AM152, A Novel LPA1 Antagonist

Amira Pharmaceuticals, Inc. announced today that it has initiated a Phase 1 clinical study with AM152, a novel LPA1 antagonist, in normal, healthy subjects.

“We are excited to begin our journey exploring the therapeutic value of AM152, a potentially novel anti-fibrotic agent. Our first step is to understand the safety, pharmacodynamic (PD) and pharmacokinetic (PK) profile of this compound in normal healthy subjects,” said Isabelle DeArmond, Vice President, Clinical Development. “We expect to have these studies completed by the middle of next year, and assuming positive results, we could then begin to study the therapeutic utility of AM152 in patients.”

“The Amira team is very proud and excited by this important milestone,” said Bob Baltera, Chief Executive Officer. “Currently, there are no FDA-approved therapies for fibrotic disease, and we look forward to better understanding the potential therapeutic benefit of an LPA1 antagonist in this area of medicine.”

While there are no LPA1 selective antagonists approved for therapeutic use, there is a strong scientific rationale for this as a target for novel treatment in various fibrotic diseases including scleroderma and idiopathic pulmonary fibrosis.

Source: Amira Pharmaceuticals, Inc

WFP Welcomes French Offer To Protect Ships From Somali Pirates

The United Nations World Food Programme (WFP) thanked
or its proposal to provide naval escorts to protect ships
food off the Horn of Africa from pirate attacks.

“We are grateful to the Government of France for this generous offer,
would reduce the threat of piracy and allow WFP to feed more hungry
in Somalia,” said WFP Executive Director Josette Sheeran at UN
in New York.

Sheeran also thanked the multinational coalition naval force off
for its increased surveillance in recent months and said she hoped it

WFP and the International Maritime Organization (IMO) have jointly
for high-level international action to stamp out piracy in waters
Somalia, following a series of attacks including on two vessels that
just unloaded WFP food in Somalia. In 2005, an upsurge of piracy in
waters, including the hijacking of two ships contracted for WFP, forced
UN agency to suspend all deliveries by sea for some weeks.

Some 80 percent of WFP food assistance for Somalia moves by sea, and
attacks have threatened to cut WFP’s main supply route,
rations for the 1.2 million people WFP expects to be feeding by the end
2007. Overall, there were 17 pirate attacks on ships in waters off
in the first half of 2007, compared with eight attacks in the same
last year.

The French proposal envisions a two-month period during which naval
would escort ships carrying WFP food assistance as they traverse
waters. Ships would be escorted to the entrance of Mogadishu port.

WFP is increasing its food distributions in Somalia so has to ship
food just as the stormy monsoon season is coming to an end, Sheeran
Before the onset of the monsoon last June, increasing pirate attacks
cut by half the number of ships available to transport WFP food
Without escorts, WFP fears the pirates will return as the heavy
seas calm, allowing them to start hunting for ships again.

Most of the pirate assaults did not appear aimed at seizing cargo
rather designed to force ship owners to pay ransom for vessels and
held hostage. The pirates are highly mobile, manning fast vessels and
satellite position-fixing gear to attack ships far out at sea,
more than 200 nautical miles off the Somali coast.

WFP is the world’s largest humanitarian agency: on average, each year, we
give food to 90 million poor people to meet their nutritional needs,
including 58 million hungry children, in 80 of the world’s poorest
countries. WFP – We Feed People.


New Evidence Shows MabThera Inhibits Joint Damage In Patients With Rheumatoid Arthritis

New data presented at the EULAR meeting (European League Against Rheumatism) show for the first time that MabThera (rituximab), a unique B cell targeted therapy, is able to significantly inhibit structural damage of joints caused by rheumatoid arthritis (RA). The study was conducted in patients who had an inadequate response to one or more TNF inhibitors and they received either MabThera plus methotrexate (MTX) or MTX alone. X-ray evidence at 56 weeks showed that the progression of bone erosions and progression of narrowing of joint spaces in patients in the MabThera group were reduced by more than 50 % compared to patients receiving MTX alone (erosion scores of 0.59 and 1.32 respectively; joint space narrowing scores of 0.41 and 0.99 respectively).

Damage to the structure of the joints ultimately causes destruction of the joints and contributes to joint deformity and loss of mobility. Patients’ ability to work and perform every day tasks such as getting dressed, walking and eating can be severely hampered.

Presenting the results, Professor Keystone, Rheumatology Department at the University of Toronto, Canada, said: “This is the first evidence demonstrating that MabThera can inhibit structural joint damage in patients with an inadequate response to one or more TNF inhibitors. Preventing structural damage is a critical outcome in treating rheumatoid arthritis. These X-ray data confirm MabThera as an effective and innovative therapy for patients with rheumatoid arthritis and highlight the value of targeting B cells.”

Repeat treatment courses

Additional new data presented at EULAR demonstrate that repeat courses of MabThera in RA patients, 6 to 12 months after the initial course, provide continued improvement of symptoms across all clinical measures. Each treatment course consists of two infusions of 1000mg given two weeks apart. The challenging goal of treatment in RA is remission and, following a second course of MabThera in patients with an inadequate response to one or more TNF inhibitors, the number of patients achieving remission doubled from 6 % following an initial course to 13 % following a second course. A similar trend was seen for those achieving the hard-to-reach goal of a 70 % improvement in symptoms (ACR70), with responses increasing from 12 % following an initial course to 21 % following a second course.

Patient perspectives

Importantly, data presented at EULAR show improvements in clinical scores are reflected in patient reported outcomes.

“While it is important to a physician to address a disease from a clinical perspective, what matters most to the patient is whether they are able to function normally and how well they feel. For example, the impact of fatigue is often underestimated, but this is something which really impacts patients’ lives. MabThera has demonstrated continuous improvements in physical and mental health aspects with repeated courses of therapy”, said Professor Tak, Director, Division of Clinical Immunology and Rheumatology at the Academic Medical Centre/University of Amsterdam, The Netherlands.

Approval Status

On 2 June 2006 MabThera received a recommendation for approval from the Committee for Medicinal Products for Human Use (CHMP) for the treatment of rheumatoid arthritis (RA) in Europe. MabThera, in combination with methotrexate, has been recommended for the treatment of adult patients with severe active rheumatoid arthritis who have had an inadequate response or intolerance to other disease-modifying anti-rheumatic drugs (DMARDs). On 28 February 2006, after priority review, Genentech and Biogen Idec received US approval for Rituxan (rituximab in the US) for the treatment of adult patients with moderately to severely active RA in combination with methotrexate for reducing signs and symptoms in those RA patients who have had an inadequate response to one or more tumour necrosis factor (TNF) therapies.

About the REFLEX study

The REFLEX study (Randomised Evaluation oF Long-term Efficacy of MabThera in RA) is a multi-centre, randomized, double-blind, placebo-controlled Phase III study. In this trial, patients who received a single course of only two infusions of MabThera with a stable dose of methotrexate (MTX) displayed a statistically significant improvement in symptoms measured at 24 weeks, compared to those receiving placebo and MTX. Patients receiving additional courses did so between 6 and 12 months after the initial course. Consistent with previous findings, analysis of the REFLEX 56-week data did not reveal any unexpected safety signals. The companies continue to monitor the long-term safety of rituximab in all clinical trials.

A further phase III development programme for MabThera therapy in patients with rheumatoid arthritis who have had an inadequate response to disease modifying anti-rheumatic drugs (DMARDs) is ongoing.

Long term safety and repeated courses

Further new data of a pooled analysis presented at EULAR confirmed the safety profile of rituximab identified in the original randomised clinical trials. The analysis included all RA patients treated with MabThera during clinical development which amounted to over 1,600 patient years with some patients being followed for over 3 years, many of whom had received multiple courses of treatment. This analysis did not reveal any unexpected safety signals.

About MabThera in rheumatoid arthritis

MabThera selectively targets a subset of B cells that express CD20, leaving stem, pro-B and plasma cells unaffected. This subset of B cells plays a key role in the autoimmune process of RA and MabThera aims to interrupt this process by inhibiting a series of reactions inflaming the synovia and leading to cartilage loss and bone erosion that is characteristic of the disease. More than 1,000 patients with RA have been treated with MabThera in clinical trials to date. A comprehensive Phase III clinical development programme is also currently underway to further investigate the potential clinical benefit of MabThera in earlier RA.

About Roche

Headquartered in Basel, Switzerland, Roche is one of the world’s leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people’s health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology. In 2005, sales by the Pharmaceuticals Division totalled 27.3 billion Swiss francs, and the Diagnostics Division posted sales of 8.2 billion Swiss francs. Roche employs roughly 70,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet (roche).

All trademarks used or mentioned in this release are legally protected.

British Society for Rheumatology:
American College of Rheumatology:

View drug information on Rituxan.

PsoriasisDX Genetic Test For Psoriatic Arthritis Now Available In Europe As A CE Marked In Vitro Diagnostic Medical Device

Molecular dermatology research and development innovator DermaGenoma, Inc. today announced that the PsoriasisDX Genetic Test for Psoriatic Arthritis (PsA) is now available as a CE Marked product under the European In Vitro Diagnostic Directive.

CE Marking is required for certain product groups to indicate conformity with the essential requirements set out in European Directives. The PsoriasisDX Genetic Test for Psoriatic Arthritis complies with the essential requirements of the European IVD Directive.

The PsoriasisDX Genetic Test helps identify those at high risk for developing Psoriatic Arthritis before they experience arthritic symptoms, providing the opportunity to lessen joint damage through early medical intervention.

“We are excited to extend this revolutionary genetics testing breakthrough to dermatologists in Europe,” says Andy Goren, CEO of DermaGenoma, Inc. “It helps doctors determine the proper treatments for patients.”


DermaGenoma, Inc.