News in Brief: Exercise program uses text messages to improve pain, function for people with knee OA; Flare of rheumatoid arthritis after COVID-19 vaccination; New understanding of immune response in RA

Knee OA benefits from online exercise program

An online strengthening exercise program has been shown by Victorian researchers to improve pain, function for people with knee OA.

People with knee OA who participated in an online exercise program that used text messages to encourage adherence experienced greater knee pain improvement and function compared to participants who didn’t received the text messages.

Researchers from the University of Melbourne said most participants experienced meaningful improvements in knee OA symptoms without needing health professional contact. Some 72% of patients receiving the texted prompts experienced clinically important improvements in pain and 68% in function – similar to outcomes achieved with therapies supervised exercise, they added.

The intervention, which is free to access, could be clinically relevant on population level the investigators also say noting that the online, unsupervised program could be easily scaleable across the country.

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Flare of rheumatoid arthritis after COVID-19 vaccination

Rheumatologists in the US have reported a case of RA flare following COVID-19 vaccination.

The patient, a 55 year-old man, had reportedly been in sustained clinical remission for more than two years but developed an acute flare of his RA with clinically significant pain and swelling in the right knee 12 hours after receiving a second dose of the BNT162b2 (BioNTech-Pfizer) vaccine.

He had continued on his usual rheumatoid arthritis treatment between the two vaccinations.

Despite taking ibuprofen and prednisone 5 mg soon after symptoms began and increasing to prednisone 10mg the following day the pain persisted, report doctors. Some nine days later doctors reported significant swelling and warmth over the right knee with pain on flexion and extension of the knee and significant findings on ultrasound.

Writing in a comment in Lancet Rheumatology the treating doctors speculated that the flare might have been triggered by an immune response to a component of the BNT162b2 vaccine.

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New understanding of immune response in RA

Monash University researchers have made a breakthrough in understanding the role played by high-risk immune genes associated with the development of RA.

The findings, published in Science Immunology, were the result of a seven-year collaboration led by Monash University, involving Janssen Research and Development, USA and the Karolinska Institute, Sweden.

The pre-clinical study of mice, genetically modified to express the human HLA-DR4 molecule – an immune system gene,  revealed how T cells recognise the molecules and also showed that highly similar T cell receptors, likely with similar recognition characteristics, are also present in “RA-susceptible” humans expressing the HLA molecules.

The findings suggest there may be an immune signature of RA development, providing a potential avenue for producing personalised medicines and  preclinical interventions to treat RA say investigators.

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