Rheumatology Round-Up: More Support Needed to Improve Knee Osteoarthritis Treatment, Older Hip Fracture Patients Need Multicomponent Home Treatments, and More.

Here are the top stories covered by DocWire News this week in the Rheumatology section. In this week’s edition of the round-up: major changes are needed in how osteoarthritis is understood and treated. A multicomponent home-based physical therapy intervention is effective in helping individuals with hip fracture regain their ability to walk. Researchers are investigating how severe pain can cause nerve damage that can permanently alter the brain and result in chronic pain, and also, the FDA approved the use of nintedanib capsules, which slow the decline of pulmonary function in adults with interstitial lung disease associated with systemic sclerosis or scleroderma.

A paper authored by Curtin University and published in British Journal of Sports Medicine has shed light on people living with knee osteoarthritis who may be needlessly suffering or receiving the wrong treatments for their symptoms, recommending a major change in how osteoarthritis is understood and treated. The paper expressed that people with osteoarthritis are often provided potentially risky treatments with limited benefit such as opioid medication, injections, and arthroscopic surgery to manage their pain. “This editorial is a call to action by international leaders in the field, from physiotherapy, rheumatology and orthopedic surgery, including an outline of three key steps that are needed to change the way healthcare professionals understand and manage knee osteoarthritis,” said Lead author Dr. JP Caneiro.

According to a new study published in JAMA, for older adults with hip fractures, a multicomponent home-based physical therapy intervention is effective in helping individuals regain their ability to walk, but has no significant impact on their everyday functions, such as crossing the street. In a parallel, 2-group randomized clinical trial, researchers evaluated 210 randomized participants. The study included a training intervention (active treatment) (n = 105) included aerobic, strength, balance, and functional training. The active control group of participants (n = 105) were administered transcutaneous electrical nerve stimulation and active range-of-motion exercises. Both groups received two to three home visits from a physical therapist. According to the results, the researchers “were pleased that in this study a sizeable number of participants achieved community ambulation capacity.”

Researchers of a study published in Nature Neuroscience are investigating how severe pain can cause nerve damage that can permanently alter the brain and result in chronic pain. A research team with the Cumming School of Medicine’s Hotchkiss Brain Institute (HBI) and researchers at Stanford University, California, headed by Dr. Gerald Zamponi, PhD, have been investigating which brain circuits are changed by injury, in order to develop targeted therapies to reset the brain to stop chronic pain. “If you understand how the brain rewires itself, you can interfere with that and you can restore it. That’s important,” says Zamponi. “If you think about it, there are some drugs you don’t want to give to kids who have chronic pain. What if you could non-invasively stimulate certain brain regions or inhibit them, and bring pain relief that way? I think it would be a tremendous, alternative approach to taking drugs.”

The U.S. Food and Drug Administration (FDA) approved the use of nintedanib capsules, which slow the decline of pulmonary function in adults with interstitial lung disease associated with systemic sclerosis or scleroderma (SSc-ILD). This marks the first FDA-approved treatment for this condition. “Nintedanib is now a treatment option to slow the rate of decline in pulmonary function in patients who have interstitial lung disease from scleroderma,” said Nikolay Nikolov, M.D., associate director for Rheumatology of the Division of Pulmonary, Allergy, and Rheumatology Products in the FDA’s Center for Drug Evaluation and Research.