New fibromyalgia criteria, real-world biologic outcomes, and more

This edition offers something for everyone. If you have lupus or RA, you’d be happy to know that we have just published a paper on the safety of hydroxychloroquine, more commonly known by its trade name “Plaquenil.” Plaquenil is widely used in both of these illnesses. It’s also used to treat malaria. But there is one problem with Plaquenil. It can cause damage to the retina. In fact, it can cause blindness. But how often do these problems occur? Pretty much, doctors haven’t known. In the paper I just published with Dr. Michael Marmor, the Stanford University ophthalmologist, we found that toxicity occurred in only ½ of 1 percent of people who used the treatment. The risk of toxicity was low in the first 7 years of exposure, but by 7 years the risk was around 1%. We hope that these findings will aid the rewriting of screening guidelines for eye problems. For now, people being treated with Plaquenil should probably get eye examinations at yearly intervals. It seems likely that by doing that, toxicity, if it occurs, can be detected early. Thanks to everyone with lupus and RA who participated in the study. This study will make a difference to how these illnesses are treated.

The NDB led the development of two sets of new criteria that should be of interest to everyone. First, we led the development of the American College of Rheumatology (ACR) criteria for diagnosing fibromyalgia. And, second, we modified the criteria so they could be used in research in everyone, whether or not you have RA, psoriatic arthritis, osteoarthritis or fibromyalgia. This is an important accomplishment because it allows us to better understand pain problems in all illnesses. Based on this research, we investigated what causes people with RA and OA to develop fibromyalgia type symptoms. We are submitted this research to the ACR annual meeting.

By now, everyone who watches television knows about fibromyalgia from all of the ads that pharmaceutical companies put each day. Here is some other information from the NDB that may help put the advertising in perspective. Do you die from fibromyalgia? No. A 35 year study sponsored by the NDB found no evidence if increased mortality. We evaluated more than 8,000 people with fibromyalgia. Joining me in the study were researchers at the University of Michigan, Georgetown University, and the University of Nebraska.

We also published a major RA study this year. It had two sets of results that I think were interesting. First, that biologic therapy wasn’t as good in real life as in clinical trials. But perhaps that was explained by the second result: Overall, people with RA were doing pretty well. Many were doing well enough so that the biologic therapy couldn’t help as dramatically as in the clinical trials.

If you want to see any of the studies, send us an email and we will get them too you. Thanks to everyone for helping make this year’s research available and important.