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• New research builds on existing evidence supporting the benefits of yoga for low back pain.
• A 4-week telehealth yoga program significantly reduced low back pain among participants with the condition.
• The researchers found certain yoga poses emphasizing hip flexion improved the flexion-relaxation ratio, a biomarker of chronic lower back pain.
• Larger studies are needed to determine the long-term effects of yoga on low back pain relief.

While yoga is not a cure-all, there is no shortage of science-backed benefits of the practice.

Yoga is frequently studied for its potential to relieve chronic low back pain, an often difficult-to-treat condition that in 2020 affected 619 million people globally.

Now, an Italian research team specializing in rehabilitative medicine has furthered our understanding of yoga’s positive impact on low back pain.

The researchers evaluated the effects of a 4-week yoga program on the flexion-relaxation phenomenon, a biomarker of chronic low back pain limiting paraspinal muscle activity or range of motion.

They recruited 10 females ages 18–40 with nonspecific chronic low back pain (NCLBP) and 11 females without. Both groups participated in a structured 8-session yoga program; the first session was conducted in a clinic, and the remaining sessions were offered via telehealth. The 30-minute sessions included a sequence of nearly 30 yoga postures (asanas), breathwork, and other mindfulness practices.

The findings, published February 21 in the Journal of Orthopaedic Research, show a significant reduction in pain intensity in the back pain group. Yoga also benefitted neuromuscular response during spinal flexion in both groups, thus improving participants’ flexion-relaxation ratio.

Due to the small number of participants and short study duration, the researchers note that further studies are needed to determine any long‐term effects of yoga on low back pain.

“Relieving back pain still remains a challenge, [and] asanas can become an addition to the range of possibilities in managing this disorder,” Dr. Alessandro de Sire, associate professor of physical and rehabilitative medicine at the University of Catanzaro Magna Graecia and physician at University Hospital Renato Dulbecco in Italy, told Healthline.

Yoga reduces back pain, improves mobility

The study builds on existing evidence supporting the benefits of yoga for low back pain relief. 

Researchers observed a reduction in pain intensity after 4 weeks using a 10-point visual analog scale (6.8 average pain at the start of the study, 3.3 after the yoga sessions).

Yoga also improved participants’ flexion–relaxation phenomenon (5.12 at the start of the study, 9.49 after the sessions), which was measured with electromyography during maximum voluntary flexion (rounding) of the spine.

Given the short-term nature of the study, researchers used a Prophet evaluation to predict positive flexion-relaxation trends for an additional month after the intervention. The evaluation forecasts that tele-yoga asana could continue to positively affect pain intensity and spinal mobility.

The yoga postures included in the study varied, but many involved some type of hip flexion (forward bend) with a neutral spine.

“I appreciate that this study explored the ways that asana can relax muscles, and it echoes what yoga traditionally tells us, which is that forward bending poses are generally calming and relaxing,” Jivana Heyman, a yoga therapist in Santa Barbara, CA, founder of Accessible Yoga and author of Yoga Revolution, told Healthline.

“Hip flexion can be very beneficial for people with low back pain because it can increase range of motion without overly engaging the lower back. My sense is that people with chronic low back pain hold additional tension in that area as a protective mechanism, and asana can help to release some of that tension,” Heyman said.

Yoga poses for chronic low back pain

There are countless studies about yoga, but they don’t always disclose which poses were used to achieve the desired outcome.

Rather than study a particular style of yoga (i.e., Hatha or Vinyasa), the researchers included a regimen of nearly 30 postures to demonstrate how yoga works to relieve low back pain more clearly.

De Sire said each pose in the sequence was held for five breaths (around 1 minute each) for a total of 30 minutes per session.

“Asanas can commonly be difficult and misleading to assimilate; providing the reader with specific postures might guarantee scientific reproducibility, but above all greater dissemination of the practice with scientific evidence,” de Sire explained.

Heyman said he appreciated the inclusion of the poses in the study.

“Often doctors refer patients with low back pain to yoga, and the patients are left to figure out what practices or classes are appropriate for them,” he said. “They could easily end up in a yoga class that is too physically intense, which could cause more injury or simply leave them feeling that yoga is not for them.”

The following yoga poses for low back pain were included in the study:

• Easy Seat (Sukhasana)
• Cat Stretch (Marjariasana)
• Mountain Pose (Tadasana)
• Crescent Lunge (Ashta Chandrasana)
• Cow Pose (Bitilasana)
• Downward-Facing Dog (Adho Mukha Svanasana)
• Pyramid Pose (Parsvottanasana)
• Pigeon Pose (Eka pada rajakapotasana)
• Half Lift (Ardha Uttanasana)
• Chair Pose (Utkatasana)
• Cobra Pose (Bhujangasana)
• Crocodile Pose (Makarasana)
• Child’s Pose (Balasana)
• Standing Foward Bend (Uttanasana)
• Half Lord of the Fishes Pose (Ardha Matsyendrasana)
• Staff Pose (Dandasana)
• Gate Pose (Parighasana) 
• Head-to-Knee Forward Bend (Janu Sirsasana)
• Cobbler’s Pose (Baddha Konasana) 
• Caterpillar Pose (Ardha Paschimottanasana)
• Eye of the Needle Pose (Sucirandhrasana)
• Belly Twist Pose (Supta Jathara Parivartanasana)
• Happy Baby (Apanasana)
• Legs Up the Wall Pose (Viparita Karani)
• Plow Pose (Halasana)
• Bridge Pose (Setu Bandha Sarvangasana)
• Corpse Pose (Savasana)

A promising intervention for low back pain relief

The study’s model predicts the positive results of yoga for back pain could be maintained long-term, de Sire explained, but larger, more rigorous studies are needed to determine this effect.

Still, Heyman said that yoga can be a helpful intervention for finding relief from low back pain.

“This study adds to the growing literature that supports yoga as a viable treatment for low back pain, which is a major cause of disability and lost work in the U.S. and around the world,” he said. 

“I have found that my students with low back pain gain even more benefit from the yoga practices that help regulate their nervous systems and reduce tension and stress. So building a well-rounded yoga practice that focuses not just on asana but on stress reduction and nervous system regulation could offer even greater benefit to people with low back pain,” he added.

Tips to get started with yoga if you have low back pain

If you live with low back pain and are interested in trying yoga, it’s a good idea to do some research to find appropriate classes and qualified instructors.

“If you’re looking to start yoga and you have low back pain, I’d recommend that you look for yoga therapists (C-IAYT) or classes with titles such as ‘Accessible Yoga,’ ‘Adaptive Yoga,’ and ‘Gentle Yoga,” Heyman shared, adding that chair yoga can also be a great place for beginners. 

“Be careful about jumping into classes with titles like ‘All Levels’ or flow classes where there are quick movements,” he noted.

Heyman said the most important component of any yoga class is clarity of instruction and the teacher’s ability to individualize the practice to meet the practitioner’s needs. 

“Talk to the teacher before class starts to let them know about your condition so they can adapt the practices for you,” he said, emphasizing yoga props as a helpful tool for finding comfortable variations within poses.

“People with low back pain tend to be very aware of what movements feel safe, and it’s important to support them in exploring these poses in a safe and accessible way,” Heyman said. 

Takeaway

A new study helps further our understanding of the benefits of yoga for low back pain relief.

The 4-week, 8-session telehealth yoga program significantly reduced low back pain among subjects with the condition. Yoga postures involving hip flexion appear to improve the flexion-relaxation phenomenon, a biomarker of low back pain.

Larger studies are needed to determine the long-term effects of yoga on low back pain relief.

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Hay fever is already common during the spring and summer months, but our changing climate could see some symptoms starting earlier in the year for allergy sufferers across the UK. Recent studies suggest that some types of pollen and other …

• An Australian study has found that high blood pressure is the top risk factor for death.
• High blood pressure contributes to cardiovascular disease by damaging the arteries.
• Experts advise that lifestyle changes can improve your blood pressure.
• Lowering blood pressure can reduce the risk of cardiovascular disease.

The authors of a new study published in the journal PLOS ONE say that high blood pressure has been the top risk factor for death among the Australian population for the past 30 years.

Additionally, it has been the primary factor leading to deaths from cardiovascular disease.

According to the American Heart Association, cardiovascular disease includes various conditions affecting the heart and the blood vessels, such as heart attack, stroke, heart failure, heart rhythm abnormalities, and heart valve problems.

The U.S. Centers for Disease Control and Prevention explains that high blood pressure is a known risk factor for cardiovascular disease.

It can damage arteries over time, making them less flexible. This reduces the flow of blood and oxygen to the heart. It can also cause the arteries in the brain to burst or become blocked.

The researchers, however, note that despite this knowledge, national health plans in Australia have not always made this condition a priority.

They felt that studying how high blood pressure compares in relation to other cardiovascular disease risk factors could help the country make more effective healthcare policy decisions.

Examining the link between high blood pressure and cardiovascular disease

To study the issue, the team from The George Institute for Global Health and UNSW, Sydney, looked at epidemiological data from the Global Burden of Disease (GBD) study, which includes data from 204 countries, including Australia, related to almost 400 diseases and 87 risk factors.

Data from 1990 to 2019 was used to determine the main risk factors for deaths from all causes and cardiovascular disease.

When they analyzed the data, they found that high blood pressure’s contribution to death declined from about 54% to 44%.

However, it remained the top risk factor in both all-cause and cardiovascular disease-related deaths.

Other top contributors included diet and tobacco use.

There were also differences related to age and sex. In particular, in men between the ages of 25-49, high blood pressure contributed more to deaths from stroke than in other groups.

What you can do to lower your blood pressure

Dr. Hoang Nguyen, a board certified interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, who was not involved in the study, stressed the importance of accurately assessing your blood pressure.

“Ironically, blood pressure readings in the physician’s office are often inaccurate; falsely elevated due to the stress of being in the physician’s office or the stress of getting there,” he explained.

“Blood pressure should be measured at rest (patient should relax for 5 minutes) while seated in a chair with uncrossed legs,” Nguyen added. “An arm cuff and not a wrist cuff should be used to measure blood pressure.”

Additionally, he advises measuring your blood pressure at home and keeping a log to share with your doctor.

“Once high blood pressure is verified, we can employ lifestyle changes to lower blood pressure, such as regular exercise,” he said.

Nguyen remarked that weight loss can also be helpful in lowering blood pressure, to the point that you may no longer require medications. “Just losing 5 lbs. can lead to a significant reduction in blood pressure,” he noted.

Limiting alcohol consumption and quitting smoking can also help, Nguyen stated, adding that smoking cessation also has other benefits for cardiovascular health.

Additionally, getting good sleep and avoiding salty foods can help lower your blood pressure, he said.

Dr. Shannon Winakur, a cardiologist at the University of Maryland St. Joseph Medical Center in Towson, Maryland, who was not involved in the study, added to the above by suggesting that people also consider whether they have any issues with pain.

“Pain management — whether a result of a chronic condition or injury — is important, as pain is a stressor that can increase your blood pressure,” she stated.

Other ways to reduce heart disease risk

Winakur noted that there is a significant overlap between what you can do to reduce your risk of high blood pressure and what you can do to reduce your cardiovascular disease risk.

One additional suggestion she made to reduce the risk of both is moving more.

“The ‘official’ recommendation is 150 minutes per week of moderate physical activity,” she said, “but I tell patients that anything is better than nothing.”

Winakur also advises not limiting yourself by thinking that exercise has to be something like running or a fitness class.

‘You can dance in your kitchen, walk your dog, park farther away from the store, anything that encourages more movement…By building opportunities for moving more into your regular routines, you’ll be gradually strengthening your heart,” she explained.

When it comes to what you eat, “A diet that consists mostly of vegetables and is low in saturated fat (animal fat, such as beef, pork, ham, bacon, and in dairy products) and low in refined carbs and sugars (as in breads, pastas, and sweets, for example), with small portions of lean meats, fish, and complex carbohydrates can contribute to improved heart — and overall health,” Winakur said.

She further advises eating food as close as possible to its natural state. 

“You don’t see a loaf of bread or chickpea pasta in the wild,” she noted.

Winakur also suggests seeing a doctor regularly and having basic testing like blood pressure, blood sugar, and cholesterol levels.

“Being aware of any potential issues early on can spur a conversation with your care provider about things you can do to stay your healthiest,” she said.

Finally, Winakur says taking steps to deal with stress is important.

“Use healthy methods for managing stress by doing things like getting enough sleep, moving in some way daily, using meditation regularly, limiting the use of alcohol, and limiting your exposure to the news and screens (TVs, tablets and cell phones) of any kind when you need to,” she concluded.

Takeaway

High blood pressure is a known risk factor for cardiovascular disease.

However, an Australian study has found that high blood pressure remains the leading risk factor for premature death from all causes, including cardiovascular disease, in that nation.

Experts advise taking steps to reduce your blood pressure by improving your diet, exercising, stopping smoking, reducing alcohol intake, and reducing stress.

This, in turn, will reduce your risk of cardiovascular disease and death.

A 28-year-old Snapchat predator who used alcohol to lure a 13-year-old schoolgirl to his car before raping her has been jailed for 10 years. Rhodri Llyr Griffiths raped and sexually assaulted his young victim after tricking her into getting into his car before driving her to a hospital car park in Ysbyty Ystrad Fawr in Ystrad Mynach, Caerphilly, […]

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• A breakdown product of excess niacin was linked to a higher risk of cardiovascular events such as heart attack and stroke.
• Niacin, or vitamin B3, is needed for a healthy nervous system. Most people get enough in their diet.
• Breads, flours and other foods are fortified with niacin. However, researchers say this may need to be reconsidered, given the new findings.

For decades, the food industry in the United States has added niacin — also known as vitamin B3 — to bread, flour and corn products to prevent pellagra, a disease caused by a deficiency of this nutrient. 

The program was so successful that today pellagra is virtually unknown in the country, except among certain populations with extreme food insecurity.

While preventing deficiency is a good thing, a new study published February 19 in Nature Medicine suggests that excess niacin in the diet may have a downside — increasing the risk of cardiovascular disease.

In the study, researchers looked specifically at a metabolic byproduct of excess niacin known as 4PY.

Researchers did not set out to examine the role of niacin in cardiovascular disease. Instead, they were trying to identify why when people are treated for other risk factors — such as diabetes and high cholesterol — some still have cardiovascular events.

In their initial research, 4PY, whose full name is N1-methyl-4-pyridone-3-carboxamide, showed up as a possible marker in the blood for cardiovascular risk. Researchers then traced this compound back to excess niacin.

They found that participants in the highest quarter of 4PY levels had about a twofold increased risk of major adverse cardiovascular events such as a heart attack or stroke, compared to those in the lowest quarter.

To put it another way: “one in four people in our cohorts had high levels of 4PY, and are at significantly higher risk for adverse cardiovascular events,” study author Dr. Stanley Hazen, chair of cardiovascular and metabolic sciences at Cleveland Clinic’s Lerner Research Institute in Ohio, told Healthline.

Researchers argue that 4PY increases cardiovascular risk through inflammation in the blood vessels, known as vascular inflammation.

Mixed effects of niacin on heart

Niacin’s ability to lower low-density lipoprotein (LDL or “bad”) cholesterol and triglycerides, and raise high-density lipoprotein (HDL, or “good”) cholesterol led to it being used as a treatment for preventing cardiovascular disease prior to the development of cholesterol-lowering statins.

Some research, though, shows that taking niacin doesn’t reduce the risk of cardiovascular disease events, or offers no extra benefit when used alongside statins. One study even found that use of niacin may slightly increase the risk of dying early.

Adding to this, the findings of the new study suggest that excess niacin may counteract some of the benefits of smaller amounts of niacin, such as supporting the nervous system.

“While niacin was previously prescribed as a cholesterol-lowering medication, its use has fallen out of favor, as multiple studies did not find as much benefit to cardiovascular health as initially thought,” said Dr. Cheng-Han Chen, interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, Calif.

Chen was not involved in the study.

“This [new] study will put another nail in the coffin for the use of niacin in heart disease,” he told Healthline.

However, Chen cautions that more research is needed to understand the relationship between different amounts of excess niacin and cardiovascular disease, especially in people taking niacin supplements.

How much niacin is too much?

To avoid a deficiency, adults need 14 to 18 milligrams of niacin per day. This can be found in 6 ounces of tuna or 4 ounces of peanuts, among other foods, including those that are fortified with niacin.

In comparison, therapeutic levels of niacin — such as amounts used in clinical trials for lowering cholesterol — are along the lines of 1,500 to 2,500 milligrams per day, the researchers write.

People taking prescription or over-the-counter niacin products were excluded from the analysis, said Hazen. So that leaves the diet as the main source of niacin for participants.

Researchers did not have data on how much niacin participants were getting in their diet. However, Hazen pointed out that ingestion of excess amounts of niacin — or related compounds such as nicotinamide adenine dinucleotide, nicotinic acid, and nicotinamide riboside — have all been shown previously to increase the level of 4PY, as well as another breakdown product, 2PY.

In this study, 2PY, also known as N1-methyl-2-pyridone-5-carboxamide, was not linked to inflammation or a higher risk of cardiovascular disease events.

Americans tend to get more than enough niacin to prevent a deficiency, ingesting 37 milligrams per day of niacin on average, according to the 2017-2020 National Health and Nutrition Examination Surveys (NHANES). In addition, that survey shows that fewer than 4% of adults report consuming less than 15 milligrams per day, the authors point out.

So most Americans get enough niacin in their diet, some of which is coming from fortified foods, which Hazen thinks may need to be reconsidered in light of the new findings.

“The main takeaway is not that we should cut out our entire intake of niacin — that’s not a realistic approach,” he said in a release. “Given these findings, a discussion over whether a continued mandate of flour and cereal fortification with niacin in the U.S. could be warranted.”

Chen cautions against people routinely taking niacin supplements, especially if they have a higher risk of cardiovascular disease. If they are considering taking niacin or related products, they should talk to their doctor first.

“However, it may be more difficult to avoid niacin-fortified foods, given their ubiquity in the food chain,” he said. So “niacin fortification may need to be examined at a higher level as a matter of public policy.”

Takeaway

Researchers found that people with higher amounts of a breakdown product of excess niacin had a higher risk of major adverse cardiovascular events such as heart attack and stroke.

This breakdown product, known as 4PY, acts through inflammation in the blood vessels to increase the cardiovascular risk, researchers say.

More research is needed to understand the link between different levels of excess niacin and the risk of cardiovascular disease events. Researchers call for a re-examination of the fortification of foods with niacin.

For years, chronic fatigue syndrome has been dismissed as being all in the mind. But new research today ruled the illness — also called myalgic encephalomyelitis (ME) — is real. Scientists have found, for the first time, key differences in the brains and immune systems of CFS patients. It suggests the disputed condition’s fatigue, which […]

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• Comedian Amy Schumer took to social media to talk about the symptoms of endometriosis.
• Endometriosis is a common condition, affecting an estimated 1 in 10 women.
• The condition has been given the nickname “the missed disease,” as it is poorly understood and difficult to diagnose. 

Amy Schumer revealed that she has endometriosis, a chronic disease where tissue similar to the tissue that lines the uterus grows outside of the uterus. 

Schumer, 42, was responding to criticism that her face appeared more swollen than usual in recent media appearances.

“I’ve enjoyed feedback and deliberation about my appearance as all women do for almost 20 years. And you’re right it is puffier than normal right now. I have endometriosis an auto immune disease that every woman should read about. There are some medical and hormonal things going on in my world right now but I’m okay,” Schumer posted on Instagram.

Endometriosis is a common condition, affecting an estimated 1 in 10 people with uteruses. 

Despite affecting so many people, the condition, which has been given the nickname “the missed disease,” is poorly understood, frequently dismissed, and difficult to diagnose. 

“Like any chronic disease , things can flare up during menses, with certain physical activities and even related to diet for some patients. The range of symptoms are so vast, it is really dependent on the extent of the disease,” Dr. Sameena Rahman, a board-certified OB/GYN and founder at Center for Gynecology and Cosmetics in Chicago, IL, told Healthline.

How endometriosis can lead to feeling swollen

People with endometriosis often report bleeding in between periods, painful periods, painful intercourse, and pain with urination or defecation. 

“Whole body swelling is not a common symptom, but feeling swollen is a common complaint,” said Dr. Chandrika Rao, a board-certified OB/GYN with Pediatrix Medical Group.

It’s entirely possible to become pregnant with endometriosis, but many people, especially those with late-stage endometriosis, experience issues conceiving. 

In many cases, the condition can be asymptomatic and people only discover they have the condition when being evaluated for infertility. 

The condition occurs in four stages, from one to four, with stage one being the mildest and stage four being the most severe. 

With stage four endometriosis, for example, thick adhesions can be found throughout the pelvic area.

“Endometriosis can be a debilitating disorder, but oftentimes it is an incidental finding. Not everyone who has endometriosis has severe symptoms,” says Rao.

Here’s what causes endometriosis

It’s unclear what causes endometriosis, but it’s thought to be multifactorial.

Some researchers suspect the condition is due to “retrograde menstruation, which occurs when menstrual blood flows back up through the fallopian tubes and into the pelvic cavity.

The blood is thought to contain endometrial cells from the uterine lining that stick to other pelvic organs, thicken, and bleed each month during menstruation. 

Other experts believe that endometriosis is caused by genetic factors, hormone dysfunction, past surgeries, and issues within the immune system. 

Risk factors include having a family history, not having a history of pregnancies, early onset of first menstrual cycle, congenital defects of the uterus, low body mass index, obstruction of menstrual flow, and short menstrual cycles lasting less than 27 days, according to Rahman. 

Endometriosis is associated with a greater risk of early menopause.

Endometriosis cannot be prevented, however, there are various strategies, including hormonal birth control, exercise, and dietary modifications, that can impact the amount of estrogen in the body, which influences the thickness of the uterine lining and reduces the risk of developing it.

How endometriosis is diagnosed and treated

A pelvic exam will typically first be conducted in people who are experiencing any of the symptoms linked to endometriosis. 

Depending on the symptoms, imaging tests, such as an ultrasound, may also be ordered to look for abnormal growths or ovarian cysts.

That said, laparoscopy, a type of minimally invasive surgery done to look inside the pelvic area, is the only way a doctor can confirm a diagnosis of endometriosis. 

While endometriosis is rarely cured, the condition — and the painful symptoms it triggers — can be treated with analgesics, hormonal therapy, and surgery.

People often have to experiment with various treatments to find a solution that alleviates their unique set of symptoms.

“You do not need surgery for adequate treatment. It is most often diagnosed clinically due to pelvic pain and managed with medications,” Rao said.

The bottom line:

Amy Schumer revealed that she has endometriosis, a chronic disease where tissue similar to the tissue that lines the uterus grows outside of the uterus. Symptoms vary from person to person but often include pelvic pain during sex, menstruation, and going to the bathroom. The condition is notoriously difficult to diagnose, and while it’s rarely curable, there are treatments to ease the symptoms.

Sorting out my Mum’s financial affairs after her death late last month has been a rollercoaster affair — both emotionally and administratively. At times, it’s required detective work that Sherlock Holmes would have been proud of, hunting down key financial documents. Occasionally, it has brought joy as unknown savings accounts have been discovered — only […]

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• A study has found that the drug abatacept could help prevent rheumatoid arthritis.
• It also appeared to improve pain, inflammation, function, and quality of life.
• It may work for this purpose because it targets immune reactions early in the process.
• Abatacept is currently only used to treat established rheumatoid arthritis.
• Experts say this could change how rheumatoid arthritis is managed.

A new study published in The Lancet indicates that the rheumatoid arthritis drug abatacept (brand name Orencia) could also be useful in preventing the disease.

Francisco Contreras, MD — Director, President, and Chairman of Oasis of Hope Medical Institute, who was not involved in the study — describes rheumatoid arthritis (RA) as being a chronic autoimmune condition with symptoms such as joint inflammation, swelling, pain, and stiffness.

“This inflammatory response, driven by the body’s immune system, can gradually result in damage to the joints and subsequent limitations in mobility and function over time,” he explained.

Abatacept is a biologic medication used to reduce the symptoms of adult rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, and psoriatic arthritis, according to Bristol Meyers Squibb, the manufacturer of Orencia.

The study’s authors note that abatacept is currently used as a second or third-line treatment for established rheumatoid arthritis.

It is administered weekly, either at home via injection or in a hospital via an intravenous drip.

Contreras said that if abatacept can also play a role in preventing rheumatoid arthritis, this could have significant implications.

“While conventional approaches to RA management primarily focus on symptom control,” he stated, “the potential preventive application of abatacept represents a paradigm shift in disease management strategies.”

Abatacept is a promising rheumatoid arthritis preventative

To study the drug’s ability to prevent rheumatoid arthritis, a team of researchers from King’s College London recruited 213 at-risk patients.

The study participants were adult men and women with early disease symptoms, such as joint pain without swelling.

Half of the patients were given treatment with abatacept for a year, while the other half received an inactive placebo.

Drug treatment was then ceased, but monitoring continued for an additional year.

The researchers found that only 6% of people treated with abatecept went on to develop arthritis after one year. This was in comparison to 29% of those given the placebo who developed the disease.

Even at the two-year mark, there was still a significant difference between the two groups, with 25% of drug-treated patients developing RA versus 37% in the placebo group.

It was also found that abatacept improved pain scores, function, and quality of life in people who received it preventatively.

Additionally, these people had lower scores for inflammation in their joint linings.

How abatecept might help prevent rheumatoid arthritis

Ani Rostomyan, PharmD, a clinical pharmacist practicing in the area of Diabetes and Genomics and Functional Medicine, said that consensus guidelines from the American College of Rheumatology and the European Alliance of Associations for Rheumatology currently advise using abatecept in people who already have established rheumatoid arthritis.

The rationale for the study was “if the pre-clinical phase of RA could be accurately defined, targeting therapy to those at highest risk of developing the more severe form of disease would possibly prevent or at least delay the onset of the disease,” Rostomyan explained.

Abatacept was chosen for the study because it can target immune reactions early in the process that can lead to the inflammation associated with rheumatoid arthritis.

This drug “is a fusion protein, composed of the Fc region of the immunoglobulin IgG1 fused to the extracellular domain of cytotoxic T-lymphocyte antigen 4 (CTLA-4),” she explained, adding that “it interrupts interaction between T-cells and antigen-presenting cells, weakening the co-stimulatory signals required for T-cell activation, differentiation, and effector responses, thereby resulting in downstream immunomodulatory effects on other inflammatory cells of the immune system.”

Rostomyan went on to say that using abatacept for this application is promising. However, in her opinion, given the state of healthcare coverage in the United States, it is unlikely to be given approval by health plans as a preventive medication.

She did note, though, that further studies into the drug could alter this assessment.

Takeaway

A new study has found that the rheumatoid arthritis medication abatacept (brand name Orencia) might additionally have applications as a preventive for the disease.

It also appears to help with symptoms such as pain, function, inflammation, and quality of life.

The reason it might work to prevent the development of rheumatoid arthritis is that it can target the immune reactions early in the process.

Abatacept is currently used as a treatment for already-established rheumatoid arthritis.

Experts say these findings could change how rheumatoid arthritis is managed. However, it seems unlikely that insurance companies in the United States will be willing to pay for its use as a preventive.