New therapies help with rheumatism today

Arthritis therapy: a lot of sports and remedies: Rheumatism is today better treatable

12/10/2013

Although there are no documented numbers, how many people in this country suffer from rheumatism, but according to the German Rheumatism League, there are about nine million people who are affected by a rheumatic disease. Today's Saturday sees the World Rheumatism Day.

Nine million Germans suffer from rheumatism
In Germany, around nine million people suffer from rheumatism. Depending on the definition, physicians summarize under this generic term between 200 and 400 diseases, some of which appear similar but often also very different. Rheumatoid arthritis or chronic polyarthritis are also included. „Rheumatoid arthritis features several characteristic symptoms“, said the President of the German Rheumatism League, Erika Gromnica-Ihle. „Painful swelling on at least three joints, usually beginning with fingers, toes or wrists that last longer than six weeks and are associated with more than 60 minutes of stiffness in the morning.“ Arthritis is based on a chronic inflammation, in contrast to osteoarthritis, which is due to misuse and overloading to a painful joint wear.

So far no cure possible
Since the inflammation is due to an overly active immune system, rheumatism is one of the autoimmune diseases. In many areas, it is still unknown why some people get rheumatism and others do not. Genetic factors play an important role and women are affected about three times as often as men, often between the ages of 50 and 60 years. However, about 15,000 children under the age of 16 are also affected in Germany. There is no cure yet, but therapies that focus on relief and mitigation, such as joint inflammation.

Three principles of therapy
Rheumatoid research is now fairly familiar with molecular processes and inflammatory processes, and as a result, more advanced rheumatoid arthritis treatments can directly intervene in this process and inhibit the progression of the disease. Earlier medications had often showered the joints with soothing drugs. The aim of the new therapy is the remission, the easing of the disease symptoms. For polyarthritis, this means a lower activity of the inflammatory inflammatory processes that destroy cartilage and bone. The therapy has been governed for some time by the three principles: early initiation of therapy, close monitoring and muscle training.

Start early and control frequently
At the latest 3 months after the first complaints medicines should be taken, because the destruction of the joints could begin already few months after outbreak of the illness. In order to maintain their functionality, the treatment should start already before a resulting damage. In order to bring the arthritis to a standstill with modern medicines, frequent medical checks of the course of the disease are important. Thus, at the beginning of the therapy every two weeks, then every four weeks and permanently every three months controls should take place. This is also so important because the drugs interfere with the immune system and can have strong side effects.

Do not become motionless
Basically applies to those affected not to fall into motionlessness. The joints must be moved to maintain their function. Therefore, joint-friendly sports such as swimming, walking or cycling have long been popular with rheumatics. Rather new are advice on targeted muscle training. But a strong musculature stabilizes and relieves the joints. „Patients should, however, exercise under physiotherapeutic guidance and only in calm phases of the disease“, said the rheumatologist Gromnica-Ihle.

Blocker of the immune system
Drugs that suppress inflammation are at the heart of rheumatism. However, painkillers are also included. These vary from patient to patient, ranging from all-around substances such as diclofenac or ibuprofen to cortisone, which is injected directly into the rheumatic knee to reduce inflammation and pain. For the long-term treatment of rheumatism blockers of the immune system are used, which inhibit the rapid proliferation and activity of defense cells. Methotrexate (MTX) is often used as the basis, and as it only takes effect after four to six weeks, doctors initially also provide cortisone as a bridging therapy.

Effective biologics
Even if three months after the basic therapy has started, there are no clear successes, so the so-called biologics come into play. Although these latest approved rheumatism drugs are the most effective weapon against rheumatoid inflammation and can not only slow but arrest joint destruction, they are not the first choice for Gromnica Ihle: „Biologics are much more involved in the immune system than MTX. This means more side effects and infection risks. It has relatively little experience with it and the antibody syringes are many times more expensive. So as long as MTX works well, biologics are superfluous.“

Stem cell therapy in making diseases
Scientists from the German Rheumatism Research Center in Berlin are now testing the so-called Selective Immune Reset against the autoimmune disease. „So far, however, this stem cell therapy is mainly used in systemic rheumatic diseases such as Lupus erythermatodis (butterfly lichen)“, so the expert. The use against rheumatoid arthritis is yet to be seen. However, there are many critical voices against such stem cell therapies.

Naturopathic remedies
Even if there is no non-drug treatment that can stop the inflammatory process, many patients rely on substances from natural medicine. Thus, studies have confirmed a mild pain relieving and anti-inflammatory effect of preparations from devil's claw. Of the gel-friendly dietary supplements, only omega-3 fish oil has proven to be a useful adjunct to therapy. Other extracts would not have met the expectations in studies. As so-called synovial fluid, syringes help with hyaluronic acid in the onset of osteoarthritis, but not in polyarthritis. Although there would be no special rheumatism diet, but the chairman of the German Rheumatism League says: „We recommend a Mediterranean diet with little red meat, lots of fish, vegetables and fruits.“ In addition, patients were advised to maintain or strive for their normal weight.

Artificial joints
As joint inflammation often occurs due to persistent or frequent inflammation of the joints, osteoarthritis also develops. Stress and friction on worn cartilage causes pain and inflammation in the joint. It can come in the advanced stage to bony growths and stiff joints. The surgery can artificially replace some of these joints, such as knees, hips, or shoulders. But for some, such as finger joints, this technology is not yet mature. With wrists an operative stiffening is possible, with which one can turn off the pain.

World-Heart Day
Like every year on Saturday, the twelfth of October, the World Rheumatism Day will take place, which was launched in 1996 by the Arthritis and Rheumatism International (ARI), the international association of self-help groups called Rheumatism. With the tag, this year's motto „Active against rheumatism - I'm in“ stands, should be made aware of the commitment of the many volunteers in the self-help organizations and the issue of rheumatism in general more public awareness. (Ad)