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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Hypnotic relaxation therapy improves sexual health for postmenopausal women with hot flashes

Main Category: Menopause
Also Included In: Psychology / Psychiatry;  Sexual Health / STDs
Article Date: 19 Aug 2013 - 1:00 PDT Current ratings for:
Hypnotic relaxation therapy improves sexual health for postmenopausal women with hot flashes

Hypnotic relaxation therapy improves sexual health in postmenopausal women who have moderate to severe hot flashes, according to Baylor University researchers who presented their findings at the American Psychological Association's recent annual meeting.

The study, which examined sexual comfort, sexual satisfaction and sexual pleasure, is a first step toward a safe and effective alternative toward hormone replacement therapy, which carries associated risks of cancer and heart disease, said Gary Elkins, Ph.D., director of Baylor's Mind-Body Medicine Research Laboratory and a professor of psychology and neuroscience in Baylor's College of Arts & Sciences.

The conclusion was based on a study funded by the National Institutes of Health. For the study, 187 women were randomly assigned to receive either five weekly sessions of hypnotic relaxation therapy or supportive counseling, said lead researcher Aimee Johnson, a doctoral student in psychology and neuroscience at Baylor University.

Led by researchers at Baylor's Mind-Body Medicine Research Laboratory, all study sessions were conducted by master's-level therapists trained in clinical hypnosis. Participants in the hypnotic relaxation therapy group received a hypnotic induction followed by suggestions for relaxation, coolness and mental imagery. Participants who received sessions of supportive counseling discussed their symptoms with a trained therapist but did not receive any hypnosis.

Women completed questionnaires at the beginning of the study, at the end of treatment and at a 12-week follow-up. They also were asked to complete a self-report questionnaire assessing the extent to which hot flashes interfered with sexual intimacy. The decrease in estrogen that accompanies menopause is associated with hot flashes, night sweats, weight gain and vaginal dryness, discomfort or pain.

"The most common complaints are being too tired, anxiety, depression, hot flashes and the fear of close contact," Elkins said. Because warmth that comes from closeness can trigger a hot flash, some women grow to fear intimacy, he said.

At treatment's end, women who had received hypnotic relaxation therapy reported significantly higher sexual satisfaction and pleasure, as well as less discomfort. This improvement also was seen at the 12-week follow-up assessment.

"Women's sexual health improved, whether because of sleeping better, less stress or fewer hot flashes, or perhaps other unknown mechanisms," Elkins said.

Researchers noted that postmenopausal sexual health can be affected by factors other than hot flashes, among them fatigue, self-esteem, a partner's health, relationship quality and a lack of interest by either or both partners.

For many women -- among them those who have had breast cancer -- hormone replacement therapy is not an option for menopause-related symptoms. Estrogen, for example, has been associated with more rapid growth of breast cancer.

Previous research by Elkins has shown that clinical hypnosis can effectively reduce hot flashes and associated symptoms among postmenopausal women, including a lessening of anxiety and depression.

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Lactobacillus reuteri Prodentis improves periodontal treatment

Main Category: Dentistry
Article Date: 19 Aug 2013 - 3:00 PDT Current ratings for:
Lactobacillus reuteri Prodentis improves periodontal treatment

A double-blind, placebo-controlled study of chronic periodontitis patients showed that treatment with Lactobacillus reuteri Prodentis as an adjunct to standard treatment significantly improved efficacy by 53 per cent.

The aim of the study was to evaluate the effects of Lactobacillus reuteri Prodentis as an adjunct to scaling and root planing, which is the standard treatment, in chronic periodontitis patients.

By the end of the 12 week long study 53 per cent fewer sites (surfaces on a teeth) in patients with deep dental pockets and supplemented by Lactobacillus reuteri Prodentis was in need for surgery, compared to the placebo group (p < 0.019). A site was considered as in need for surgery if the pocket depth was =6 mm or =5 mm and bleeding.

After the intervention period it was also concluded that 67 per cent of the patients in the placebo group fell into the high-risk category for disease progression, while the corresponding figure for patients supplemented by Lactobacillus reuteri Prodentis was only 27 per cent (p < 0.027). In the published article the authors point out that these figures are comparable to what is reported in different studies using a combination of two different antibiotics as an adjunct to scaling and root planing.

Among the patients with more serious problems there was significantly more pocket depth reduction and attachment gain (p < 0.05) in the group supplemented by Lactobacillus reuteri Prodentis compared to corresponding patients in the placebo group. The study, which was published online 15 August 2013 in Journal of Clinical Periodontology, included 30 patients.

"This study is important because it shows that less patients will be in need for surgery and thus both suffering and money for these periodontitis patients could be saved with BioGaia ProDentis. The results will also help us further penetrate dental offices around the world and thereby contribute to the growth of our oral health business", says Peter Rothschild, President, BioGaia.

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Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study

Journal of Clinical Periodontology - DOI: 10.1111/jcpe.12155

Authors: Wim Teughels, Andac Durukan, Onur Ozcelik, Martine Pauwels, Marc Quirynen, Cenk Haytac Mehmet

BioGaia

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Personal website chronicling improves depressive symptoms in women with breast cancer

Main Category: Breast Cancer
Also Included In: IT / Internet / E-mail;  Depression
Article Date: 14 Aug 2013 - 2:00 PDT
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Personal website chronicling improves depressive symptoms in women with breast cancer

Adults increasingly are conveying their personal experience with serious disease online, but do such chronicles help the authors or their audience? In the first known study of its kind, UCLA researchers have discovered that creating a personal website to chronicle the cancer experience and communicate with the author's interpersonal circle can reduce depressive symptoms, increase positive mood, and enhance appreciation for life in women diagnosed with breast cancer. Published online ahead of print in the Journal of Clinical Oncology, the study was led by Annette Stanton, member of the Jonsson Comprehensive Cancer Center and professor of psychology and psychiatry/biobehavioral sciences.

Explaining the impetus for the study, Stanton said, "From our own and others' previous research, we know that expressing emotions surrounding the experience and gaining social support can be helpful for people diagnosed with cancer, and we know that interpersonal interventions can be useful." However, most interpersonal interventions to promote quality of life in adults diagnosed with cancer involve the patient's partner, primary caregiver, or other cancer patients. "Our goal in this research was to provide a platform on which breast cancer survivors could reflect on their experiences, as well as communicate with and leverage support from their existing social networks, especially friends and family," Stanton said. "The idea for this trial really took off when I met two sisters who had created personal websites for each other when each was diagnosed with cancer."

In Project Connect Online (PCO), a randomized trial conducted with 88 breast cancer survivors, Stanton and colleagues led three-hour workshops in which women created personal websites. Women randomly assigned to the control group were offered the workshop six months later. All participants completed standard measures of psychological status before being assigned to their respective groups and six months after selection.

In the PCO workshops conducted with small groups, women learned about potential uses of the websites, such as expressing emotions related to cancer, providing medical status updates, and letting others know what would be helpful. Women also proactively considered common concerns of website authors, including the pressure to be positive or eloquent. They then engaged in hands-on website creation and at the end of the three-hour sessions had created their websites and authored their first posts. According to Stanton, "We worked closely with a website developer so participants had several choices for how their sites looked, but all sites had the same functions. It was inspiring to see women of so wide an age range (28 to 76 years old) and of such varied computer experience develop their websites in just a few hours."

The women assigned to PCO found their websites particularly valuable for telling the stories of their cancer experiences, expressing emotions, and reducing how much information they had to repeat for family and friends. Visitors to the websites found them useful for providing updates on the authors' health and for helping visitors feel emotionally close to authors. The women in PCO demonstrated statistically significant improvement in depressive symptoms, positive mood, and life appreciation. The effects were particularly strong for women in active medical treatment, most of whom had advanced (metastatic) disease. Women are more often motivated to tell their stories, express cancer-related emotions, garner support, and keep others informed during active medical treatment and the often unpredictable course of metastatic disease than those who have completed their medical treatments for cancer. "We are encouraged by these positive findings," Stanton said, "especially for cancer survivors with the most need, those in active medical treatment or with more advanced disease. Our next step is to gain support for a larger test of Project Connect Online."

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Project Connect Online: Randomized Trial of an Internet-Based Program to Chronicle the Cancer Experience and Facilitate Communication, Annette L. Stanton, Elizabeth H. Thompson, Catherine M. Crespi, John S. Link and James R. Waisman, Journal of Clinical Oncology, Published online before print August 12, 2013, doi: 10.1200/JCO.2012.46.9015

This research was supported by the Susan G. Komen for the Cure Foundation, the Breast Cancer Research Foundation and the National Institutes of Health.

UCLA's Jonsson Comprehensive Cancer Center

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