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Adding tofacitinib to treatment with DMARDs improves pain and function in patients with active RA

Main Category: Arthritis / Rheumatology
Article Date: 20 Aug 2013 - 1:00 PDT Current ratings for:
Adding tofacitinib to treatment with DMARDs improves pain and function in patients with active RA

Adding tofacitinib to treatment with disease-modifying anti-rheumatic drugs (DMARDs) may help improve symptoms in patients with active rheumatoid arthritis (RA). Nonbiologic DMARDs, including methotrexate, are commonly used to treat RA. However, DMARDs alone do not always adequately treat the disease.

Tofacitinib is a novel, oral, Janus kinase inhibitor that treats RA. Researchers sought to determine the safety and efficacy of tofacitinib taken in combination with nonbiologic DMRDs.

Patients with inadequately controlled RA (n = 792) despite treatment with nonbiologic DMARDs were randomly assigned to one of four twice-daily treatment sequences: 5 mg of tofacitinib; 10 mg of tofacitinib; placebo advanced to 5 mg of tofacitinib; or placebo advanced to 10 mg of tofacitinib.

The study showed that when used in combination with various nonbiologic DMARDs, tofacitinib, 5 mg and 10 mg twice daily, compared with placebo, rapidly reduced the signs and symptoms of RA and improved physical function. Adverse events included decreases in neutrophil counts, increases in high- and low-density lipoprotein cholesterol level, and small increases in serum creatinine and aminotransaminase levels.

Tofacitinib in Combination With Nonbiologic Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis: A Randomized Trial, Joel Kremer, MD; Zhan-Guo Li, MD, PhD; Stephen Hall, MD; Roy Fleischmann, MD; Mark Genovese, MD; Emilio Martin-Mola, MD, PhD; John D. Isaacs, PhD; David Gruben, PhD; Gene Wallenstein, PhD; Sriram Krishnaswami, PhD; Samuel H. Zwillich, MD; Tamas Koncz, MD; Richard Riese, MD, PhD; and John Bradley, MD, Ann Intern Med. 2013;159(4):253-261. doi:10.7326/0003-4819-159-4-201308200-00006

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Speedier scans reveal new distinctions in resting and active brain

Main Category: Neurology / Neuroscience
Article Date: 05 Aug 2013 - 0:00 PDT Current ratings for:
Speedier scans reveal new distinctions in resting and active brain

A boost in the speed of brain scans is unveiling new insights into how brain regions work with each other in cooperative groups called networks.

Scientists at Washington University School of Medicine in St. Louis and the Institute of Technology and Advanced Biomedical Imaging at the University of Chieti, Italy, used the quicker scans to track brain activity in volunteers at rest and while they watched a movie.

"Brain activity occurs in waves that repeat as slowly as once every 10 seconds or as rapidly as once every 50 milliseconds," said senior researcher Maurizio Corbetta, MD, the Norman J. Stupp Professor of Neurology. "This is our first look at these networks where we could sample activity every 50 milliseconds, as well as track slower activity fluctuations that are more similar to those observed with functional magnetic resonance imaging (fMRI). This analysis performed at rest and while watching a movie provides some interesting and novel insights into how these networks are configured in resting and active brains."

Understanding how brain networks function is important for better diagnosis and treatment of brain injuries, according to Corbetta.

The study appears online in Neuron.

Researchers know of several resting-state brain networks, which are groups of different brain regions whose activity levels rise and fall in sync when the brain is at rest. Scientists used fMRI to locate and characterize these networks, but the relative slowness of this approach limited their observations to activity that changes every 10 seconds or so. A surprising result from fMRI was that the spatial pattern of activity (or topography) of these brain networks is similar at rest and during tasks.

In contrast, a faster technology called magnetoencephalography (MEG) can detect activity at the millisecond level, letting scientists examine waves of activity in frequencies from slow (0.1-4 cycles per second) to fast (greater than 50 cycles per second).

"Interestingly, even when we looked at much higher temporal resolution, brain networks appear to fluctuate on a relatively slow time scale," said first author Viviana Betti, PhD, a postdoctoral researcher at Chieti. "However, when the subjects went from resting to watching a movie, the networks appeared to shift the frequency channels in which they operate, suggesting that the brain uses different frequencies for rest and task, much like a radio."

In the study, the scientists asked one group of volunteers to either rest or watch the movie during brain scans. A second group was asked to watch the movie and look for event boundaries, moments when the plot or characters or other elements of the story changed. They pushed a button when they noticed these changes.

As in previous studies, most subjects recognized similar event boundaries in the movie. The MEG scans showed that the communication between regions in the visual cortex was altered near the movie boundaries, especially in networks in the visual cortex.

"This gives us a hint of how cognitive activity dynamically changes the resting-state networks," Corbetta said. "Activity locks and unlocks in these networks depending on how the task unfolds. Future studies will need to track resting-state networks in different tasks to see how correlated activity is dynamically coordinated across the brain."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our neurology / neuroscience section for the latest news on this subject.

This research was funded by the European Community’s Seventh Framework Programme Grant Agreement HEALTH-F2-2008-200728 (BrainSynch) and by the Human Connectome Project (1U54MH091657-01). V.B. was additionally supported by a fellowship from the University of Chieti. M.C. was supported by R01 MH096482-01 (NIMH) and 5R01HD061117-08 (NICHD). Betti V, Della Penna S, de Pasquale F, Mantini D, Marzetti L, Romani GL, Corbetta M. Natural Scenes Viewing Alters the Dynamics of Functional Connectivity in the Human Brain. Neuron, published online.

Washington University School of Medicine

Please use one of the following formats to cite this article in your essay, paper or report:

MLA

Washington University School of Medicine. "Speedier scans reveal new distinctions in resting and active brain." Medical News Today. MediLexicon, Intl., 5 Aug. 2013. Web.
5 Aug. 2013. APA

Please note: If no author information is provided, the source is cited instead.

'Speedier scans reveal new distinctions in resting and active brain'

Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

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All opinions are moderated before being included (to stop spam). We reserve the right to amend opinions where we deem necessary.

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Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

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