Year: 2026

Categories : Exercise Mental HealthTags :

For Better Mental Health in Middle Age, Watch Less TV

On By ModernMedia
Photo by RDNE Stock project

Replacing time spent watching TV with other activities can help prevent depressive disorder in middle-aged adults, revealed a new study in European Psychiatry, published on behalf of the European Psychiatric Association by Cambridge University Press. The effects were less pronounced in older and younger adults.  

Lead researcher Rosa Palazuelos-González, of the University of Groningen, said that this new study is unique for investigating how reallocating time from TV-watching to various physical activities and sleep affects the onset of depression. Most studies until now have focused on identifying correlations between sedentary lifestyles and incidences of depression, rather than tracking how replacement activities affect the condition. 

“We found that reducing TV-watching time by 60 minutes and reallocating it to other activities decreased the likelihood of developing major depression by 11 percent,” said Palazuelos-González. 

“For 90- and 120-minute reallocations, this decrease in likelihood goes up to 25.91 percent.” 

Middle-aged people benefit more from watching less 

The benefits for middle-aged people who replace TV-watching with other activities are especially pronounced. Among this demographic, reallocating 60 minutes daily from TV-watching to other activities decreased the probability of developing depression by 18.8%. Reallocating 90 minutes resulted in decreased likelihood of 29%, and 120 minutes led to a reduction of 43%. 

All reallocations of TV-watching time to specific activities were associated with reduced depression risk, except for reallocating only 30 minutes to household activities, which did not yield a significant effect. When reallocating 30 minutes specifically to sports, the reduction was 18%; to work/school physical activities, 10.2%; to leisure/commute activities, 8%; and to sleep, 9%. Time reallocations to sports, at any given duration, resulted in the largest reductions in the probability of major depression onset compared to all other activities. 

Fewer comparable benefits for older adults and young adults 

In older adults, reallocating TV-watching time proportionally to other activities did not lead to statistically significant reductions in onset of depression. Only substituting TV-watching time with sports reduced the probability of becoming depressed, from 1.01 to 0.71% with 30 minutes, 0.63% with 60 minutes, and 0.56% with 90 minutes. 

In young adults, reallocating TV-watching time to one or multiple movement activities did not significantly change the likelihood of them developing depression. However, this group is also more physically active than older age groups – the researchers suggest that they may have already surpassed the physical activity threshold that is protective against depression.  

This research was developed using a population-based cohort study (a Dutch initiative named ‘Lifelines’) with a four-year follow-up, which included 65 454 non-depressed adults. Patterns across age groups were examined carefully. Participants self-reported time spent in active commuting, leisure, sports, household, physical-related activities at work or school, TV-watching, and sleep. Major depressive disorder was assessed using the Mini International Neuropsychiatric Interview. 

Source: EurekAlert!

Categories : Diet and NutritionTags :

Evidence Behind Intermittent Fasting for Weight Loss Fails to Match Hype

On By ModernMedia
Photo by Malvestida on Unsplash

Intermittent fasting is unlikely to lead to greater weight loss in overweight or obese adults than traditional dietary advice or doing nothing, a new Cochrane review finds. 

Obesity is a significant public health problem that has become a leading cause of death in high-income countries. Worldwide adult obesity has more than tripled since 1975, according to the WHO. In 2022, 2.5 billion adults were overweight. Of these, 890 million were living with obesity.

Intermittent fasting has surged in popularity in recent years, fuelled by social media, lifestyle influencers, and claims of rapid weight loss and metabolic benefits.

No meaningful difference in weight loss

Researchers analysed evidence from 22 randomised clinical trials involving 1995 adults across North America, Europe, China, Australia, and South America. Trials examined multiple forms of intermittent fasting, including alternate-day fasting, periodic fasting, and time-restricted feeding. Most studies followed participants for up to 12 months.

The review compared intermittent fasting with traditional dietary advice and with no intervention. Intermittent fasting did not appear to have a clinically meaningful effect on weight loss compared to standard dietary advice or doing nothing. 

Reporting of side effects was inconsistent across trials, making it difficult to draw firm conclusions. The evidence base remains limited, with only 22 trials, many with small sample sizes and inconsistent reporting. 

Hype outpaces the evidence

First author Luis Garegnani also cautioned against the hype surrounding fasting online. 

Intermittent fasting just doesn’t seem to work for overweight or obese adults trying to lose weight. It may be a reasonable option for some people, but the current evidence doesn’t justify the enthusiasm we see on social media.

— Luis Garegnani, Universidad Hospital Italiano de Buenos Aires Cochrane Associate Centre. 


Few trials have looked at the long-term results of intermittent fasting. The authors stressed that obesity is a chronic condition, and short-term trials make it difficult to guide long-term decision-making for patients and clinicians. 
 
The majority of the included studies enrolled predominantly white populations in high-income countries. As obesity is a rapidly growing crisis in low- and middle-income countries, further research is needed in these populations.

The authors therefore warn that these results may provide clues, but cannot be extrapolated to the entire population, as they may vary depending on sex, age, ethnic origin, disease status, or underlying eating disorders or behaviours.
 

With the current evidence available, it’s hard to make a general recommendation. Doctors will need to take a case-by-case approach when advising an overweight adult on losing weight.

— Eva Madrid, Cochrane Evidence Synthesis Unit Iberoamerica. 

By Mia Parkinson

Source: Cochrane Review

Categories : General InterestTags :

SAHPRA Fast-Tracks Access to Critical Foot and Mouth Disease Vaccines to Protect SA’s Livestock

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Photo by Gabriela Cheloni

The South African Health Products Regulatory Authority (SAHPRA) confirms that it has granted Section 21 authorisation for the importation of the Dollvet Foot and Mouth Disease (FMD) vaccine with conditions and is currently assessing an additional application for the same vaccine.

Foot and Mouth Disease is a highly contagious viral disease affecting cloven-hoofed animals such as cattle, pigs, sheep, and goats. It causes fever and painful blister-like sores in the mouth, on the teats, and between the hooves. While many animals recover, outbreaks can result in severe production losses, high mortality in young animals, and significant economic consequences for the agricultural sector.

Speaking on the authorisation, Dr Boitumelo Semete-Makokotlela, Chief Executive Officer of SAHPRA, said:

“The health of our livestock is critical to South Africa’s food security, economic stability, and the livelihoods of our farmers. By granting Section 21 authorisation for the importation of FMD vaccines, SAHPRA is ensuring that veterinarians and farmers have timely access to safe, effective, and scientifically approved tools to protect animals against this highly contagious and devastating disease”.

Section 21 of the Medicines and Related Substances Act provides a mechanism for the controlled importation of medicines and vaccines not yet registered in South Africa, under strict regulatory oversight. This pathway enables SAHPRA to respond rapidly to urgent public and animal health outbreaks while maintaining rigorous standards of quality, safety, and efficacy. Authorisations granted under this provision are temporary and subject to ongoing review.

All imported vaccines undergo strict regulatory controls and quality assurance processes. Distribution will be coordinated by the Department of Agriculture: Animal Health, which is responsible for implementing national disease control measures.

FMD spreads rapidly through direct contact with infected animals, contaminated equipment, vehicles, clothing, feed, and even via wildlife carriers. Outbreaks can lead to movement restrictions, quarantines, trade limitations, and increased compliance costs for farmers. Loss of South Africa’s FMD-free status can trigger immediate export bans on livestock and related products, affecting foreign revenue losses and market stability.

The Department of Agriculture has emphasised that FMD is a controlled disease and that vaccination must take place only within officially approved programmes. Unregulated vaccination may mask infections, weaken surveillance systems, and delay the country’s ability to regain its FMD-free status under international standards set by the World Organisation for Animal Health (WOAH).

“Our collaboration with SAHPRA reflects the importance of partnerships in safeguarding animal health. The South Africans farming community can be assured that every vaccine authorised for use in the country undergoes careful evaluation  for safety, efficacy, especially against locally circulating strains and quality and we are optimistic that the disease will be contained” said Dr Bothle Modisane, Chief Director for Animal Health at the National Department of Agriculture.

SAHPRA remains committed to transparency and will continue to update stakeholders on developments related to veterinary vaccine import authorisations for FMD control.

Source: SAHPRA

Categories : Respiratory DiseasesTags :

New Study Investigates the Role of Mucus Plugs in COPD

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Understanding the underlying biology of mucus pathology is critical to identifying new therapeutic targets.

Photo by engin akyurt on Unsplash

In people with chronic obstructive pulmonary disease (COPD), dysfunctional airway mucus is common. Mucus plugging (mucus that accumulates in the lungs and reduces airflow) and chronic bronchitis are both related to dysfunctional airway mucus. Sometimes mucus plugging and chronic bronchitis co-occur, but it is quite common to have one or the other but not both conditions. Given the limited availability of disease-modifying treatments for COPD, understanding the underlying biology of mucus pathology is critical to identifying new therapeutic targets.  

In a new study published in the American Journal of Respiratory and Critical Care Medicine, researchers at Boston University Chobanian & Avedisian School of Medicine have found that mucus plugs in the lungs alter the pattern of gene activity in a way that is similar to chronic bronchitis, suggesting that there may be similar underlying causes to both conditions. It is believed these researchers are the first group to study gene activity differences associated with mucus plugging. 

“Mucus plugs are quite common in people with COPD and they are associated with diminished quality of life and increased mortality. By identifying how the presence of mucus plugs impacts the biology of the lung we hope to be able to better treat them, or prevent them from forming in the first place,” says corresponding author Marc Lenburg, PhD, professor of medicine at the school.

The researchers studied participants in the Detection of Early Lung Cancer Among Military Personnel (DECAMP) 2 study who were mostly older US military veterans at high risk for lung cancer due to a history of heavy smoking, many of whom had COPD. Computed tomography was performed on them to determine who had mucus plugs and for those that had them, how extensive they were. From that group, a pulmonologist collected cells from their airways and sequenced the RNA from those cells to determine the level of gene activity. The researchers then compared the gene activity from each individual with the extent of mucus plugging to find genes that had increased (or decreased) activity in individuals with more extensive mucus plugging. Once they had this mucus plugging ‘gene signature’, they compared it with gene signatures from other diseases.

According to the researchers, having a better understanding of how mucus plugging impacts the lung and its relationship to chronic bronchitis may give new clues about how mucus dysfunction develops, which could be helpful for developing new therapies to better treat mucus dysfunction.  “By uncovering the molecular pathways that drive mucus plugging and chronic bronchitis, we aim to identify biological targets for earlier diagnosis and intervention. Ultimately, we hope these insights will translate into therapies that restore airway health, reduce respiratory symptoms, and improve the quality of life for people living with these chronic lung diseases,” says coauthor Ehab Billatos, MD, an assistant professor of medicine at the school. 

Source: Boston University

Categories : Cancer Obstetrics & GynaecologyTags :

Does a Past Abortion or Miscarriage Affect Breast Cancer Risk?

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Photo by National Cancer Institute

The potential effect of induced abortion and miscarriage on the risk of breast cancer has remained debated and has been a persistent source of misinformation. Many previous studies have been small and based on self-reported data. Now, a study published in Acta Obstetricia et Gynecologica Scandinavica found that prior abortion or miscarriage was not linked with an increased risk of developing pre- or postmenopausal breast cancer.

In the nationwide Finnish registry-based study, investigators analysed data on 31 687 women with breast cancer diagnosed in 1972–2021 and 158 433 women without breast cancer.

The risk of breast cancer was found to be similar among women with a history of induced abortion and women with no history of abortion, both before and after 50 years of age. Risks were also similar among women with and without a past miscarriage.

In addition, breast cancer risks did not vary significantly by the number of abortions or miscarriages, nor by the time of first abortion or miscarriage.

“Miscarriage or induced abortion as potential risk factors for breast cancer has continued to raise concerns and has led to the spread of misinformation. In this study using high-quality Finnish registry data, we can reliably eliminate these concerns,” said corresponding author Oskari Heikinheimo, MD, PhD, of the University of Helsinki and Helsinki University Hospital. “Induced abortion or miscarriage are not risk factors for breast cancer, even if there are several of them. This information is important and reassuring for millions of women around the world.”

Source: Wiley

Categories : Diet and NutritionTags :

Two Hours’ Longer Fast Before Bed Improves Cardiometabolic Health

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Participants stopped meals three hours before bed, dimmed the lights and extended their overnight fast by two hours

Photo by Cottonbro on Pexels

A new Northwestern Medicine study has personalised overnight fasting by aligning it with individuals’ circadian sleep-wake rhythm, an important regulator of cardiovascular and metabolic function, all without changing their caloric intake. 

The study found that among middle-age and older adults who are at higher risk for cardiometabolic disease, extending the participants’ overnight fast by about two hours, dimming the lights and not eating for three hours prior to bedtime improved measures of cardiovascular and metabolic health during sleep, as well as during the daytime. Nighttime blood pressure fell by 3.5mmHg while heart rate dipped by 5% compared to controls. while adherence was good – nearly 90%.

“Timing our fasting window to work with the body’s natural wake-sleep rhythms can improve the coordination between the heart, metabolism and sleep, all of which work together to protect cardiovascular health,” said first author Dr. Daniela Grimaldi, research associate professor of neurology in the division of sleep medicine at Northwestern University Feinberg School of Medicine.

The study was published Feb. 12 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, part of the American Heart Association.

“It’s not only how much and what you eat, but also when you eat relative to sleep that is important for the physiological benefits of time-restricted eating,” said corresponding author Dr Phyllis Zee, director of the Center for Circadian and Sleep Medicine and the chief of sleep medicine in the department of neurology at Feinberg.

Previous research has found only 6.8% of US adults had optimal cardiometabolic health in 2017 to 2018. Poor cardiometabolic health can lead to chronic illness, including type 2 diabetes, non-alcoholic fatty liver disease and cardiovascular diseases.

Time-restricted eating has continued to surge in popularity because research has shown it can improve cardiometabolic health and rival traditional calorie‑restricted diets, but most studies have focused on how long people fast, not how their fast lines up with their sleep schedule – a key factor in metabolic regulation.

Given the nearly 90% adherence rate in the study, the study’s novel approach of leveraging the sleep period as an anchor for the timing of time-restricted eating may be a more accessible non-pharmacological strategy for improving cardiometabolic health, particularly in middle-aged and older adults who are at higher risk for cardiometabolic disease, the study authors said.

The study authors said they plan refine the protocol from this study and take it to larger multi-centre trials. 

Improved blood pressure, heart rate, blood-sugar control

In the 7.5‑week study, people who finished eating at least three hours before going to bed saw meaningful improvements compared with those who kept their usual eating routines. They experienced:

  • Improved nighttime patterns in blood pressure (dipping by 3.5%) and heart rate (dipping by 5%): Their bodies showed a more natural drop in both measures during sleep, which is an important sign of cardiovascular health. Notably, their hearts beat faster during the day when they were active and slowed at night when they were resting. A stronger day-night pattern is linked to better cardiovascular health.
  • Better daytime blood‑sugar control: Their pancreas responded more efficiently when challenged with glucose, suggesting it could release insulin more effectively and keep blood sugar steadier.

In the study, 39 overweight/obese participants (36 to 75 years old) completed either an extended overnight fasting intervention (13 to 16 hours of fasting) or a control condition (habitual fast of 11 to 13 hours). Both groups dimmed the lights three hours before bedtime. The intervention group consisted of 80% women.

Source: Northwestern University

Categories : OphthalmologyTags :

Growing Evidence that Metformin Could Treat Age-related Macular Degeneration

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Retina showing reticular pseudodrusen. Although they can infrequently appear in individuals with no other apparent pathology, their highest rates of occurrence are in association with age-related macular degeneration (AMD), for which they hold clinical significance by being highly correlated with end-stage disease sub-types, choroidal neovascularisation and geographic atrophy. Credit: National Eye Institute

Doctors have found further evidence that metformin is associated with less progression of age-related macular degeneration (AMD), the most common cause of blindness in Western countries. In a study of over 2000 people with diabetes, people over the age of 55 years taking metformin were 37% less likely to develop the intermediate stage of AMD over five years compared to those not taking metformin. The results were published in BMJ Open Ophthalmology.

AMD is a disease which affects the central retina or macular at the back of the eye. It eventually causes the light-sensitive tissue to die off (geographic atrophy, a form of ‘dry’ AMD) or be damaged by abnormal blood vessel growth (‘wet’ AMD). Intermediate and advanced AMD affects 10-15% of people over 65 years of age (1.1 to 1.8 million people in the UK), and is the commonest cause of blindness in high-income countries.

The annual cost of AMD is estimated to be £11.1billion in the UK. Geographic atrophy has no treatment in the UK and Europe, while treatments for wet AMD are expensive and unpleasant (repeated injections into the eye).

The research from the University of Liverpool used pictures taken of the eyes of 2000 people attending the routine diabetic eye disease screening programme in Liverpool over 5 years. The researchers assessed whether AMD was present on the photographs and how severe it was, and then compared those taking metformin and those who were not. They also adjusted for factors which might bias the result, such as age, sex, and duration of diabetes. The odds of developing intermediate AMD over 5 years in the metformin group was 0.63 compared to the no metformin group (95% confidence range 0.43 to 0.92).

A potential benefit from metformin in AMD has been suspected before, but this is the first study to grade AMD from eye photographs. Previous studies on metformin have used secondary information on AMD such as GP diagnostic codes, or insurance claims in the US.

Dr Nick Beare, an eye doctor who led this research, says: “Most people who suffer from AMD have no treatment, so this is a great breakthrough in our search for new treatments. What we need to do now is test metformin as a treatment for AMD in a clinical trial. Metformin has the potential to save many people’s sight.”

Source: University of Liverpool

Categories : Cancer NeurologyTags :

Could a Common Vitamin Treat Glioblastoma?

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Findings indicate vitamin B3 looks promising to help rearm a compromised immune system

Unrestricted tumour growth in mouse brain, left, compared to the tumour growth in a mouse who received niacin treatment, right (both after 42 days). Courtesy Yong lab

Edward (Ed) Waldner had no idea why he didn’t feel well, but he knew he didn’t feel like himself. At 55 years of age, he felt exhausted all the time. It didn’t seem to matter how hard he had worked that day. He wondered if he had sleep apnoea. He noticed his walking was off. His heels would drag now and again. One day, when his symptoms were worse than usual, he decided to go to the Emergency department. 

“The doctor said I had a mass on my brain and needed to see an oncologist,” says Waldner. 

The mass was glioblastoma, a deadly brain cancer. Treatment often involves a three-pronged approach: surgery to remove as much of the tumour as possible, followed by radiation and chemotherapy. However, despite advances in cancer treatment, the aggressive cancer comes back. 

University of Calgary researchers are investigating whether adding high doses of vitamin B3 or niacin to the treatment plan could be beneficial. They approached Waldner about being in the trial.

“I have no problem trying to help anybody. I agreed. I want to help myself, too,” says Waldner. “I can tell you being part of this research helps me mentally because we’re trying. When I left the hospital after surgery I was told, that’s it, that’s all we can do.”

Hotchkiss, Charbonneau members partner for study

The research is led by two members of both the Hotchkiss Brain Institute and Arnie Charbonneau Cancer Institute – Dr Gloria Roldan Urgoiti, MD, PGME’16, an oncologist specialised in brain cancers, and Dr Wee Yong, PhD, a neuroscientist whose research focuses on immune effects on the brain. Together, they designed a study to investigate whether niacin could rejuvenate compromised immune cells to kill tumour cells. The research began in the Yong lab, with mice, where findings showed niacin prolonged survival. That work evolved into a Phase I and II clinical trial.

“Normally, the immune system will try to counter and prevent tumour growth; however, this brain cancer supresses the immune system,” says Yong, a professor at the Cumming School of Medicine (CSM). “Niacin treatment rejuvenates immune cells so they can do what they are supposed to do, attack and kill the cancer cells. I see it as an ongoing ‘battle for the brain.’”

Studying the benefits of adding niacin to chemotherapy, radiation

The clinical trial was designed to determine the maximum dose and potential benefit of controlled-release niacin that could be added to the recommended chemotherapy and radiotherapy treatments. Researchers decided the study would stop if the progression-free survival over six-months did not improve by at least 20 per cent compared with older studies. Early results involving 24 patients showed 82 per cent of the participants were free of progression of the cancer at six months; an increase of 28 per cent from previous studies. The researchers say this is a promising advancement for this incurable cancer. 

“Glioblastoma is the most aggressive brain cancer in adults. Survival of patients with this condition hasn’t changed significantly for 20 years,” says Roldan Urgoiti, a clinical associate professor at the CSM. “Anything that may help should be explored, but it requires strict protocols and safety monitoring.”

The findings were published in the Journal of Neuro-Oncology.

The researchers caution that high amounts of vitamins, like niacin, have toxicity and can have a negative impact on someone’s health if not monitored closely by medical professionals. 

The team hopes to be able to do the final analysis, that will include 48 participants by the end of 2026 or early 2027. 

Waldner says he’s feeling really good these days and is just happy to hear the word “stable” when he goes for his regular scans. 

Source: University of Calgary

Categories : HospitalsTags :

Nurses Match Doctors in Delivering Hospital Care

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Nurse-led hospital care matches doctor-led care for safety and effectiveness

Photo by Hush Naidoo on Unsplash

Nurses can safely deliver many services traditionally performed by doctors, with little to no difference in deaths, safety events, or how patients felt about their health, according to a new Cochrane review. In some cases, nurse-led care even outperformed doctor-led care.

Healthcare services are facing pressure due to an ageing population, complex health needs, long waiting lists, and doctor shortages. Receiving care from nurses, rather than doctors has been proposed as one way to improve access to hospital services for patients who may otherwise face long waits.

A group of researchers from Ireland, United Kingdom, and Australia evaluated nurse-doctor substitution in inpatient units and outpatient clinics, analysing 82 randomised studies involving over 28 000 patients across 20 countries. Studies included advanced nurse practitioners, clinical nurse specialists and registered nurses substituting for junior or senior doctors across specialties such as cardiology, diabetes, cancer, obstetrics/gynaecology, and rheumatology.

Nurse-led hospital care matches doctor-led care for safety and effectiveness

The review found little to no difference between nurse-led and doctor-led care for critical outcomes, including mortality, quality of life, self-efficacy, and patient safety events. While most clinical outcomes showed no difference between groups, nurses may achieve better outcomes in some areas, including diabetes control, cancer follow-up, and dermatology. Doctor-led care performed slightly better in a small number of sexual health and medical abortion follow-up services.

Our findings show that nurse-led services provide care that is just as safe and effective as doctor-led services for many patients. In some areas, patients actually experienced better outcomes when nurses led their care.

— Professor Michelle Butler, lead author from Dublin City University


The models of substitution varied widely, with different grades of nurses operating autonomously, under supervision, or following specialized protocols. There were also differences in training, level of responsibility, and mode of substitution, all of which may influence outcomes.

Butler added:

In some cases, patients had earlier, more frequent, or on-demand appointments with nurses, or had an additional educational component to their care, which may have helped to improve their outcomes.


Evidence on direct costs was limited and varied across studies, partly due to differences in reporting methods, currencies and time periods. Seventeen studies reported reduced costs for nurse-led care, while nine suggested higher costs due to longer consultations, referrals, or prescription differences.

Not a one-size-fits-all solution

However, nurse-doctor substitution is not a one-size-fits-all approach. The authors caution that these interventions should always be interpreted within context. 

Nurse substitution isn’t simply a one-for-one replacement. To work well, these services need the right training, support and models of care, but the evidence shows patients are not disadvantaged and can benefit in meaningful ways.

— Timothy Schultz,  senior author and researcher from Flinders Health and Medical Research Institute


Expanding nurse-led services may help address doctor shortages, but the authors urge that policymakers should consider the impact of these interventions on the nursing workforce, including training and organization.

While the evidence base was substantial, the authors note important gaps. Most studies were from high-income countries, with the majority (39%) conducted in the United Kingdom. The authors call for more studies across specialties, nurse roles and patient types not yet evaluated, as well as stronger consistency in how outcomes are measured. They also highlight the need for more research in low- and middle-income countries, where nurse-led roles could potentially improve access to care in regions facing doctor shortages.

By Mia Parkinson

Read the review here

Source: Cochrane

Categories : RheumatologyTags :

Study Finds People on Colchicine Less Likely to Need Joint Replacement

On By ModernMedia
Photo by Towfiqu barbhuiya: https://www.pexels.com/photo/person-feeling-pain-in-the-knee-11349880/

Gout is the most common form of inflammatory arthritis, with worldwide prevalence of approximately 4%.  The accumulation of monosodium urate crystals in gout leads to the clinical manifestations of the disease and if left inadequately treated, leads to chronic arthritis with joint damage. Due to its anti-inflammatory properties, colchicine, an alkaloid drug derived from the autumn crocus plant, is commonly used in the management of gout for both prophylaxis and treatment of gout flares.

A recent study on colchicine’s potential benefit for cardiovascular disease noted that participants who were taking the drug had fewer joint replacements than those taking a placebo. Since colchicine is commonly used in gout, researchers wondered if colchicine would lower risk of joint replacement in those with gout as well. Further, because osteoarthritis is the most common reason for joint replacement, and because osteoarthritis and gout can occur together, researchers wondered if colchicine could lower the risk of joint replacement in those with both gout and osteoarthritis. 

A new study from Boston University Chobanian & Avedisian School of Medicine has found that people with gout who were prescribed colchicine had a modest 12% risk of joint replacement compared to those who did not receive the drug. Additionally, those with both gout and osteoarthritis who took colchicine had a 23% lower risk of needing joint replacement. 

While it would have been ideal for a clinical trial to address the question of whether colchicine reduces the need for joint replacement in gout, it was not readily feasible to conduct such a trial of adequate sample size and duration. Therefore, the researchers used real-world evidence from a UK population-based database in which they identified people with gout, and then divided that pool into those who were newly prescribed colchicine and those who were not. They then assessed the frequency of knee and hip replacement in both groups. 

According to the researchers, these findings suggest that colchicine may have benefits beyond symptom relief alone. “This observation could have broad implications for duration of colchicine use in gout, which is often limited to just the first six months of getting started on a urate-lowering therapy or limited to treatment of flares,” explains corresponding author Tuhina Neogi, MD, PhD, Professor of Rheumatology and professor of medicine at the school. 

Additionally, Neogi believes these findings have implications for potential benefits of colchicine for osteoarthritis irrespective of gout, which is the most common form of arthritis and a leading reason for joint replacement surgery. “Prior trials of colchicine in osteoarthritis have been largely negative, but they likely have been too small and had too short a duration to detect potential effects,” adds Neogi who also is chief of rheumatology at Boston Medical Center.

These findings appear online in the journal Arthritis & Rheumatology.

Source: Boston University