News in brief: Knee OA digital relief; Patient voices missing from rheumatology research; Novel treatment for Feltys syndrome

Wednesday, 3 Mar 2021

Digital physical therapy better than GP for knee OA care

Patients with knee OA get better relief from chronic joint pain with a digital-delivered physical therapy intervention compared to usual care from GP visits, a UL trial has shown.

In a randomised controlled trial (RCT) conducted by the University of Nottingham involving 105 adults with OA, those who used Joint Academy’s reduced their pain by 41%, while patients receiving traditional care only experienced a 6% decrease.

Patients in the digital treatment were connected with licensed physical therapists via a smartphone application where they received education and daily exercises. In the other group, patients continued their traditional self-management program and visited their GP when needed. The results were published in JAMA Network Open.

Patient voices missing from rheumatology trials

A decade after EULAR recommended the inclusion of patient representatives in scientific projects, less than 2% of clinical trials in rheumatology still do not have any patients as research partners, according to NZ and Australian researchers. A review of 622 rheumatology trials found that only 11 (1.8%) had patient research partner involvement.Patients were not involved as partners in any industry-initiated trials, and the patient involvement was limited to trial design and/or management rather than commissioning or undertaking stages, according to the report by Professor Nicola Dalbeth in Auckland.

IV immunoglobulin for Feltys syndrome

Intravenous immunoglobulin (IVIg) should be considered as an adjunctive therapy in patients with refractory Feltys syndrome, according to NSW clinicians who reported its successful use in 71-year-old woman with long-standing seropositive rheumatoid arthritis, admitted with neutropenic fever and extensive oral mucositis. The woman was diagnosed with suspected Felty syndrome and had been on low-dose prednisone, G-CSF and tofacitinib. She was trialled IVIg after she failed to respond to weekly methotrexate and two doses of second weekly rituximab. Her neutrophil count improved and she was weaned off other medications. The authors of the case report said IVIg exerts an effect on the immune system via multiple potential pathways, ultimately downregulating the destruction of neutrophils. It may also expand the number of regulatory T cells, inhibit Th17 and Th1 pathway, and downregulate pathogenic antibody production, they wrote in the Internal Medicine Journal.

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