Arthritis Digest 3 - 2016 UK.pdf

7/26/2019 Arthritis Digest 3 - 2016 UK.pdf

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HEALTH NEWS INTERVIEWS FOOD TRAVEL BENEFITS PRODUCTS

ARTHRITISARTHRITISTHE LATEST SCIENCE EXPLAINEDTHE LATEST SCIENCE EXPLAINED

DigestDigest

2016 Issue 3 www.arthritisdigest.co.uk

MINDFULNESSThe new way

to unwind

MINDFULNESSThe new way

to unwind

Under thespotlight:Can supplementshelp?

Under thespotlight:Can supplementshelp?

Meet Austin Healey...Meet Austin Healey...

FATFACTS

Whichones toeat forhealth

FATFACTS

Whichones toeat forhealth

on how rugby took its toll on his body on how rugby took its toll on his body

WIN

anEasi-G

rip

trowel

seepag

e7

WIN

anEasi-G

rip

trowel

seepag

e7

Under

pressureHammer toesexplained

Under

pressureHammer toesexplained

DRUGSREPURPOSINGNew therapeutic uses

DRUGSREPURPOSINGNew therapeutic uses


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D e s ig n e d to fi t in th e s a m e

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AR T R T SAR T R T S

2 0 1 6 Issue 3digestcontents

Wh e th e r y o u re a ru g b y fa n , o r lo v e w a tc h in g Stric tly Co m e

D a n c in g m o st o f u s w ill k n o w Au stin H ea le y a s b e in g s u p e r

fit a n d a lw a y s o n th e g o . Ho w e v e r, fo r m a n y y e a r s h e h a s su ffe r e d

d e b ilita tin g p a in d u e to a r th r itis . As w e ll a s u n d e r g o in g k e y h o le

s u r g e r y fo r h is in ju r ie s , Au s tin n o w ta k e s su p p le m e n ts w h ic h h a v e

h e lp e d to e a se th e p a in . Re a d h o w h e h a s o v e rc o m e h is p ro b le m s

a n d n o w is a b le to c y c le , b o x a n d s k i in r e la tiv e e a s e .

E lse w h e re , w e re k e e p in g y o u u p to d a te w ith th e la te st n e w s a n d

p r o g r es s in tr e a tm e n ts . As w e ll a s fo c u s sin g o n h a m m e r to e s , a

c o m m o n , p a in fu l c o n d itio n fo r m a n y , th e le a d in g a r th r itis c h a r ity ,

Ar th r itis Re s e a r c h U K , h a s c o n tr ib u te d a g a in to th is is su e w ith a

fe a tu r e lo o k in g a t th e la te st d e v e lo p m e n ts in d r u g s r ep u r p o s in g .

Its o fte n c o n fu sin g to k n o w e x a c t ly w h ic h fa ts a r e g o o d fo r y o u

a n d w h ic h o n e s to a v o id . D ie tic ia n , G u ls h in d e r Jo h a l, ta k e s a lo o k

a t fa ts th is m o n th a n d sp e lls o u t w h ic h o n e s m a y h e lp w ith a r th r itis

sy m p to m s. An d w h y n o t co n sid e r g o in g o n a m in d fu ln e ss re tre a t?

Its th e la t e s t b u z z w o r d fo r r e la x a t io n a n d r e lie v in g s tr e s s.

E n jo y th e is su e

5 F a t fa c t s

W hich are good for you?

7 P r o d u c t r o u n d u p

Keeping things sim ple

9 T h e d r u g d e n

Latest treatm ents

1 1 A u s tin H e a ly

C oping with arthritis pain

1 5 S u p p lm e n t s e r ie s

Focus on glucosam ine

1 7 L a t e s t t r e a t m e n t s

D rugs repurposing

1 9 U n d e r p r e s s u r e

H am m er and clawtoeexplained

3 0 M in d fu le s s r e t r e a t s

Six of the best

ontents:

S L a s t tim e w e ra n a c o m p e t itio n to w in a N o B e n d P e t B o w l. T h e lu c k y w in n e rs

a r e : M s M Sm ith , P ly m o u th ; M s C G a r ey , E a s t Su s se x ; M r s J Re n s h a w , We st

Su s ss ex ; M r s M K e lly , Ay r sh ir e; M r s E T h o m a s , L i n c o ln s h ir e; M r K B is h o p ,

B irm in g h a m ; M rs J C h a lk e , E a s t Su s se x ; M r & M rs B W H o b b s ,

L in c o ln s h ir e ; M s J J e n n in g s , Su ffo lk ; M r s Alb in s , No rfo lk .


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o r p o s t t o : D ig it a l He a r in g Aid In fo r m a t io n Se r v ic e L t d (A9 1 8 HE )

FR EEPO ST LO N 1 5 6 5 1 , L o n d o n SE 1 1 B S o r re q u e s t d e ta ils o n lin e a t w w w .d h a is .c o .u k

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m ak e sure yo ure arm ed w ith th is rev o lutionary

new F R E E Hearing Aid G uid e.

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earing aid ex p ert

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Duetoconsum erled p ressurep ricesarenow fallingforthelatestd igitalhearingaid sasneverb efore.M yb rochuretellsyouhow youcange tap rop eraid atad ecentp riceA NDensurecorrectaftercarefrom areliab led isp enser.

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www.dhais.co.uk

Q u o t e A 9 1 8 H E)

fte r 3 0 y e a rs a s M a n a g in g

D ire c t o r o f s o m e o f th e U K s

la rg e s t h e a r in g a id rm s , M a rk M o s s

o w s w h a t h e a rin g a id s sh o u ld

re a lly c o s t. He a ls o k n o w s th a t if y o u

b u y a c h e a p h e a rin g a id w ith o u t

th e p ro p e r a d v ic e a n d a fte r-c a re

- y o u c o u ld n d t h e a id is n o t s o

c h e a p a f te r a ll. Th a t s w h y h e h a s

n o w p ro d u c e d a b ro c h u re to h e lp

p e o p le w h o a re th in k in g o f b u y in g ah e a rin g a id fo r th e v e ry rs t tim e o r

c o n s id e rin g a n u p g ra d e t o a b e tte r

m o d e l. Th e fa c t is m a n y p e o p le w h o

s u ff e r fro m h e a rin g lo s s a re re lu c ta n t

to a tte m p t to b u y a h e a rin g a id

b e c a u s e th e y n d th e w h o le p ro c e s s

c o n fu s in g a n d a re n o t s u re w h e re to

n d t ru ly in d e p e n d e n t a d v ic e a n d

th e b e s t p ric e s .

Th is is u n fo rtu n a t e b e c a u s e th e r e

a re m a n y p ro fe s sio n a l in d e p e n d e n t

h e a rin g a id d is p e n s e rs w h o ta k e

g re a t c a re a n d p rid e in p ro v id in g

th e la t e s t h e a rin g s o lu tio n s fo r y o u r

in d iv id u a l n e e d s . Ho w e v e r, o n e

n a t io n a l c h a in is c h a r g in g tw ic e

th e p ric e fo r a h e a rin g a id th a n

y o u c a n g e t w ith o th e r d is p e n s e rs .

M a n y la rg e c o m p a n ie s w h o e m p lo y

d is p e n s e rs a re o w n e d b y He a rin g

Aid M a n u fa c tu re rs c h e m is ts a n d

o p tic ia n s h a v e a ls o tu rn e d to s e llin g

h e a rin g a id s .

Th e m a rk e t is c h a n g in g a n d

c u s to m e r s a re g e ttin g y o u n g e r,

b u y in g d ig ita l a id s fo r th e m ild e s t o f

h e a rin g p ro b le m . So m e s im p ly w a n t

a tin y c o rre c t o r th a t w ill t in to t h e

e a r a n d n o t b e n o tic e d a t a ll s o it

is p ra c tic a lly in v is ib le . So m e h e a r in g

a id s w o rk w ith o u t a n y th in g in t h e

e a r b u t b y u sin g b o n e c o n d u c tio n

th ro u g h a p a ir o f g la s s e s . Wh a t

is d e n ite is th a t p e o p le w a n t

s o m e t h in g to a lle v ia t e t h e ir

h e a rin g lo s s b u t is s o t in y t h a t

it c a n n o t b e s e e n .

N o thing in either ear

2016

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T h e in f o r m a t io n w e w ill s e n d y o u w ill b e f ro m o u r a u t h o r is e d a s s o c ia t e fo r y o u r a re a . If y o u d o n o t w is h t o r e c e iv e 3 r d p a r t y

m a r k e tin g in f o rm a t io n b y m a il p h o n e e m a il o r o t h e r w is e p l e a s e a d v is e . C e r t a in h e a r in g a id s m a y n o t a lw a y s b e a v a ila b l e in

a ll a r e a s a n d m a y n o t h e lp a ll t y p e s o f h e a r in g lo s s .


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s s s i o i eoek d e a k o c h r g

2 1 Is su e 3

d ig estfood

ARTHRITISARTHRITIS

FOOD NEWS on a plate

In r e c e n t y e a r s, th e m e d ia h a ve fu e lle d a

fr e n z y e n c o u r agin g p e o p le to c u t o u t a s

m u c h fa t fr o m th e ir d ie t a s p o s sib le .

H o w e ve r, w e k n o w th a t fa ts a re e s se n tia l to

go o d h e a lt h . E a t in g t h e r igh t f a ts o n a r e gu la r

b a s is ca n h e lp u s m a in ta in a h e a lth y b o d y a n d

m in d w h ils t h e lp in g u s to a b s o r b vita m in s A ,

D , E a n d K . T h e re is a n o ta b le d iffe re n c e

b e tw e e n fa ts a n d th e e ffe c t th e y h a ve o n o u r

h e a lth a n d b e in g a b le to id e n tify th e m o s t

b e n e fic ia l fa ts m a y h e lp c o n tro l in fla m m a tio n

in s o m e t y p e s o f a r th r itis .F a t s a r e h igh in c a lo r ie s , c o n ta i n in g n in e

k ilo c a lo r ie s p e r gr a m , m a k in g th e m th e m o st

c a lo r ific fo o d gr o u p o n th e E a t w e ll p la t e .

C o n su m in g to o m u c h fa t, go o d o r b a d , c a n

le a d to w e igh t ga in w h ic h w e k n o w h a s a

d e tr im e n ta l e ffe c t o n in fla m m a tio n in th e b o d y .

O b s e rva t io n a l s tu d ie s s u gges t th a t o b e s it y

in c r e a s e s th e r is k f o r o s te o a r th r itis a n d

r a n d o m is e d c lin ic a l tr ia ls h a ve s h o w n a w e igh t

lo ss o f m o r e th a n 5 o ve r a five - m o n th p e r io d

c a n re su lt in m o d e st im p ro ve m e n t s in p a in

a n d jo in t fu n c t io n . I t is th e r e fo r e e s s e n t ia l to

c o n tro l th e qu a n titie s w e c o n s u m e to h e lp u s

m a in ta in a h e a lth y b o d y m a ss in d e x ( B M I) .

T h e ty p e a n d a m o u n t o f fa t a re im p o r ta n t .C o n su m in g th e m o r e d a m a gin g sa tu r a te d f a ts

a n d tr a n s -fa tty a c id s m a y in c r e a se fa c to r s su c h

a s b lo o d c h o le s te r o l th a t le a d to h e a r t d is e a s e

a n d tr igge r in fla m m a tio n in th e b o d y . T h is

c a n b e b a d n e w s fo r a r th r itis su ffe r e r s.

S a tu r a te d fa ts a re n a tu r a lly f o u n d in r e d

m e a t, fu ll fa t d a ir y fo o d s su c h a b u tte r a n d

c h e e s e , a n d h a r d c o o k in g fa ts su c h a s p a lm o il

a n d la r d . S e ve r a l s tu d ie s h a ve s h o w n th a t

s a t u r a t e d fa t s t r igger fa t tis s u e in fla m m a t io n .

T h e r e h a s b e e n so m e sp e c u la tio n a b o u t th e

b e n e fits o f c o c o n u t o il, w h ic h c o n ta in s m e d iu m

c h a in fa tty a c id s , a n d c la im s h a ve b e e n m a d e

a b o u t th e h e a lth b e n e fits o f th e o il s u c h a s

d e c re a se d in fla m m a tio n . W e m u s t re m e m b e r,

h o w e ve r, th a t a la rge p r o p o r tio n o f c o c o n u t

o il is sa t u r a t e d fa t . C o c o n u t o il c a n b e u s e d i n

s m a ll qu a n titie s , b u t s h o u ld n o t b e th e m a in

s o u r c e o f fa t in th e d ie t . O live o il a n d r a p e s e e do il a r e go o d o ils to u s e in eve r y d a y c o o k in g.

Trans fatsT r a n s fa ts a re m a d e fro m a c h e m ic a l p ro c e ss

t h a t tu r n s liqu id o il in to a s o lid fa t . T r a n s

fa t s o r tr a n s fa t ty a c id s c a n r a is e b lo o d

c h o le s te r o l leve ls a n d a r e t y p ic a lly f o u n d in

h a r d m a rga r in e s , fr ie d fo o d s , s o lid c o o k in g

fa t s su c h a s la r d , gh e e , s h o r te n in g, b a k e d

go o d s su c h a s c a k e s , b is c u its , c r a c k e r s a n d

ta k e a w a y fo o d s .

A vo id in g h y d r oge n a t e d a n d p a r tia lly

h y d r oge n a te d o ils in fo o d p r o d u c ts is

re c o m m e n d e d b e c a u s e th e y a re p a r tic u la rly

d a m agin g to t h e h e a r t a n d m igh t t rigge rin fla m m a t io n in a r th r itis su ffe r e r s.

Monounsaturated andpolyunsaturated fatsM o n o u n sa tu r a te d a n d p o ly u n sa tu r a te d fa ts

a re ge n e r a lly re c o m m e n d e d a s th e m a in

s o u r c e s o f fa t in y o u r d ie t if y o u h ave a r th r itis .

M o n o u n sa tu r ate d fa ts c a n h e lp to r e d u c e

c h o le s te r o l leve ls in th e b lo o d w h ic h , in tu r n ,

c a n r e d u c e y o u r ris k o f h e a r t d is e a se .

M o n o u n s a tu r a te d f a t is fo u n d n a tu r a lly in

o live s , o live o il, r a p e s e e d o il, avo c a d o s a n d

n u ts a n d se e d s su c h a s w a ln u ts, a lm o n d s,

c a s h e w s a n d p is ta c h io s . O live o il, in p a r t ic u la r ,

c o n ta in s h e a lth y fa ts a n d o le o c a n th a l w h ic h h a s

p r o p e r tie s s im ila r to s o m e a n ti- in fla m m a to r y

d ru gs a n d c a n r e d u c e in fla m m a tio n a n d jo in t

c a r t ilage d a m age.

A ga in , th e s iz e o f p o r tio n s is im p o r ta n t s oa s t o a vo id w e igh t ga in . T h e go ve r n m e n ts

gu id e lin e s re c o m m e n d o n ly a ta b le sp o o n o f

o il fo r fo u r p e o p le w h e n c o o k in g.

Polyunsaturated fatsP o ly u n s a tu r a te d fa ts co n ta in tw o ty p e s o f

e s s e n t ia l fa t ty a c id s , o m ega 3 fa t ty a c id s a n d

o m ega 6 fa tty a c id s . T h e y a r e ty p ic a lly fo u n d

in c o ld - w a te r fish s u c h a s m a c k e r e l, sa lm o n ,

p ilc h a r d s a n d sa r d in e s. T h e y c a n a ls o b e

fo u n d in n u ts a n d s e e d s , e s p e c ia lly fla x s e e d s .

P o ly u n sa tu r a te d o ils ty p ic a lly u s ed a t h o m e

in c lu d e s u n flo w e r, s o y , p e a n u t, s a fflo w e r a n d

gr a p e s e e d .

Omega 3 fatty acidsO m e ga 3 fa tty a c id s su p p le m e n ts a n d o ily fis h

h a ve b e e n lin k e d to im p r o ve m e n ts in a r th r itic

sy m p to m s fo r m a n y y e a rs. A lth o u gh th e re is a

la ck o f la rge, clin ica lly c o n tro lled trials

e x a m in in g th e e ffe c t o f o m ega 3 fa t ty a c id

su p p le m e n ts ( E P A a n d D H A ) u s e d fo r

o ste o a r t h r itis a n d fib r o m y a lgia , t h e r e is

a n e c d o ta l e vid e n c e w h ic h h a s sh o w n it m a y

b e o f b e n e fit fo r so m e p a tie n ts . T h e r e is

a p p r o x im a te ly o n e gr a m o f o m ega 3 fa tty a c id s

p e r 3 .5 o u n c e s o f fish a n d th e go ve r n m e n t

re co m m e n d s tw o p o r tio n s o f fish p e r w e e k ,

o n e b e in g o ily .

O m e ga 3 in ta k e h a s b e e n lin k e d to lo w e re din fla m m a tio n in r h e u m a to id a r th r itis , r e a c tive

a r th r itis , s y ste m ic lu p u s , e r y th e m a to s u s a n d

a n k y lo s in g s p o n d y litis . G o u t s u ffe r e r s s h o u ld

e x e r c is e a little c a u tio n w ith fis h c o n s u m p tio n ,

d u e to its h igh p u r in e c o n te n t. R e s e a rc h h a s

sh o w n th a t o m e ga 3 fa tty a c id su p p le m e n ts

w h e re a m in im u m d o se o f 2 .7 g/d a y o f

E P A /D H A fo r a m in im u m o f th r e e m o n th s

w a s give n m a y h a ve b e n e fic ia l e ffe c ts o n s o m e

p a tie n ts w h o h a ve r h e u m a to id a r th r itis .

M o r e stu d ie s a re n e e d e d w h e re th e e ffe c t o f

a n a lges ic s a r e c o n t ro lle d fo r b u t o ve r a ll s tu d ie s

h a ve sh o w n th a t th e M e d ite rr a n e a n d ie t

w h e r e lo ts o f h e a lth y fa t s s u c h a s o ily fis h a n d

o live o il a re c o n su m e d c a n h e lp so m e p a tie n tsw ith r h e u m a to id a r th r itis .

It is important to consult your healthprofessional before making any changes toyour diet.

S o m e fa ts a re c la im e d to b e g o o d fo r y o u w h ile o th e rs c a n trig g e r in fla m m a tio n .Gulshinder Johal s e n io r d ie tic ia n fro m th e B ritis h D ie te tic A s so c ia tio n re v ie w s th e e v id e n c e

v o c a d o s W a ln u ts

O live o ila lm o n


6/32


7/32

T h is q u ir ky kit c h e n a c c e s s o r y

m ake s lg h t w o r k o f th e fid d l

b u s in e s s o f s e pa r a t in g e g g s .

W h e t h e r y o u a re b a kin g

c a ke s o r m a kin g m e r in g u e s o r

s o u ffl, s im pl s q u e e z e t h e

Y o lkF r o g s b e ll a n d y o u r e g g

yo lk w illb e sw iftl su c ke d u p,

s epa r a t in g it fr o m y o u r e g g

w h ite . A n o th e r g e n tl s q u e e z e

a n d Y o lkF r o g w illd e po s it y o u r

y o lk in to a n o th e r b o w l

M a d e fro m fo o d - g ra d e

s ilc o n e , a fu n b u t u s e fu l

g a d g e t fo r th e kit c h e n .A v a ila b le fr o m T h e K it c h e n

G ift C o fo r 7 .9 5 p lu s p &p ) ,

v isit

w w w .t h e k it ch e n g ift c o .c o m

o r te l 0 1 2 0 2 7 3 6 4 1 4 .

R T R IT IS

R T R IT IS

w w w .a r t h r itis d ig e s t.c o .u k

T h e E a s i-G r ip T r o w e lis

pa r t o f a r a n g e o f

e r g o n o m ic a ll d e s ig n e d

g a rd e n to o l w h ic h h e lp

m ake g a r d e n in g e a s ie r fo r

th o s e w h o h a ve a w e a k

gr ip. T h e spe ciall a n gl d

h a n d l w illke e p y o u r h a n d

a n d w r is t in a n e u tr a l

s t r e s s - fr e e po s it io n ,

m akin g it c o m fo r t a b l t o

u s e w h e n t a c kln g a ll

th o s e tr ic ky w e e d s th a t

s pr in g u p a t th is tim e o f y e a r T h e t ro w e l(P G T -T )u s u all c o s t s 1 1 .9 5 ( fr e e p& p if y o u q u o t e a r d ipp1 0

u n til1 6 th A u g u s t 2 0 1 6 ) fr o m w w w .pe t a-u k.c o m

(te l 0 1 3 7 6 5 6 3 4 7 6 ) b u t w e h a v e s ix t o g iv e a w a y.

C O M P E T I T I O N T I M E

T o e n te r s im p ly fill o u t a n d r e tu r n t h is fo r m

N a m e : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

D a te o f b ir th : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

A d d r e ss : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

P o s tc o d e : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

T e l ph o n e :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

W h a t I lke a b o u t A rthritis ige st _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

P o st to A rth ritis ig e st, r iffin P u b ls h in g S o l t io n s ,

4 S t Jo h n s R o a d , T u n b r id g e W e ll T N 4 9 N P

20 1 ss u e3digestprodu ts

E A S Y F I X E S

A s im pl id e a t o h e lp m e n d h o l s , r ips a n d s ta in s

o n l a t h e r s o fa s , c h a ir s a n d c a r s e a t s , M a s t a pl s ta

a r e in s t a n t r epa ir kit s t h a t a r e v e r y e a s y t o appl. If

y o u w o u l fin d a r e pa ir to y o u r fu r n itu r e d iffic u l,

M a s ta P l s ta h a s a r a n g e o f s e l-a d h e s iv e r e pa ir

pa t c h e s t h a t w illd o t h e t r ick in a n in s t a n t .

M a s ta P l s ta w a s a fin a ls t in l s t y e a r s N e c ta r

In n o v a t io n o f th e Y e a r U K a w a rd s .

A v a ila b le in a r a n g e o f s iz e s , t h is 5 c m x 5 c mr e d s m a ll c ir c le c o s t s 8 .9 5 , v is it

w w w .m a s t p la s t a .c o m .

T h is c l v e r d e v ic e is pe r fe c t fo r pe o pl w it h

a r t h r itis , a w e a ke n e d g r ip o r d e c r e a s e d h a n d

s e n s a t io n . T h e D y c e m n o n - slp j r o pe n e r s

w illo pe n a n y j r w ith e a s e . S o ft a n d m all a b l

fo r a d d e d c o m fo r t, th e y a r e d e s ig n e d w ithu n iq u e g r ip b a r s a n d a r e d o m e s h a pe d s o

t h a t t h e y fit c o m fo r t a b l in t h e palm o f y o u r

h a n d .

T h e j r o pe n e r s h a v e m a n y o th e r u s e s

in c l d in g o pe n in g s t iff d o o r kn o b s , t u r n in g

t a ps , o pe n in g m e d ic in e b o t tl s , d o o r l cks

a n d u n d o in g lg h t fit tin g s .

T h e D y c e m Ja r O pe n e r s d o n o t c o n t ain

a n y l te x , a re e a sy to c l a n a n d c o m e in b l e ,

s il e r o r y e ll w .

A v a ila b le fr o m D y c e m fo r 5 .9 9 , v is it

w w w .d y c e m .c o m o r t e l 0 1 1 7 9 5 5 9 9 2 1 .

I S T H I S A Y O L K ?

T A K E T H E W E I G H T O F F Y O U R F E E T

A N O P E N A N D S H U T C A S E

P R O D U C T N E W SA ro u n d -u p o f n e w p ro d u c ts sy ste m s a n d

se r v ic e s th a t c o u ld m a k e life a little sim p le r

If y o u fin d s ta n d in g fo r a n y l n g t h o f t im e d iffic u l, w h y n o t ta ke a s e a t o n t h is n ift y w e ig h in g

s c a l sto o l M a d e fr o m b l c k po w d e r e d s te e l th e s to o lc o m e s c o m pl t e w ith fo u r l g s a n d a

fu ll- fu n c t io n in g s e t o f s c a l s . A lly o u h a v e t o d o is s it o n

th e s c a l s , lft u p y o u r fe e t a n d r e a d y o u r w e ig h t

A v a ila b le fo r 9 9 , v is it w w w .g e t t in g p e r s o n a l.c o .u k o r

t e l 0 8 4 5 2 1 7 6 3 8 2


8/32

R T R IT ISR T R IT IS

2 1 6 Is su e 3 digestresearch

S c ientists fr o m the G enes, D ev elo pment and

D isease G ro up at the S panish N atio nal CancerR esearc h Centre CN IO ), hav e d isc o v ered themo lecular c o mmunic atio n that is estab lishedb etw een inflamed sk in and lo ss o f b o ne mass,w hich means that peo ple w ith pso r iasisex perience w id espread b o ne lo ssas a result o f the d isease.

T he stud y , w hich w as ledb y E rw in W ag ner, andpub lished inScien ceTra n sla tion a l Med icin e

sug g ests that thisd isc o v er y hig hlig hts thepo ssib ility to treatpso r iasis w ith d rug s that

are alread y o n themark et, o r are inad v anced c linical tr ialstag es, that w o uld hav ead d itio nal b enefits fo r theb o ne.

In a prev io us stud y, E rw in W ag nersteam g enerated a mo use mo d el fro m w hichthey had remo v ed a g ene in the cells that fo rmthe epid ermis, mimic k ing w hat happensd uring inflammato r y sk in d iso rd ers inhumans. T hey d isc o v ered that this mo usemutant suffered fr o m b o ne lo ss.

D uring this research they fo und that the

immune cells in the sk in o f this animal mo d el

g enerated larg e amo unts c y to k ine IL -1 7 apro tein o f the immune sy stem that ac tiv atesc ellular inflammatio n in respo nse to d amag e.IL -1 7 trav els thro ug h the b lo o d stream to the

b o nes and , o nce there, inhib its thefo rmatio n o f the sk eleto n.

H o w ev er, treating these micew ith IL -1 7 b lo c k ers, then led

to b o ne fo rmatio n.D uring further analysis,

researc hers o b ser v edthat pso r iasis patientshad b o ne lo ss c o mparedw ith healthy peo ple,and this c o r related w ith

inc reased lev els o fcy to k ine IL -1 7 in theb lo o d , sug g esting that

peo ple w ith pso r iasissho uld b e mo nito red fo r this

lo ss o f b o ne mass, o r thepresence o f hig h lev els o f these

fac to rs in the b lo o d . T reating pso r iasis patients w ith IL - 1 7

b lo c k ers so me alread y o n the mark et c o uld hav e a b enefic ial effect o n the lo ss o fb o ne tissue, unlik e o ther c o mpo und s thatmig ht o nly affect sk in inflammatio n, say s z g e U lu k an, first autho r o f the stud y .

e o p le w ith p so ria sis e x p e rie n c e

w id e sp re a d b o n e lo ss

Oralsteroid safe and effectivefirst-line treatm ent for gout

C artilage restoration

procedures now

viable for the over 40s

w w w .arthritisdige st.co .uk

Tw o n e w studie s at the H o spital fo r

Spe cial Surge ry (H SS) and pre se n te d atthe annual m e e ting o fthe A m e ricanA cadem y o fO rtho pae dic Surge o n s,hasfo und that cartilage re sto ratio n surge ry,using vario us type s o fplugs to fill the ho leo r dam age d are a,is a viable tre atm e n t fo rpe o ple o ve r 40.

D r Rile y JW illiam s III,a le ad aut ho r anddire cto r o fthe Institute fo r C artilageRe pair at H SS,says that w hile vario uscartilage re sto ratio n pro cedure s havede m o nstrate d success rate s ranging fro m50% 90% ,the m ajo rity o fre po rte dre sults w e re in patie n ts age d 30 o ryo unge r.

O ur studie s are the first to lo o k ato utco m e s o fthre e spe cific pro ce dure suse d to re pair dam age d cartilage in pat ie n tso ver 40, he says.

Fo r the H SS studie s pat ie n ts hadde gen e rative change s in the ir cartilage an diso late d are as o fpain and sw e lling,characte ristic o farthritis.M o st o fthepatie n ts did n o t m e e t the crite ria fo r to talkne e re place m e n t.C artilage re sto ratio n isn o t in te n de d fo r patie n ts with advance dbo n e -o n-bo n e arthritis.

The first study include d 35 patie n tsw ho se dam age d cartilage w as unde r the irkne e cap.The se co nd study include d 61

patie n ts w ho se cartilage dam age w as atthe e nd o ftheir fe m ur bo ne in t he kne ejo in t.The m e an age in bo th studie s w as51.5,and participan ts had n o kn e e injuryo the r than the cartilage le sio n.

A t the ave rage fo llo w -up o f3.5 ye ars,the vast m ajo rity o fpatie n ts re po rte dhighe r activity leve ls an d de cre ase d pain,as w e ll as a high de gre e o fsatisfactio nw ith t he pro ce dure ,acco rding toD r W illiam s.The re w e re n o stat isticallysignificant diffe re nces in o utco m e s am o ngthe diffe re n t tre atm e n ts.

Fo r the first tim e ,this m iddle -age dgro up o fat hle tic individuals m ay have

so m e go o d o pt io n s to re pair cartilagele sio ns, says D r W illiam s.In additio n toim pro ving the ir quality o flife ,this m ayhelp the m to delay the n e e d fo r a kne ere place m e nt do w n the ro ad.

A n e w t r i a l , p u b l i s h e d i n An n a ls o f

In te rn a l M e d ic in e h a s fo u n d t h a t a n o r a l

s t e r o i d h a d s i m i l a r e f fe c t i v e n e s s t o a n

o r a l n o n - s t e r o i d a n t i - i n f l a m m a t o r y

d r u g N S A ID ) f o r i m p r o v i n g

p a i n i n p a t ie n t s w i t h

a c u t e g o u t .

U s i n g t w o

d o u b l e - b l i n dr a n d o m i s e d ,

c o n t r o l l e d

t r i a l s , i t w a s

s h o w n t h a t

o r a l s t e r o i d s

a n d N S A ID s

h a v e s i m i l a r

a n a l g e s i c

e f fe c t iv e n e s s f o r

m a n a g e m e n t o f

g o u t , a l t h o u g h t h e

t r i a l s w e r e s m a l l

a n d h a d o t h e r

m e t h o d o l o g i c a l

l i m i t a t io n s .In a m u l t i c e n t r e t r ia l ,

r e s e a r c h e r s c o m p a r e d t h e e f f e c t i v e n e s s

a n d s a f e t y o f o r a l p r e d n i s o l o n e v e r s u s

o r a l i n d o m e t h a c i n i n 4 1 6 a d u l t p a t i e n t s

w i t h a c u t e g o u t .

F o r t h e t r ia l , p a r t ic i p a n t s w e r e

r a n d o m l y a s s ig n e d t o r e c e i v e e i t h e r

p r e d n i s o l o n e o r in d o m e t h a c in , a n d

n e i t h e r t h e t r ia l r e s e a r c h e r s o r t h e

p a t i e n t s k n e w w h i c h m e d i c a t i o n w a s

b e i n g a d m i n i s t e r e d .

T h e r e s e a r c h e r s

f o u n d t h a t b o t hg r o u p s o f

p a t ie n t s

r e p o r t e d

s im i l a r p a i n

r e l i e f , w i t h n o

s e r io u s a d v e r s e

e v e n t s .

T h e s t u d y

c o n c l u d e d

t h a t o r a l

p r e d n i s o l o n e a n d

i n d o m e t h a c i n h a d

s i m i l a r a n a l g e s i c

e f f e c t i v e n e s s a m o n g

p a t i e n t s w i t h a c u t eg o u t .

P r e d n i s o l o n e i s a n

e f fe c t iv e a n d s a f e f i r s t - li n e o p t io n f o r

t r e a t m e n t o f a c u t e g o u t .

I

a

Mu


9/32

R ese arch ers from th e U niv ersity

of C al ary h a v e d is cov e re d a

nove lm ec h anism to s top

a u toim m u ne d is e a se s w ith ou t

com p rom is ing im m u nit y in

g e neraland h a v e now d e v elop e d

a n e w cl s s of d ru g s t h a t c an

h arnes s t h is m e c h anism to tre a t

v a riou s a u toim m u ne d is e a s e s .

D r P ere S antam aria , la dre s e a rc h er in t h e s t u d y , w h ic h

w a s p u b lsh e d in N a tu r e h a s

s h ow n t h a t nanop art icl s

( p art icl s th ou s and s of tim e s

sm a ll r th a n a ty p ica lce ll

d ec orated w ith p rotein targ ets,

a cting as b ait for d isea se-c au sing

w h ite b lood c ell, c a n b e u s e d to

re p rog ram m e t h em to s u p p re s s

th e d is e a s e t h e y intend e d to

c a u se .

T h is ne w c l s s of d ru g s

(nanom ed ic ine s c alld N a v a c im s )

e x p loits a na tu ra ll occ u rring

p roce ss, p rev iou sl u nknow n to

sc ientists, th a t is w ire d into ou r

im m u ne s y s t em to p rote c t u s

a g a ins t a u toim m u ne d is e a s e s .

T h e re s e a rc h ers d is cov e re d

th a t th is m e c h a n ism , and th e

nanom e d icines th a t ex p loit it,

c a n b e a p p le d to s e v e ral and

p otentia ll a ll a u toim m u ne

d is e a s e s in an im al, s im p l b y

c h ang ing t h e b a i t on t h e

nanop a rticl s.

T h is d iscovery is sig nifica nt

b e c a u s e w e now k now h ow to

s top a u toim m u ne d is e a s e s in a

h ig h l s p e c ific m anner w ith ou t

com p rom is ing im m u nit y in

g eneral s a y s D r S antam aria .

A sum m a ry ofthe la testdrugsbein g tried,tested a n d broughtto m a rket

w w w r th r itis d ig e s t c o u k

2 1 6 Issue 3

D a ta from a 5 2 - w e e k s tu d y of 5 9 6

p a t ients w it h m od era t e to s e v ere

rh e u m a toid art h rit is h a s b e e n

u s e d to s u p p ort an a p p lc a t ion

for a new , afford ab l b iosim ilr

d ru g d e v e lop e d b y S a m s u n g

B ioe p is c alld B ene p al, to b e

m a d e a v a il b l in E u rop e .

B iosim ilrs a re b iologic a l

t h era p ie s t h a t are d e s ig ne d to

fu nction alm ost id e ntic a ll to a n

ex isting lcensed trea tm ent and

d elv er t h e s am e p rove n s a f e t yand e f fe c t iv e ne s s , b u t a t a

consid erab l low er p rice th an th e

ol er d ru g s .

B e ne p al is a n e w b ios im ilr

ve rs ion of t h e a nti- T N F t h era p y

e t anerc e p t , w it h tra d e s u nd er t h e

nam e E nb rel P eop l w ith

rh eu m a toid a rth ritis or oth er

inflm m atory d is e a s e s ,

ov erp rod u ce a p rotein ca lld

T N F , w h ic h c a u s es infl m m a tion

and d am a g e to t h e b ones , c a rtilg e

an d t is s u e . A nti- T N F d ru g s b loc k

t h e a c t ion of T N F p rote ins ,

re d u c ing th e inflm m a t ion, b u t

th e y c an b e v ery c os tl .

R e s u l s from th e s tu d y s h ow e d

th at th is new b iosim ilr offered

e q u iv a lnt e f fic a c y to th e ole r

E nb reland i t h a s now b e en

g ranted m ark eting au th orisation

as a tre a tm ent for a d u ls w it h

m od era t e to se v ere rh e u m a toid

a rth ritis, p soria tic a rth ritis,non-ra d iog rap h ic a x ial

sp ond y loarth ritis and p lq u e

p soriasis.

P rof P e ter T a y lor p rofe ssor of

m u s c u losk e lt als c ienc e s a t t h e

U niv e rs it y of O x ford s K enned y

Institu te of R h eu m atolog y, say s,

F or m ore th an 15 ye ars, anti-T N F

t h era p ie s h a v e re v ol tionis e d t h e

c a re a nd ou tlook of p a tie nts lv ing

w it h c h ronic inflm m atory

d is e a s e s su c h a s rh e u m a toid

a rth ritis.

H ow e v e r a c c e ss to th e s e

h ig h l - e f fe c t iv e tre a tm ents h a sb e e n re stricte d b y h ig h c os ts . T h e

d ev elop m ent of b iosim il r d ru g s

is a w elom e sol tion to h el

allv ia te som e c h allng es to

ac ce ss.

HE D U G DE N

ig est ru g s

A R T R T SA R T R T S

lu c o c o r t ic o id t h e ra p y b e n e fit s

o s t e o a r t h rit is p a t ie n t s w it h s e v e re p a in

N ew versio n o f eta nercept d ru gm a d e a v a ila ble in u ro pe

e w c la s s o f d r u g to tr e a t a u t o im m u n e d is e a s e s

O ra l o p io id s n o m o re e ffe c tiv e in re lie v in g

p a in th a n a n ti-in fla m m a to ry d ru g s

A ne w stu d y , p u b lsh e d in

O s te o a r th r it is a n d Ca r tila g e h a s

a s s e s s e d t h e b ene f it s of

g l cocorticoid joint injec tions

for s p e c ific s u b g rou p s of p eop l

w it h k ne e a nd h ip os teoart h rit is

a nd fou nd th a t p e op l w ith

ex trem e p ain are m ore lke l to

b ene fit from th is tre a tm ent.

G l cocorticoid a s a tre a tm ent

of arth ritis h as b ee n in u se

s inc e t h e 1 9 4 0 s . T h is ty p e of

steroid -b ase d th erap y is injec tedd ire ctl into th e joints to a d d ress

k ne e an d h ip inflm m a t ion and

to offer p a in re lef.

T h is s tu d y w a s a n internat ional

res e a rc h p roje c t w h ic h involed

sc ientist from th e A rth ritis

R e s e a rc h U K C e ntre of

E x ce llnc e in S p orts, E x ercise

and O s teoart h rit is a t t h e

U niv e rs it y of O x ford , and t h e

A rt hrit is R e s e arc h U K P rim ary

C are C entre a t K e e lU niv e rs it y.

L e d b y th e E ra sm u s M C

M e d ic alU niv e rs it y C en tre in

R ot terd am , d a t a from s e v en

p u b ls h e d clnic altrial w a s

a nal se d , u sing inform a tion on

6 2 0 p a t ients .

T h e re s e a rc h ers s a y , T h is

ind iv id u alp a t ien t d a tam e t a - an als is d em ons tra t e s t h a t

p a t ien ts w ith s e v e re k ne e p a in a t

b a se lne d eriv e m ore b e nefit from

intra -a rticu l r g l cocorticoid

injec tion at s h ort-te rm follow -u p

th an th os e w ith l s s se v ere p a in

at b ase lne.

A ne w stu d y w h ic h a im e d to

com p a re th e e ffec tive ness of ora l

non-steroid a la nti-infl m m a toryd ru g s ( N S A I D s ) a n d op ioid s , in

red u cing k nee osteoa rth ritis

p a in, h a s fou nd th a t ora lop ioid s,

incl d ing th e l s s p ot ent

tram a d oland t h e m ore p otent

h y d rom orp h one and ox y cod one,

d o not p rov id e b etter p a in relef

th a n N S A ID s.

F or th e s tu d y , p u b ls h e d in

O s te o a r th r it is a n d Ca r tila g e

rese a rch ers id entified 1 7 stu d ies

th a t m e t incl sion crite ria,

w h ic h inc l d e d ra nd om is e d

controll d trial th a t ev a l a ted

oralN S A ID s or op ioid s for k neeoste oarth ritis.

D r E lna L os ina , l a d a u t hor

of th e stu d y and p rofessor of

orth op a e d ic s u rg ery a t B rig h am

a nd W om e n s H os p ita la nd

H arv a rd M e d ic alS c h ool B os ton,

M a s sa c h u s e tts , e x p l ins , O u r

h y p oth e s is w a s t h a t op ioid s

w ou l p rov i d e a g re a ter am ou nt

of an ale s ic b en e fit s, an d w e w ere

su rp ris e d th a t w e d id not se e

su ch a d ifference .


10/32

Nam e

Addres s

Postcode

C a lln g a lliP a d o r n d r o id T a b l t O w n e r s

If y ou ev er fi n d y our tab let frustratin g, aren t q uite sure how to do thin gs

or just thin k y ou m ight n ot b e gettin g all y ou should from it, read on ...

T ablets are becoming hugely popular.

A nd no w onder - theyre lighter and

easier to carry around than a P C . Y ou

can sit in a comfy armchair and brow sethe w eb or ev en v ideo call your family

around the w orld.

T heyre easier to use than P C s in lots

of w ays, too.

B ut theres a catch. In fact, tw o.

C a tc h n u m b e r 1 :

T heyre different from P C s. S o if you

already know how to use a P C , you hav e

to start again.

C a tc h n u m b e r 2 (th e b ig o n e ):

T here are lots of important featuresthat are hidden. T heres no button

for them, saying click here . A nd you

simply cant w ork it out. Y ou need to

know to slide the screen from the left, or

drag the thingy-me-bob to the right.

S omeone needs to tell you these things

its just not possible to w ork it out as

you w ouldnt ev en know theyre there

If I r a n th e w o r ld ...

If I ran the w orld, these dev ices w ould

come w ith a proper manual. B ut w henthey do come w ith a manual, its on the

dev ice, so you can only get at it if you

already know how to use the thing

A nd w hen you do get at it, its usually

w ritten assuming you already know how

to use it - w hich makes it a bit pointless.

T hats w hy Iv e w ritten these books:

iPa d s O n e Ste p a t a Tim e andAn d ro id

Ta b le ts O n e Ste p a t a Tim e (ideal for all

A ndroid tablets - N exus, H udl, K indle

F ire, S amsung G alax y T ab and so on...)

P la in E n g lis h - th a ts n o t a ll...

T hey explain how to use the dev ice, in

plain simple language, w ith pictures of

the screen show ing ex actly w here to tap

or slide your fi ngers. N o jargon

B u t th a t s o n ly h a lf th e s to r y

P art of the problem people hav e w ith

these dev ices is that its not alw ays

obv ious how to use them. T hats w here

these books come in.

B ut the other problem is that its not

obv ious w h a tthey can do. T here arethousands of apps out there that let

it do all sorts of things and if you dont

know about them, you might be missing

something youd fi nd really useful.

T hats w hy Iv e published a sort of

companion to the iP ad & A ndroid books:

G e t M o r e fr o m Y o u r Ta b le t: 6 2 f r e e

a p p s th a t le t y o u r ta b le t d o a ll s o r ts o f

th in g s

Its an 8 0 page book cov ering the

apps that I think you might fi nd useful.

T he main types of apps that are w orth

know ing about. It tells you w hats out

there and how to get hold of it... then

how to use it and (most importantly) w hy

you w ant to

B e tte r th a n WHSm ith s B e s t ?

A s soon as these books came out, I

started getting comments like:

T hank you for producing such asuperb book it is really helping me. I

had bought one (a book) in W H S miths

a short w hile ago and couldnt get on

w ith it at all - J.S .

and I am delighted w ith the new

book on tablets, so many things I didnt

understand before, being of the retired

brigade its a great help. D W adsw orth

T he price? E ach book is just 1 1 .9 7 ,

plus one lot of p& p at 2 .9 9 . G ood v alue

if it helps you get the most out of your

ex pensiv e tablet... but theres more:

T h a ts n o t a ll - th e r e s m o r e ...

If you order one of the O ne S tep at a

T ime books (either the iP ad v ersion or

the A ndroid one) and the G et more

A pps book at the same time, Ill throw in

a free gift.

Its a copy of a booklet calledA Ta b le t

As s o r tm e n t: L ittle -k n o w n tr ic k s tip s

a n d h a n d y fa c ts th a t m a k e u s in g a ta b le t

m u c h e a s ie r a n d m a k e it w o r k b e tte r .

N ot the snappiest name, I know , butit does w hat it says on the tin. O rder

your books now , and Ill let you have one

free as a thank you.

F r e e tr ia l: s e n d n o m o n e y n o w

Y ou can hav e the books on trial so you

can check them out. P ay nothing until

youre happy that theyre w orth it.

If for some reason you dont think

theyll help you, send them back andow e nothing (but I dont think youll

w ant to for one minute).

It makes it as easy as possible for you

to see how they could help you.

A fter all, the sooner using your tablet

becomes easy, the better. Imagine

know ing exactly how to get it to do w hat

you w ant it to. A nd if you ever cant

remember, you can just pull out the book,

fl ick to the right page, and there you go.

B e s t o r d e r y o u r s to d a y ...

D ont put it off and risk losing this

page in the magaz ine or forgetting.

Just call us on 0 1 2 2 9 7 7 7 6 0 6 and talk

to L ouize, S imone, E mma or Jess now .

O r if you prefer, just fi ll in the coupon

below and post it to us at T he H elpful

B ook C ompany, 1 3 B D ev onshire R oad

E state, M illom, C umbria, L A 1 8 4 JS .

E ither w ay w ell get your books in the

post to you straight aw ay for you to have

a look at, along w ith your free copy oftheTa b le t As s o r tm e n tif youv e ordered

both books.

W e w ont share your details w ith

anyone else.

W hy not order the books on free trial

now , w hile its fresh in your mind?

A D 0 51 6A

The Books Id like

please tic k

iP a d s O ne Step at a Tim e

And roid O ne Step a t a Tim e

et m ore fro m Y ou r T b let

E ac h b o o k is 1 1 . 9 7 and theres a

char ge o f 2 .9 9 pe r o r d e r fo r p p

If y o u o r d e r tw o o r mo r e b o o k s

y o ull also auto matically g et a free

c o py o f A T ab let A sso rtment g uid e

Y es, p lease sen d m e m y b ooks on free trial I un derstan d

I don t n eed to p ay un til I get them an d am hap p y with them )

FAS T DESPATCH

We desp atch the

sam e day we hear

from you

M o st o f ou r custo mers like t o k no w w hen w e b r ing o ut new

pro d uc ts o r run spec ial, limited o ffers. If y o u D O N T w ant to hear

fro m us just tick this b o x o r c all us. W ell nev er pass o n y o ur

d etails to ano ther c o mpany, w hether y o u tic k the b o x o r not. O r c all 0 1 2 2 9 7 7 7 6 0 6


11/32

w w w a r th r itis ig e s t o u k

R T R IT IS

R T R IT IS

Tom any,AustinH ealeyisknow nforhis

prow essontherugbypitch,asaform er

England,BritishLionsandLeicester

Tigersplayer.M orerecently,hew illhave

grabbedtheattentionofaw holenew group

offans,probablyofthefem alevariety,ashe

w altzedhisw ayintoourlivesin2008onthe

BBCsStrictlyC m eD ancing.

Butw hatm ostofusdontrealiseisthatw henhew asheaddow ninthescrum ,orfox

trottingw ithprofessionaldancerEricBoag,

hew asinincrediblepain,duetothearthritis

thathastroubledhim form anyyears.

Ifirststartednoticingjointpainbackin

2001,w henIw as28,hesays.Firstofallw ith

m yshoulder,thenm ybackandthenw ith

arthritisinm yknee,w henithadgotsom uch

m orenoticeableafteranoperation.

Austinplayedinhisfirstinternationalin

1997w henhetookpartintheIrelandv

Englandgam e.H isfavouredpositionw as

scrum -half,buthew ouldalsobeseenin

fly-halforw ingpositionsasw ell.H eknew

therew ouldbeinjuriesim possibletoavoidinagam elikerugby.H esaysadoctortold

him hew asgoingtohavereallybadarthritis

w henhew asolder,buthereckonstheytold

m ostoftheplayersthesam ething.

i s lo c a t e d s h o u l d e rH ethinkstheproblem sbackin2001started

becausehehadntgivenhim selftim etoget

overaninjuryAustindislocatedhisshoulder

playingforEnglandagainstSouthAfricain

the1999 orldCup.H edidntgettheshoulder

fixedproperlybecauseitw ouldhavem eant

toom uchtim eaw ayfrom thegam ebut,

instead,justhaditcleanedout.

Irushedtorehabilitatem yselftogetreadyforthe2001H einekenfinal.Austinw as

playingthegam einincrediblepain,butsom e

sayitw asoneofhisbestm om entsplayingfor

histeam ,theLeicesterTigers.

H ow ever,therewerelongterm consequences.

ithanym ajortraum ayouhave,you

inevitablyfindthatyouregoingtoexperience

long-term issuesw ithit.

H edescribeshow,w ithhisshoulderinjury,

heshouldhavehadthelabrum trim m edand

becauseitw asnt,itgrounditselfaw ayover

theyearsandinsteadofaballgoingintothe

socket,hehasaspike.H esayshew asin

constantpainforthreeyears.

N owtheshoulderandthepainhefeelsin

hisotherjoints,particularlyhisknees,com esandgoes,afterhestartedtolookforsolutions

tothepainhim self.

Atonestagehew astakinghighdosesup

to100m gaday ofthenon-steroidal

anti-inflam m atorydrug(N SAID )diclofenac

w hich,hesays,w asntideal.H edtriedavariety

ofsupplem entssuchaschondroitin,and

painkillers,butnothingseem edtow ork.Then

afriendsuggestedhetriedajointsupplem ent

calledG O PO JointH ealth theonly

supplem enttocontainG O PO ,acom pound

isolatedfrom R sacanina.Everyonereactsdifferentlytotakingthings,

w hetheritsfrom yourG Porover-the-counter

supplem ents,andIm agreatbelieverthatitsdifferentthingsforeachindividualandthese

reallyseem edtom akeadifferenceandworked

w ellform e.

O nceyouvefinishedtheloaddose,yougo

ontom aintenanceanditslikew henyoulose

w eightm yjointsjustfeltlightandIgenerally

feltlighter.ThethingIfindw itharthritisisit

m akesyoufeelquiteheavyyoufeelgravitya

lotm oreandthatfeelingdim inished.

Lastyear,Austinalsounderw entkeyhole

surgerytohisleftkneetorem oveasm all

sectionofbone.

hilelifeforAustinnowisrelatively

pain-free,thatw asntthecasew henheem barkedonStrictlyC m eD ancing.

Likealotofsportspeople,Iscoffedand

thought,itsnotgoingtobeasdifficultas

playingsport,butitw asincrediblyhard.Ihad

thought,youshouldtryplayingprofessional

rugbythatshardbutIendedupbeingthe

fittestIveeverbeen!

Austinknow sthatheisnotalonew iththe

issueshehasw itharthritis.Illm eetupevery

nowandthenw itholdm atesfrom rugbyand

afteracoupleofbeerssom eonegetsuptogo

tothetoiletandyoucanjustseethestandard

signs thecreakingjointsandthesighs!

N ow,though,thankstothekeyholesurgery

andG O PO JointH ealthsupplem ents,Imabletorideabike,Ibox,Icangoskiingafter

threedaysofskiingIdbeinrealpainandtaking

painkillers.N ow therestheabsolutejoyof

skiinganditsareallysatisfyingfeeling.

G O P O isanactivec m p undderivedfr mr sehipsw ithnaturalanti-inflam m at rypr perties.G O PO isf und nlyinGO PO

J intH ealthcapsules,18.49f r12 0 capsulesfr m superm arketsandpharm aciesnati nw ide,w w w.g p .c .uk.

Form ore inform a tiononm a na gingjointpa invisitwww pa tie ntinfo/jointpa inh b

A stinH e a le yisc rre ntlytra iningtota k e pa rtinthe D a lla glioCycle S la m2016tora ise m one yfornd e rprivile ge dchild re n Form ore inform a tionvisitwww d a llagliofo nd a tion com

d i g e s t i n t e r v i e w2 1 6 Is su e 3

T ...

P la y in g ru g b y le ft A u s tin

H e a le y w ith jo in t p a in a n d

a rth ritis S u p p le m e n ts a n d

s u rg e ry h a v e h e lp e d re lie v e

h is sy m p to m s i l l i a n R o w e

r e p o r t s

W ith a n y m a jo r

tr a u m a y o u h a v e , y o u

in e v ita b ly fin d th a t

y o u r e g o in g to

e x p e r ie n c e lo n g - te r m

iss u e s w ith it

AustinHea ley


12/32

A un iq ue p assp ort to a

lfe tim e o f h o ld a y

H o w H P B w o rk s HPB is design ed to giv e y ou an d y our fam ily holiday s for life. To achiev e this it is structured

as a life assuran ce b on d in v estin g after p roduct charges in p rop erties an d securities. Prop erties are b ookedfor a n o p rofit User Charge an d Poin ts issued with the Bon d. There is a q uarterly fee of un der thirty p oun dslin ked to RPI with all other m an agem en t fees p aid from securities. Y ou m ay cash in after two y ears at a v aluelin ked to that of the p rop erties an d securities b ut y ou m ay get b ack less than y ou p aid b ecause of chargesan d chan ges in the v alue of HPBs p rop erties an d securities. In excep tion al circum stan ces cashin g in m ay b edeferred for up to twelv e m on ths. No m edical exam in ation req uired. HPB is av ailab le ex clusiv ely through HPBM an agem en t Lim ited who will on ly charge for their serv ices if y ou in v est.

M o s t o f u s d r e a m o f h a v in g o u r o w n h o lid a y

h o m e in b e a u tif u l c o u n tr y s id e o r n e a r s u n -d r e n c h e d b e a c h e s . T h e H o lid a y P ro p e rty

B o n d is a p r a c tic a l a n d a f fo rd a b le w a y o f

m a k in g th a t d r e a m c o m e tr u e .

In fa c t a s a n in v e s to r y o u w ill h a v e n o t ju s t o n e

b u t o v e r 1 4 0 0 s u p e r b h o lid a y h o m e s to c h o o s e

fr o m a n d s ta y in fo r th e w h o l e o f y o u r lif e

r e n t-f re e .

H PB s g r o w in g p o r tfo lio o f p r o p e r tie s in c lu d e s

v illa s c o tta g e s a n d a p a r tm e n ts a c r o s s 1 3

E u r o p e a n c o u n tr ie s in c lu d in g o v e r 5 0 0 in t h e

U K a ll m a in ta in e d fo r y o u b y o n -s ite s ta ff.

M a n y o f o u r h o lid a y p r o p e r tie s a r e m o d e r n

p u r p o s e -b u ilt d e v e lo p m e n ts . O th e r s a re in

h is to r ic h o u s e s w h ic h w e h a v e lo v in g ly r e s to r e d

o r re n o v a te d .

T h e w a y th e B o n d w o r k s is s im p le . Fa m ilie s

lik e y o u r s in v e s t a f e w th o u s a n d p o u n d s in a

fu n d a n d g a in a f in a n c ia l in te r e s t in o u r e n tir e

p r o p e r ty p o r tfo lio . A n in itia l to ta l p a y m e n t o f a slittle a s 5 0 0 0 g iv e s y o u th e r ig h t to h o lid a y r e n t-

fr e e in a n y o f th e s e p r o p e r tie s fo r th e w h o le o f

y o u r life o r y o u r c h ild r e n s liv e s .

So th is y e a r y o u c o u ld b e h o lid a y in g a t St B r id e s

C a s tle in Pe m b r o k e s h ir e o r Lo d g e Y a r d in th e

Y o r k s h ir e D a le s b o t h o f w h ic h w o n p r e s tig i o u s

a r c h ite c tu r a l a w a r d s . N e x t y e a r it c o u ld b e o u r

1 8 t h c e n t u r y c h a te a u L e M a n o i r d u H ilg u y in

B r itta n y o r o u r re s to r e d m e d ie v a l fo r tr e s s o f

Stig lia n o in Tu s c a n y .

So if y o u lik e th e id e a o f h o lid a y in g in tr u ly

m e m o r a b le p r o p e r tie s y e a r a fte r y e a r th is is y o u r

o p p o r tu n ity t o f in d o u t m o r e .

Ple a s e re a d H o w H PB w o r k s b e lo w to

u n d e r s ta n d th e m a in r is k s a s w e ll a s th e b e n e fits

o f a n in v e s tm e n t a n d th e n r e q u e s t a c o p y o f o u r

in f o r m a tio n p a c k a n d D V D .

H P B s cluster of trulli in the sun-drenchedregion of P uglia in the southeast of Italy


13/32

d v e n t u r e

T his advertisement is issued by H P B M anagement L imited H P B M ) registered at H P B H ouse, N ew market, S uffolk, C B 8 8 E H . H P B M is

authorised and regulated by the F inancial C onduct A uthority and is the main U K agent and the property manager for H P B , issued by H P BA ssurance L imited H P B A ) registered in the Isle of M an and authorised by the F inancial Services A uthority there. H olders of policies issuedby the company w ill not be protected by the F inancial S ervices C ompensation S cheme if the company becomes unable to meet its liabilitiesto them but Isle of M an compensation arrangements apply to new policies. T he Trustee of H P B is H S B C T rustee G uernsey) Limited registeredat P ark P lace, P ark Street, S t Peter P ort, G uernsey, C hannel Islands, G Y 1 1 E E . T he S ecurities M anager is Stanhope C apital LL P registered at 35P ortman Sq uare, London, W 1 H 6 LR . H P B M and H P B A are part of the H P B M arketing G roup and are not independent of each other. H P B M isable to advise only on H P B A s products. P rize draw : 1 st prize 1 ,2 5 0 , 2 nd prize 7 5 0 , plus 5 x 1 0 0 , all in cash. N o purchase necessary. D raw n2 9 th July 2 0 1 6 . W inners noti ed, w inners list available 1 1 th A ugust 2 0 1 6 . C laim prizes by 3rd O ctober 2 0 1 6 . T hose under 1 8 , H P B inv estors,employees, associates or those in their households are not eligible. O ne entry per household. Full rules on req uest.

Th e Ho lid a y P ro p e r ty o n d

v isith p b c o u k /d ig e s t call0 8 0 0 6 6 5 4 9 0

Fo r y o u r FR EE in fo rm a t io n p a c k a n d to e n te r o u r 2 ,5 0 0 Ca s h Priz e D ra w

M r M rs M iss M s ddress

P ostcode

Telephonem il

B y resp o n d in g yo u ag ree to u s sen d in g yo u fu rth er in fo rm atio n b y letter SMS telep h o n e an d /o r em ail. O th er m em b ers o f th e

H PB g ro u p m ay a lso co n tac t yo u in an y o f th ese w ays w ith o th er h o lid ay o ffers. If yo u w o u ld p refer th em n o t to p lease tick h ere

or complete and return this coupon to:fr e e p o s t H P B

G D 8 4

HP s M a n o ir d u Hilg u y

ritta n y

HP s St rid e s C a stle

in P e m b ro k s h ire HP s Stig lia n o in Tu s c a n y


14/32


15/32

o t h g lu c o s a m in e a n d c h o n d ro itin a r e

s u b s ta n c e s th a t o c c u r n a tu r a lly in th e

b o d y . G lu c o s a m in e is a n a tu r al su g a r

m a d e fro m th e s im p le c a rb o h y d r a te g lu c o se

a n d th e a m in o a c id g lu ta m in e . It is p r o d u c e din th e b o d y to p ro v id e n a tu r a l b u ild in g b lo c k s

fo r g r o w th , re p a ir a n d m a in te n a n c e o f ca r tila g e ,

th e s m o o th tis su e th a t lin e s th e jo in ts a n d

h e lp s to g i v e it its e la s t ic b u ffe r in g p r o p e r t ie s .

C h o n d r o itin is a m o le c u le a n d m a k e s u p a

c o m p o n e n t o f h u m a n c o n n e c tiv e tissu e s fo u n d

in c a r tila g e a n d b o n e a n d h e lp s r e ta in w a te r.

F o r m a n y y e a r s, p e o p le h a v e b e e n ta k in g

g lu c o sa m in e a n d c h o n d ro itin a s a c o m b in a tio n

s u p p le m e n t to tr e a t o s te o a r th r itis p a in a n d

h e lp to e a s e th e s y m p to m s o f th e ir stiff jo in ts .

C h o n d ro itin su lp h a te is m a n u fa c tu re d fro m

th e c a r tila g e o f a n im a ls , o r it c a n b e m a d e

s y n th e t ic a lly in a la b o r a to r y . F o r d ie t a r y

su p p le m e n ts, g lu c o s a m in e is d e r iv e d fro ms h e lls o r s h e llfis h , s u c h a s s h r im p s , lo b s te r s

a n d c r a b s ), v e g e ta b le s o u r c e s, o r it c a n a ls o b e

m a d e in a la b o r a to r y.

TheevidenceO steoarth ritisT h e re h a v e b e e n a n u m b e r o f tr ia ls lo o k in g

in to th e e ffe c tiv e n e s s o f ta k in g a c o m b in a tio n

o f g lu c o s a m in e a n d c h o n d ro itin su lp h a te in

tr e a tin g o s te o a r th r itis . F in d in g s h a v e b e e n

m ix e d , w ith s o m e ev id e n c e su p p o r tin g th e u s e

o f g lu c o s a m in e su lp h a te to tr ea t k n e e

o s te o a r t h r itis b e t te r t h a n o th e r jo in ts .

In a 2 0 0 5 re v ie w o f 2 0 g lu c o s a m in e stu d ie s,

a n im p r o v e m e n t w a s fo u n d in jo in t p a in ,s tiffn e ss a n d fu n c tio n w ith o n e b r a n d o f

g lu c o s am in e R o tto p h a r m , m a rk e te d a s D o n a ,

V ia r tr il a n d X ic il) b u t n o t o th e r s.

T h e G lu c o s a m in e /c h o n d ro itin A r th r itis

In te rv e n t io n T r ia l G A IT ) , c o n d u c te d in 2 0 0 8 ,

w a s a la rg e ra n d o m ise d p la c eb o - c o n tr o lle d

tr ia l in v o lv in g 1 ,6 0 0 p e o p le w ith k n e e

o s te o a r t h r itis a t v a r io u s s ite s a c r o s s th e U S .

R e se a rc h e r s in v e s tig a te d w h e th e r g lu c o s a m in e

a n d /o r ch o n d r o itin c o u ld tre a t th e p a in o f

k n e e o s te o a r th r itis a n d a n a n c illa r y s tu d y

in v e s tig a te d w h e th e r th e s e d ie ta r y su p p le m e n ts

c o u ld d im in ish th e str u c tu r al d a m a g e o f k n e e

o s te o a r t h r it is .

T h e a n c illa r y s tu d y r e s u lts , p u b lis h e din A r t h r it i s h e u m a t i s m sh o w e d th a t

g lu c o s a m in e a n d c h o n d ro itin su lp h a te ,

to g e t h e r o r a lo n e , a p p e a r e d t o fa r e n o b e tte r

th a n a p la c e b o in s lo w in g lo s s o f c a r tila g e in

k n e e o s te o a r th r itis . H o w e v e r , it w a s fo u n d

th a t in te r p r e tin g t h e r e su lts w a s c o m p lic a te d ,

b e c a u s e p a r tic ip a n ts ta k in g a p la c e b o h a d a

s m a lle r lo s s o f c a r tila g e , o r jo in t s p a c e w id th ,

th a n p r ed ic te d .

A n e w stu d y in 2 0 1 3 , h o w e v e r, le d b y P ro fJo h a n n e M a r te l- P e lle t ie r o f th e o s te o a r th r itis

re se a rc h u n it a t th e U n iv e r sity o f M o n tre a l

H o sp ita l R e se a rc h C e n tr e in C a n a d a , u n d e rlin e d

th e p o te n tia l b e n e fits o f g lu c o s a m in e a n d

c h o n d r o itin s u p p le m e n ts fo r o s te o a r th r itis ,

c o m p a r e d w ith tr a d itio n a l tr ea tm e n t o p tio n s .

F o r th e s tu d y , a to ta l o f 6 0 0 p a t ie n ts w ith

k n e e o s te o a r th r itis w e re d iv id e d u p , b a s ed o n

w h e th e r th e y r ec e iv e d c o n v e n tio n a l

p h a rm a c o lo g ic a l tre a tm e n t a n d /o r g lu c o s am in e /

c h o n d ro itin su lp h a te o v e r a 2 4 - m o n th p e rio d

a n d w e re a s se ss ed fo r k n e e str u c t u r a l c h a n g e s

u sin g q u a n tita tiv e m a g n e tic re so n a n c e

im a g in g q M R I) .

T h e stu d y , p u b lish e d in th e A n n a l s f h eR h e u m a t i c i s e a s e s fo u n d th a t p a tie n ts ta k in g

g lu c o s a m in e a n d c h o n d ro itin su lp h a te

e x p e r ie n c e d a re d u c tio n in c a r tila g e v o lu m e

lo s s o v e r th e tw o - y e a r p e r io d .

T h e s e b e n e fits w e r e s e e n r e g a r d le s s o f

w h e th e r th e p a tie n ts w e re a ls o r e ce iv in g m o r e

c o n v e n tio n a l tre a tm e n t u s in g a n a lg e s ic

th e ra p ie s o r N S A ID s. T h e stu d y sa id th a t m a n y

o f th e b e n e fits w e re n o t p ic k e d u p o n X -r ay s,

b u t c o u ld o n ly b e d e m o n stra te d b y u s in g q M R I.

R h eum atoid A rth ritisW h e n it c o m e s to th e b e n e fits o f g lu c o s a m in e

a n d c h o n d r o itin in r h e u m a to id a r th r itis, th e

e v id e n c e is m u c h le ss c le a r. A lth o u g hc h o n d ro itin su lp h a te h a s b e e n s h o w n to

in h ib it e n z y m e s in s y n o v i a l flu id th a t a r e

lin k e d to d e s tr u c tio n o f c a rtila g e in r h e u m a tic

d is e a se , th e r e is a la c k o f e v id e n c e to s u p p o r t

g lu c o s a m in e u s e fo r r h e u m a to id a r th r itis a n d

e x p e r ts b e lie v e m o re r e se a rc h is n e e d e d in

t h i s a r e a .

Cantherebeanynegativesideeffects?O v e r-th e - co u n te r g lu c o sa m in e a n d

c h o n d r o itin c o m e w ith n e x t to n o w a rn in g s

o f a n y s id e e ffe c ts , a n d th e y a r e c o n s id e r e d to

b e u su a lly m ild a n d in fre q u e n t. T h e se in c lu d e :

S to m a c h u p se ts; C o n stip a tio n ;

D ia rr h o e a ;

H e a d a c h e s;

R a sh e s .

I f y o u a r e a l le r g ic to s h e llfis h , y o u s h o u ld

m a k e s u r e th a t y o u ta k e th e s h e llfis h - fr e e

v a r ie ty . A n d fo r th o se w h o s u ffe r fro m d ia b e te s,

g lu c o sa m in e m a y in c re a se y o u r b lo o d su g a r

le v e ls , s o d is c u s s w ith y o u r d o c to r b e fo r e

ta k in g th e m . T h e re a re a lso so m e r ep o r ts o f

p o ss ib le in te r a c tio n w ith c h e m o th e r a p y d r u g s

a n d d r u g s th a t lo w e r b lo o d c h o le s te r o l.

C anIgetitinm ydietA lth o u g h e d ib le s ea fo o d su c h a s sh r im p s,

lo b ste rs a n d c ra b s c a n p r o v id e tr ac e a m o u n ts

o f g lu c o s a m in e in th e ir sh e lls , th e s e c a n b e

d iffic u lt to c h e w a n d d ig e s t a n d a r e n o t

c o m m o n ly u se d in d ish e s . G lu c o s a m in e o c c u r s

n a t u r a lly i n a ll fo r m s o f h e a lth y c a r tila g e , a n dw h ile th e p a r ts o f a n im a ls th a t w e n o lo n g e r

e a t , s u c h a s s n o u ts a n d jo in t tis su e s , a r e

fa s h io n a b le in s o m e c ity r e sta u r a n ts , y o u

p r o b a b ly w o n w a n t to e a t c a r tila g in o u s o ffa l

o th e r th a n to fla v o u r a ste w .

2 1 6 Is su e 3

digestreview

15

AD

T hird in a new series lifting the lid on different supplements

W h a t d o e s th e e v id e n c e s a y a b o u t g lu c o s a m in e s u lp h a te

a n d c h o n d ro itin a n d a r th ritis GillianRow e i n v e s t i g a t e s

ARTHRITISARTHRITIS w w w r th r itis d ig e s t c o u k

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w w w r th r itis d ig e s t c o u k AR T H R IT ISAR T H R IT IS

e e p in g y o u activ e at an y a g e

E m u O il a p s ules

DrPeterGhosh,directoroftheresearchlabatRoyalNorthShoreHospitalinSydney,Australia,startedarthritisresearchinthe1960s.Oftenworkinginconjunctionwith

DrM ichael W hitehouse,of theDepartmentofPathology,UniversityofAdelaideinSouthAustralia,thesetwoscientistsareknownasthecountrysleadingexpertsonthedevelopmentandevaluationofup-to-dateanti-arthritistreatments.DrGhoshandW hitehouseworked

onthestudytitled,TheAnti-ArthriticActivityofEmuOil,whichdemonstratedthatEmuoildoeseliminateinflammationandpaininmanypatients.Theyalso

discoveredthatEmuoil,doesnothaveanyknownnegativesideeffects.Thesefindingsaresupportedby

scientificevidence,announcedDrGhosh.Emuoiloffersthebestreliefeverforvictimsofthiscripplingdisease.Continuinglaboratoryexperiments

have consistentl y confirmed thetherapeuticusefulnessofEmuoilforarthritissufferers,whilethousandsoftestimonialshavecomeinfromhappycustomers.M rW ilson,aregularcustomer,said:

Isufferwitharthritisinmultiplejointssotakingcapsulesregularlyhasbeengreatinhelpingwithmyarthriticpain.

S tudie s on E m u O il f or Arthritis

T o order v i s i t on li n e a t

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AR TH R ITIS can be crippling and painful. A rthritis sim ply

m ean s inflam m ation of the joints and it tends to be used to

describe over 20 0 m uscle and joint problem s through ou t the

bod y. A rthritis can affect anyon e at an y age and there are

approxim ately over nine m illion people in the U K , and an

estim ated 1 0% of m odern A ustralians and 1 5% of A m ericans

that are d aily arthritis su fferers.

Peopleoftenhavetotakeexpensiveprescriptionmedicationtorelieve

arthritis,thismedicationcanoftenhavenegativesideeffects.Inrecentyearstherehavebeenamazingresultsfromstudies,usingEmuOilforArthritis.EmuOilis100%natural,andhasbeenusedinAustralianmedicinetorelievejointandmusclepainforcenturies.Emuoilisadeeplypenetratinganti-inflammatory.Lorememuoilcapsulescontain500mgof100%naturalemuoil.Taking

thecapsulesmayassistinreducingpainandinflammationassociatedwitharthritis,jointconditionsandinthemaintenanceofgeneralwel l-being.Theyhavebeenshowntobebeneficialinassistingwithreducinginflammationassociatedwithdigestivedisordersincluding,IBS,IBD,CrohnsDiseaseandulcers.InadditionLoremhasdevelopedEmuBalmwhichisanaturalhealing

balmthatharnessesthenaturalpowerofEmuOil,andblendsitwithessentialoilsknownfortheirabilitytorelievepain,reduceinflamma-tion,improvecirculationandrelaxtightmuscles.Itisfastactingandnon-greasywhenmassagedintotheskin.

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rug repurposing looks at w hether anex isting drug used to treat onecondition could w ork for another

disease. It is already used in a v ariety ofconditions ranging from diabetes to cancerand arthritis.

O steoarthritis and musculoskeletalconditions affect around 1 0 million people inthe U K , and finding medicine to help treat thedisease is v ital, as predictions suggest thatthese painful, debilitating conditions are set togrow w ith an ageing population. W e knowthat drug development takes a long time, solooking at ex isting medicines and seeing howthey could be used is one route to consider.

M any people struggle w ith the pain ofosteoarthritis, thinking that nothing can bedone to help. T his isnt the case. B y taking astrategic approach to identifying people w ith,or at risk of, osteoarthritis and supportingthem to manage the condition, much can bedone to help people w ith osteoarthritisimprove their quality of life.

T here are some obvious w ins from drugrepurposing because it can offer a faster,cheaper and less risky alternative. H ow ever,drugs still need to be tested thoroughly in thenew conditions to compare them w ith thecurrent gold-standard, check their safety andto ensure that the correct dose is used.

H ow is drug repurposing usedin osteoarthritisM ethotrex ate w as originally developed as achemotherapy drug in the 19 5 0 s and has sincebeen administered at a very high dose tocancer patients. A t a low dose, and because oftotally different mechanisms of the drug, ithas now become a first line of therapy forrheumatoid arthritis.

P rofessor P hilip C onaghan, w ho is leadingtw o clinical studies at L eeds U niversity, w ithfunding from A rthritis R esearch U K , says, T he main advantage of repurposingmedicines is that w e usually have a lot of

experience w ith the existing drug, in particularrelating to side effects people may experience.U sually w ith years of drug use, even subtleside effects become obv ious, and w e can tellw hich types of patients might experiencethose side effects. W ith time, w e have also

generally learnt more about how an arthritistherapy w orks, and these insights help us todecide w hich drugs might be useful in otherrheumatic conditions.

M ethotrex ate for k neeosteoarthritisT he number of people w ith knee osteoarthritissits at around 4 .7 1 million but A rthritisR esearch U K predicts that figure could be ashigh as 8 .3 million by 2 0 3 5 1 . T his is partly dueto an increasingly ageing population as w ell asa rise in obesity, w hich w ill place an unsus-tainable burden on health serv ices and theeconomy.

C urrently, treatments for knee osteoarthritis

are limited to painkillers and surgery and as aresult people w ith the condition often livew ith severe pain and have significant difficultyin carrying out their normal day-to-dayactiv ities. A lthough its still a few years aw ayfrom reaching its full conclusion, a pilot studylooking at repurposing methotrexate for kneeosteoarthritis has show n promising results,w ith 3 7 of participants experiencing a 4 0reduction in pain, and 5 0 having a 2 0reduction.

S cientists are now embarking on a largertrial to assess its effectiv eness. If this trial hasa positive outcome, methotrexate couldprovide another option for people and offer a

non-surgical treatment.

H and osteoarthritisIn another study being led by P rofessor P hilipC onaghan, the research team are inv estigatingw hether a drug called hydroxychloroquine is

effective at relieving pain in people w ith handosteoarthritis. T hey also w ant to see if thedrug could slow or stop the damage to jointscaused by the disease.

P eople w ith hand osteoarthritis often haveproblems w ith day-to-day tasks impacting onboth their q uality of life and general health.C urrent treatments for hand osteoarthritis arelimited because they have been show n to onlyw ork for short periods and are not effectivefor all patients. In addition, many of thesetreatments have side-effects w hich restrict

their use.T hese treatments only target pain so there is

an unmet need for treatments that can alsoslow progression of the disease.

H ydroxychloroquine is another treatmentthat has been used very successfully to treatrheumatoid arthritis. W hats more scientistsw ill ex amine w hether hydroxychloroq uinecould lead to a reduction in pain as w ell. T hisw ould introduce a new option for people w iththe condition w ho fail to respond to currenttreatments. It also has very few side effects.

A lthough the process starts from a betterposition, drug repurposing isnt entirely riskfree and trials are still needed to examine the

effectiveness of these treatments as w ell as toensure their safety in a new population.H ow ever, if the results of these trials arepositive, this could lead to new treatmentsbeing available to people w ith osteoarthritisw ithin the nex t 5 -1 0 years.

Ifyouwanttofollowmoreofourdevelopmentsfollowusviafacebook.com/arthritisresearchukorwww.arthritisresearchuk.org

1 Osteoarthritis in G eneral Practice,Arthritis

Research U K .

2016 ssue 3dig esttherapy

R T R I T ISR T R I T IS

There are someobvious wins fromdrug repurposing

because it can offer afaster, cheaper and

less risky alternative

w w w .arthritisdigest.co.uk 17

W h a t d o w e m e a n b y d r u g r e p u r p o s in g ? R eb ecca C ouper

c o m m u n ic a tio n s m a n a g e r a t A r th ritis R e s e a rc h U K re p o r ts

ru

re ur osi g

The third in our new series on the latest developments in arthritis treatments

P rofessor P hilip C onag han is leading tw o clinicalstudies at L eeds U niv ersity


18/32

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2 0 1 6 Is u 3 digesttherapy

ARTHRITISARTHRITIS

www.arthritisdigest.co.uk 19

Under the spotlight:

What are they, what are the symptoms and how are they treated?

G illianR ow e investigates

Hammer toe and claw toe

Hm m ertoea nd lw toea rec om m on

toea norm litiesin thefeetwhih

n ep inful nd m keitd iffiultto

w lk H m m ertoea nd lw toeh ppenwhen

thereisa ontr ture( end ing ofoneor

oth jointsofthese ond thir fourth orfifth

little toes T hea norm l end ingc n put

pressureon thetoe p rtiulrlywhen we ring

shoes usingpro lem sto d evelop

heforefoot nd toesa rem d eup of

sever l onesa nd theseb onesc onne tto

form thetoejoints h jointissurround e

ya joint psulem d eoflig m entsth thol

theb onestogethera nd two tend onsrun long

theb ottom ofe h toeth ta llowsusto url

ourtoes with nothertend on running long

thetop th tr isesthetoe

hed ifferen eb etween h m m ertoea nd

lw toeisth tin h m m ertoethefirstjointiso ke upw r nd them i d lejoint end s

d ownw r , whilea lw toed eform ity

involvesa norm lpositionsofa llthreejoints

in thetoea nd onsistsofa o ke upfirst

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ttheend ofthetoea rec urle d ownw r

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C ausesherea rea num erofre sonswhywec n

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we ringa shoeth tistooshort n m ny

people these ond toeisa tu llylrgerth n

the igtoe nd iftheshoesa resize to fitthe

igtoe these ond nd even thethir toea re

om prom ise nd h veto end to fitthe

shoe P ointe shoesa nd highheelsa relikely

to h ve n effe ttoo sthefootisc onst ntly

eingpushe d own nd thetoesa resqu she

d ow nw r s

llfittingshoeswilla lso usethetoestoru

g insttheshoe le d ingto orns nd lluses

whih furthera ggr v tethec ond ition

nflm m torya rthritis su h srheum toi

rthritis n d m gethetoejointsa nd thism y

m kethem om eoutofposition d islo te

m m ertoes na lsoc om ea outinpeople

whoh veb unionsoftheb igtoe A stheb ig

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foot these ond toec n end up with a h m m er

toed eform ity

lw toesa rec om m on in peoplew ith high

a rhesa nd c a na lsoc om efrom a m usle

im ln ein whih thed eepertoem us lesa re

we kerth n thesurf em usles a lthough

gener llythistypeofm us leim lneo ursfrom m oreseriousnerve ond itions

H ereditaryhereisa lsosom eevi en eth tthec ond itions

nb ehere itry stud ypu lishe in2

found th tm en nd wom en with a f m ily

historyofb unions nd lessertoed eform ities

su h sh m m ertoea rem orelikelyto d evelop

the ond ition them selves

R ese r hersa tH a rv r M e i a lS c hoolin

theU S stud ie d a t on 1 , 3 7 0 peoplew ith a n

ver gea geof 6 whotookp rtin the

r m ingh m oot tud y I n thestud y the

p rtiip ntsund erwentfootex m in tionsto

seewhethertheyh d unions h m m erorc lwtoeorplnt rsofttissue trophy a ond ition

wheretheprote tive ushion in the llofthe

footb re ksd own orthins

ese r herso serve th t 1 ofthestud y

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d eform itiesweresignifi ntlym orelikelyto

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Arthritis Digest 3 - 2016 UK.pdf

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