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Arthritic fingers can be painful. I’m simply asking you to learn the risks and benefits of the “exciting” bone therapy, denosumab, discussed below.
And in all that time the single most important thing I’ve learned about modern medicine is that each and every therapy comes with risks and benefits, pros and cons. While arthritic fingers certainly are a problem, denosumab can also cause problems. Understand the risks and benefits of this powerful therapy.
Full transparency- I live with a blood cancer called multiple myeloma. Bone strengthening therapies such as denosumab, are a component of the FDA standard-of-care treatment plan for multiple myeloma. As such, I have learned a lot about bone strengthening therapies such as denosumab.
According to the study linked below, denosumab had little effect on pain and function of arthritic fingers. I could be wrong but it seems to me that all of the above listed risks are a lot to take for “radiologic changes.”
Your call. If you are interested in learning more about evidence-based non-conventional anti-inflammatory supplements email me at David.PeopleBeatingCancer@gmail.com
Thank you,
David Emerson
“”These are exciting times in the field of finger polyarthritis, as there are new data that help us better understand and possibly treat arthritis in the hands…”
A promising approach for the erosive form of finger polyarthritis is treatment with an osteoporosis medication: The monoclonal antibody denosumab, which targets the receptor activator of nuclear factor-kappa B ligand…
Finger polyarthritis often takes a back seat to arthritis of the knees and hips, which is why Kloppenburg referred to it as a “forgotten disease.” It is not a rarity, however. “Up to 10%-25% of older women suffer from it.”
The term “hand arthritis” may be misleading. “It sounds so simple, as if it were just one joint,” said Kloppenburg. In fact, it is mostly a polyarticular disease that affects various finger joints, usually middle and end joints, and the thumb saddle joint.
Arthritis leads to deformities, painful movement restrictions, and sometimes erosive joint changes. “This is seen in around 10% of people with symptomatic, radiologically detectable finger polyarthritis, often accompanied by inflammation,” said Kloppenburg…
“What we really lack are medications that can stop, reverse, or prevent structural damage,” said Kloppenburg. In other words, disease-modifying osteoarthritis drugs are needed. The understanding that there are apparently different endotypes of arthritis helps in the search for potentially suitable agents. “The best known are synovitis-driven, cartilage-driven, and bone-driven endotypes.”
“We know that osteoclast and osteoblast activation play a role in arthritis, and that’s also what we see in erosive finger polyarthritis,” said Kloppenburg. Studies suggest that osteoclasts resorb the subchondral bone, leading to bone remodeling at the cartilage interface. MRI studies, such as a meta-analysis with data from nearly 2000 patients, support this observation. “There is an association between these subchondral bone lesions and local joint tenderness,” said Kloppenburg…
Could osteoporosis medications help? That question was exactly what researchers from Belgium investigated in a randomized, placebo-controlled phase 2a study. They enrolled 101 patients with at least one erosive or pre-erosive interphalangeal joint, a soft swelling in at least one interphalangeal joint with ultrasound evidence of synovitis, and temporary inflammatory activations. Over 48 weeks, participants received subcutaneous denosumab or placebo every 12 weeks.
The primary endpoint was the change in the Ghent University Scoring System at week 24. The semiquantitative score developed specifically for finger polyarthritis combines radiologic signs of progressive erosion and repair. A significant improvement was achieved, which was even more pronounced after 48 weeks…
“This is a really exciting study,” said Kloppenburg, despite one disappointment. “Unfortunately, they could not demonstrate an improvement in pain and function.” The difference on the numerical rating scale from 0 to 10 was only 0.3 points in favor of denosumab at week 24, which was not significant. Kloppenburg attributed it to the study design and suggested new randomized controlled studies with pain as an outcome.
“It was only about radiologic changes,” said Lems, who also found the study “quite remarkable,” especially “in a disease where we do not have many treatment options.” ”