Monday, October 28, 2013

ACR Meeting 2013 in San Diego the scientific part




These are some of my interests in the ACR meeting 2013 in San Diego. It's a kind of overview. I'll use it to comment directly and/or to show the links to further information on this blog (at most times). So it's a work in progress. I'll date all the the entries, because otherwise I wouldn't know myself, when I'd written which entry. I've kept the colour coding. Black entries are past the meeting. The original text is at the end in small letters.
01.11.2013


AC0025
Poster #2353: A dual target inhibitor - BTK and JAK3 (AC0025). Preliminary rat study.
29.10.2013

Adalimumab and smoking
Poster #2439: Smoking not associated with reponse to adalimumab in axial SpA. The smoker's choice?
29.10.2013

Alginate-Chitosan beads
I'm very skeptical, but I'll have my time to see how this develops as the study is on rabbits (#76).
27.10.2013

Apremilast
There are a few posters on apremilast (PDE4) in psoriatic arthritis.
27.10.2013

B cell differentiation inhibition
There's a new approach. The cereblon E3 ubiquitin ligase complex is modulated by CC-220, which results in an inhibition of B cell differentiation. I must admit, that I hear of this for the first time. Two abstracts: #41 and #42.
27.10.2013

Brodalumab
Phase 2 study, 24 weeks physical function in psoriatic arthritis. #318
27.10.2013

CC-220
See: B cell differentiation inhibition
27.10.2013

CD40
Poster #40 on blockade of CD40 - CD40L pathway, which "dampens multiple immune responses". Preclinical characterization.
27.10.2013

Clazakizumab
Poster #2385: Anti-IL-6 MAB clazakizumab shows higher potency than tocilizumab. Will this be an advantage? Maybe tocilizumab should be available before clazakinumab comes to the market (which might take a while!)
29.10.2013

Delayed release prednisone
Poster #2265: Delayed release prednisone. I question the study, because I don't consider two hours of morning stiffness as stable disease and would change therapy. The authors compare prednisone given in the evening with a delay mechanism with prednisone given in the morning. They should have compared the delayed release prednisone with common prednisone, given in the evening, at the time. If someone present a study done this way ... , but I guess no one will, at least the drug company can't be interested.
29.10.2013
Methods, as in the abstract: “CAPRA-1, a 12-week, double-blind, controlled study, randomized patients to IR-prednisone taken in the morning or DR-prednisone taken once daily at bedtime (eg, 10pm) in addition to standard DMARD treatment. …”
01.11.2013
Fibrofog and Alzheimer's
This is good news! the data by Katz et al. don't support a transition from fibrofog to Alzheimer's disease.
27.10.2013

Fibromyalgia
Poster #1108 on methylphenidate in Fibromyalgia - conclusions with too many hypothesis.
Dianne Whiting presented an interdisciplinary program for Fibromyalgia. Exercises, Yoga, education, CBT, more.
Poster #1092 on low dose naltrexone in Fibromyalgia - luckily it ended: may be effective, further trial needed. My 2 ct.: dead end street.
28.10.2013

Fish oil and knee OA
Poster #2147: Fish oil doesn't have an effect on structural progression of knee OA. They used 9 g, which would be 18 cps. in Germany.
29.10.2013

Fostamatinib
OSKIRA-2, a phase 3 study. I'll have to check the to posters with earlier publications. #455 and #456.
27.10.2013
Poster #1295 talks about mechanisms for fostamatinib induced blood pressure elevation. And, how about data on radiographic progression?
28.10.2013

Free fatty acids
Poster #1842: Free fatty acids affect arthritic cell. Exact nature not known yet.
29.10.2013

GLPG0634 (JAK1 inhibitor)
#478 Study on dogs and monkeys.
27.10.2013
Poster #2381: GLPG0634 effects on DAS28 and ACRxx, but only in a four week study. Good respose rates though.
29.10.2013

HAQ and consequences of physical activity
Poster #2273: Patient Survey on HAQ reveals an unrecognized aspect of disease activity in RA: consequences of physical activity.
29.10.2013

HM-0523
A novel Syk inhibitor. Abstract #474 tells us that HM-0523 significantly ameliorates the severity of arthritis in rodents.
27.10.2013

Iguratimod
There's a study on iguratimod, which has received Japanese approval in Sept. 2012. Too bad, only N=23! So they should present a larger overview. I don't know, why the company isn't pressing to get an approval by FDA or EMEA.
28.10.2013

Ixekizumab
#343 shows a phase 2 study.
27.10.2013

Knee osteoarthritis
A look at a satellite symposium on glucosamine, chrondroitin sulfate, and hyaluronic acid in knee osteoarthritis.
http://rheumatologe.blogspot.de/2013/11/osteoarthritis-satellite-symposium-at.html
04.11.2013

Life events and developing RA
Poster #2402: Association between life events and an increased risk of developing RA.
29.10.2013

Mavrilimumab
Poster #2378: Mavrilimumab shows a study on lung AE in cynomolgus monkeys. Not very reassuring.
29.10.2013
But there's more, I've found all in all studies, which are worth discussing.

Methotreate
Study #1362 claims: iSyMind reduces MTX induced nausea. A pilot trial of N=4. These people have chuzpe! Perhaps they think of a change of paradigm?
28.10.2013
Poster #1977: Pain related anxiety as a barrier to use methotrexate (MTX) - needle, autoinjector etc. tested on healthy volunteers.
29.10.2013

NI-0101
Poster #????: Novel anti-human TLR4 MAB (NI-0101). Cell study!
29.10.2013

Omega-3 fatty acids and SLE
Poster #2538: SLE patients benefit from omega-3 fatty acids.
29.10.2013

Opiods in Osteoarthritis
EA Wright and colleagues looked at the development of opioid prescriptions in patients with knee osteoarthritis. The authors found a steady increase. The public impact of higher opioid use should be carefully monitored.
27.10.2013

Psoriatic Arthritis - conventional DMARDs
A study be E Lie and colleagues (#343) looked at conventional DMARDs in psoriatic arthritis. The drug survival rate of SSZ after two years is about 30%, LEF is at 41%, and MTX lies at 62%. And MTX achieves higher rates of ACR20, ACR50 and ACR70 at 6 months.
27.10.2013

Sleep disturbances in rheumatic conditions
Poster #1930 i s on sleep disturbances (SD) in different rheumatic conditions. SD leads to higher disease activity.
Authors stress to look also at SD and not only at joint swelling and pain. I'd like to add fatigue.
29.10.2013

Strontium ranelate
A study of strontium ranelate in long bone fractures with delayed union. Single arm study though. Not convincing.
28.10.2013
It seems that the drug company of strontium ranelate is desperately seeking a new field. How about comparing strontium ranelate to a bisphosphonate in the same indication?
01.11.2013

Tender Point Measurement at home (FMS)
There's a study suggesting that self measurement of tender points will have a positive effect. I see in it a method to promote pain sensitization. And: don't physicians and patients have better topics than tender points to talk about?
27.10.2013

Tocilizumab
SC equal to IV. I hope, we"ll soon see an approval to be able to use it.
27.10.2013
Poster #1207: Efficacy of tocilizumab in pats. with AA amyloidosis. But not all responding.
alhkim @alhkim thinks of dz heterogeneity.
I'm surprised that it should work at all in AA amyloidosis. I was waiting for some study, as Prof. Kishimoto mentioned it earlier this year.
28.10.2013

Tofacitinib
There have been eight posters on tofacitinib today. #438 to #445. Most were circling around the question of side effects.
ORAL Sequel had a higher rate of SAE than ORAL Standard (#438).
Tofacitinb has the same rate of gastrointestinal events as TNFi (3439).
Cardiovascular events are not increased (#440).
Tofacitinib has a higher rate of herpes zoster (#441).
Tolerability with and without DMARDs are equal (#442).
US and rest of the world pats. are equal in respect of efficacy and side effects (#443).
Dosing every two weeks has less side effects (#444).
Tofacitinib is an independent risk factor in multi morbid elderly patients (#445).
27.10.2013
Effects of smoking in pats. receiving tofacitinib. Need for longer observation #1418
28.10.2013
Poster #1977: After a plethora of posters on tofacitinib, just one with data on radiographic progression.
29.10.2013

Triple therapy
There's a study on discontinuation rates of triple therapy in RA, result: high rate, but further work is needed.
28.10.2013

Unique self joint examination tool
Poster #2242: Despite a unique self joint examination tool, pat. and physicians joints counts differ significantly.
29.10.2013

Ustekinumab
Poster #????: Actually more than one poster on ustekinumab in psoriatic arthritis. It's approved in Europe, now.
29.10.2013

VX-509
Poster #2350: New data by VX-509 (JAK3i). Pain, HAQ-DI etc. are better, but DAS28 or ACR20 aren’t shown.
29.10.2013

Weather and RA
Poster #1359 addresses the question: Does RA disease activity correlate with weather conditions? DAS28 is lower under sunny and dry weather conditions.
28.10.2013
There have been two posters/abstracts addressing the issue, look here: http://rheumatologe.blogspot.de/2013/11/influence-of-weather-on-rheumatoid.html
06.11.2013




This is the scientific part of my ideas on the 2013 ACR meeting in San Diego. I plan it to write part of it, while I'm still at the meeting and not afterwards. So it's a work in progress. I'll keep topics in alphabetical order per day and rearrange the text at home. I'll go into details to some of the topics, when I'm back home.

Alginate-Chitosan beads
I'm very skeptical, but I'll have my time to see how this develops as the study is on rabbits (#76).

Apremilast
There are a few posters on apremilast (PDE4) in psoriatic arthritis.

B cell differentiation inhibition
There's a new approach. The cereblon E3 ubiquitin ligase complex is modulated by CC-220, which results in an inhibition of B cell differentiation. I must admit, that I here of this for the first time. Two abstracts: #41 and #42.

Brodalumab
Phase 2 study, 24 weeks physical function in psoriatic arthritis. #318

CC-220
See: B cell differentiation inhibition

CD40
Poster #40 on blockade of CD40 - CD40L pathway, which "dampens multiple immune responses". Preclinical characterization.

Fibrofog and Alzheimer's
This is good news! the data ba Katz et al. don't support a transition from fibrofog to Alzheimer's disease.

Fostamatinib
OSKIRA-2, a phase 3 study. I'll have to check the to posters with earlier publications. #455 and #456.

GLPG0634 (JAK1 inhibitor)
#478 Study on dogs and monkeys.

HM-0523
A novel Syk inhibitor. Abstract #474 tells us that HM-0523 signicifantly ameliorates the severity of arthritis in rodents.

Ixekizumab
#343 shows a phase 2 study.

Opiods in Osteoarthritis
EA Wright and colleagues looked at the development of opioid prescriptions in patients with knee osteoarthritis. The authors found a steady increase. The public impact of higher opioid use should be carefully monitored.

Psoriatic Arthritis - conventional DMARDs
A study be E Lie and colleagues (#343) looked at conventional DMARDs in psoriatic arthritis. The drug survival rate of SSZ after two years is about 30%, LEF is at 41%, and MTX lies at 62%. And MTX achieves higher rates of ACR20, ACR50 and ACR70 at 6 months.

Tender Point Measurement at home (FMS)
There's a study suggesting that self measurement of tender points will have a positive effect. I see in it a method to promote pain sensitization. And: don't physicians and patients have better topics than tender points to talk about?

Tocilizumab
SC equal to IV. I hope, we"ll soon see an approval to be able to use it.

Tofacitinib
There have been eight posters on tofacitinib today. #438 to #445. Most were circling around the question of side effects.
ORAL Sequel had a higher rate of SAE than ORAL Standard (#438).
Tofacitinb has the same rate of gastrointestinal events as TNFi (3439).
Cardiovascular events are not increased (#440).
Tofacitinib has a higher rate of herpes zoster (#441).
Tolerability with and without DMARDs are equal (#442).
US and rest of the world pats. are equal in respect of efficacy and side effects (#443).
Dosing every two weeks has less side effects (#444).
Tofacitinib is an independent risk factor in multi morbid elderly patients (#445).

Sunday, 27th of October.


Fibromyalgia 
Poster #1108 on methylphenidate in Fibromyalgia - conclusions with too many hypothesis.      
Dianne Whiting presented an interdisciplinary program for Fibromyalgia. Exercises, Yoga, education, CBT, more.
Poster #1092 on low dose naltrexone in Fibromyalgia - luckily it ended: may be effective, further trial needed. My 2 ct.: dead end street.

Fostamatinib
Poster #1295 talks about mechanisms for fostamatinib induced blood pressure elevation. And, how about data on radiographic progression?
Iguratimod
There's a study on iguatimod, which has received Japanese approval in Sept. 2012. Too bad, only N=23! So they should present a larger overview. I don't know, why the company isn't pressing to get an approval by FDA or EMEA.

Methotreate
Study #1362 claims:  iSyMind reduces MTX induced nausea. A pilot trial of N=4. These people have chuzpe! Perhaps they think of a cange of paradigm?

Strontium ranelate
A study of strontium ranelate in long bone fractures with delayed union. Single arm study though. Not convincing.

Tocilizumab
Poster #1207:  Efficacy of tocilizumab in pats. with AA amyloidosis. But not all responding.
alhkim @alhkim thinks of  dz heterogeneity.
I'm surprised that it should work at all in AA amyloidosis. I was waiting for some study, as Prof. Kishimoto mentioned it earlier this year.

Tofacitinib
Effects of smoking in pats. receiving tofacitinib. Need for longer observation #1418

Triple therapy
There's a study on discontinuation rates of triple therapy in RA, result: high rate, but further work is needed.

Weather and RA
Poster #1359 addresses the question: Does RA disease activity correlate with weather conditions? DAS28 is lower under sunny and dry weather conditions.

Monday, 28th of October

AC0025
Poster #2353: A dual target inhibitor - BTK and JAK3 (AC0025). Preliminary rat study.

Adalimumab and smoking Poster #2439: Smoking not associated with reponse to adalimumab in axial SpA. The smoker's choice?

Clazakizumab
Poster #2385: Anti-IL-6 MAB clazakizumab shows higher potency than tocilizumab. Will this be an advantage? Maybe tocilizumab should be available before clazakinumab comes to the market (which might take a while!)

Delayed release prednisone Poster #2265: Delayed release prednisone. I question the study, because I don't consider two hours of morning stiffness as stable disease and would change therapy. The authors compare prednisone given in the evening with a delay mechanism with prednisone given in the morning. They should have compared the delayed release prednisone with common prednisone, given in the evening, at the time. If someone present a study done this way ... , but I guess no one will, at least the drug company can't be interested.

Fish oil and knee OA
Poster #2142: Fish oil doesn't have an effect on structural progression of knee OA. They used 9 g, which would be 18 cps. in Germany
      
Free fatty acids
Poster #1842: Free fatty acids affect arthritic cell. Exact nature not known yet.

GLPG0634
Poster #2381: GLPG0634 effects on DAS28 and ACRxx, but only in a four week study. Good respose rates though.

HAQ and consequences of physical activityPoster #2273: Patient Survey on HAQ reveals an unrecognized aspect of disease activity in RA: consequences of physical activity.

Life events and developing RA Poster #2402: Association between life events and an increased risk of developing RA.

Mavrilimumab
Poster #2378: Mavrilimumab shows a study on lung AE in cynomolgus monkeys. Not very reassuring.

Methotrexate and anxiety Poster #1977: Pain related anxiety as a barrier to use methotrexate (MTX) - needle, autoinjector etc. tested on healthy volunteers.

NI-0101
Poster #????: Novel anti-human TLR4 MAB (NI-0101). Cell study!


Omega-3 fatty acids and SLE
Poster #2538: SLE patients benefit from omega-3 fatty acids. 

Sleep disturbances in rheumatic conditions
Poster #1930 i s on sleep disturbances (SD) in different rheumatic conditions. SD leads to higher disease activity.
Authors stress to look also at SD and not only at joint swelling and pain. I'd like to add fatigue.
 Tofacitinib Poster #1977: After a plethora of posters on tofacitinib, just one with data on radiographic progression.

Unique self joint examination toolPoster #2242: Despite a unique self joint examination tool, pat. and physicians joints counts differ significantly.

UstekinumabPoster #????: Actually more than one poster on ustekinumab in psoriatic arthritis. It's approved in Europe, now.


VX-509 Poster #2350: New data by VX-509 (JAK3i). Pain, HAQ-DI etc. are better, but no DAS26 or ACR20 is shown.
 

Tuesday, 29th of October
 

Sunday, October 27, 2013

ACR Meeting 2013 in San Diego the social part


Finally I arrived at San Diego Airport. Modern flight connection are always fun to look, if you end up at the intended point. you might remember my and other participants of this year's EULAR meeting to attend the tweetup, so why should going to San Diego have less problems? I've selected a direct flight from London Heathrow and a good connection from Duesseldorf. The plane was late, I missed the flight ... and went to the connecting flight center with a wonderful staff, who got me on a plane to Washington D.C., where I've spent the night a good hotel (advertising laws prohibit telling you the name). Next day I was on the early plane to San Diego (started the day at 36 deg. F and got off the plane at 64 F) and could see interesting landscape in the South West of the US. As I haven't been on a day plane across this part of the US, I enjoyed the flight very much and so the Yin Yang principle was showing off - there's always something white in black and vice versa.


Snowy peaks



Canyons



Downtown San Diego

I might change some of the images late or work on them. All in all you see a work in progress.

After arriving a day late at me hotel, I had the opportunity to see a little bit of San Diego and Coronado, which is a must. Especially as I know a very good book store near the famous Hotel de Coronado (the one shown in "Some like it hot" by Billy Wilder, starring Marilyn Monroe and Jack Lemmon). I went to the hotel as I'm also a friend of the Italian opera.


Coronado Ferry and the Congress Center in the back

More picture on the other camera, from which I might select other pictures later.


Now it's on with the meeting - and ... I'm looking forward to this evenings's tweetup.

I've already met with the people around the Rheumatoid Patient Organization, more to meet this evening.




You might recognize Britt @HurtBlogger and Shannon @SocialMediaShan


Yesterday evening we had our tweetup. Thanks to Paul Sufka at a real nice place in the Gaslamp Quarter. Lots of interesting talks with rheumatologists and patients around the world. I'd miss something, if this tweetup wouldn't be here.


That's where the action was ... later with Reggae Music

Here's a who's who of the participants at the San Diego 2013 ACR Sunday evening tweetup (alphabetical order of Twitter names):
@BetsyRapp               Betsy Rapp
@carvicab                  Carlo V. Cballero
@claireriddell77         Claire Riddell
@drbeckyg                 Rebecca Grainger
@drbhana                   Suleman Bhana
@dsymons                  Dana Symons
@kitteybeth               Katie Beth Young
@Larhumato               Francis Berenbaum
@philipcrobinson        Philip C. Robinson
@psufka                     Paul Sufka
@rawarrior                 Kelly Young
@Rheumatologe          Lothar M. Kirsch 
@RonanTKavanagh      Ronan T. Kavanagh
@samwhittle               Sam Whittle
@SocialMediaShan       Shannon Ragland
@stefansiebert            Stefan Siebert
@synovialjoints           Antoni Chan
And there were also, Anne, Becky, Isabelle.
(Any mistake or omission is my mistake - please notify me and I'll make the necessary corrections)



Too bad, some picture aren't clearly seen, but we'll work on it in the future.

I liked the talks, the internationality (U.S.A., Colombia, Ireland, Northern Ireland, France, Germany, Australia, New Zealand, South Africa - did I miss a country?) - hope that today more will join. And I liked that physician and patients come together.

Today I had a busy morning and looked at lots of posters.
Midday we had our noon tweetup with quite a lot of people attending, 2/3 hadn't been at yesterday's tweetup, so I'd like to call our two meeting successful. Thanks for organizing and also for participating.


Won't like having missed the 2nd tweetup!

Today I went to some interesting session, looked at a multitude of posters, even more interesting than the days before. And I took time to relax in San Diego's sunshine.


Directly from the Congress Center


Relaxing after a session at the Hilton


Interior of the San Diego Convention Center


A look to the city of San Diego from the CC


The Hotel del Coronado


The wish I was there picture





Sunday, October 20, 2013

Wetter und entzündlich-rheumatische Erkrankungen



Es ist nicht ungewöhnlich, dass Patienten mit entzündlich-rheumatischen Erkrankungen über eine Zunahme von Symptomen bei bestimmten Wetterbedingungen berichten. Einige meiner Patienten fühlen anhand ihrer Symptome, dass es bald regnen wird. Andere Patienten mit rheumatoider Arthritis berichten, dass Kälte, feuchte Witterungsbedingungen oder Luftdruckänderungen ihre Symptome, wie Schmerzen, Steifigkeit oder Gelenkschwellungen, verschlechtern.
Die Ergebnisse von Studien zu den Auswirkungen des Wetters auf die rheumatoide Arthritis sind hingegen nicht schlüssig

Wetterfühligkeit – Befunderhebung aus den letzten Wochen:

„Nicht das Wetter an sich, sondern die Veränderung, egal, welche Richtung führt bei mir zu mehr Beschwerden.“ (weibl, RA)

„Wenn so ein Wetterumschwung ist. Ich weiß aber nicht, ob das nicht eine Kopfsache ist. Wenn so eine Regenfront kommt. Bei Sonnenschein geht es mir besser.“ (weibl., RA)

Wetterfühligkeit: keine (weibl., PsoA)

„Vielleicht lag es daran, als es wieder schlechter wurde. Ich fand die Wärme richtig schön. Man kann doch nicht alles aufs Wetter schieben. Wenn es nicht so schlagartig gehen würden, sondern die Temperaturen so peu à peu runtergehen würden.“ (weibl., RA)

„Das nasskalte Wetter ist nicht gerade förderlich. Aber es geht dann nicht besonders heftig. Das warme Wetter liegt mir, aber sonst bekomme ich auch nicht so Schübe.“ (weibl, AS)

„Ganz schlimm. So ein Wetter [nass-kalt] ist tödlich.“ (weibl, AS)

„Schwitzen bei warmem Wetter, sonst nichts.“ (weibl., RA)

„Seit das Wetter von warm wieder umgeschwungen ist, habe ich wieder mehr Beschwerden. Aber vielleicht bilde ich mir das nur ein. (männl., RA)

Wetterfühligkeit: „Ich würd’ sagen nein.“ (männl., RA)

„Das hängt vom Wetter ab. So nass-kalt, da hab’ ich wieder mehr Beschwerden. Ich merk’ 100%ig, wenn sich das Wetter dreht.“ (weibl., RA)

„Den Wetterumschwung merke ich sofort im Rücken.“ (männl., PsoA)

„Es gibt eine Wohlfühltemperatur. Es darf nicht zu heiß und nicht zu kalt sein.“ (weibl., RA)

„Seit dem Wetterumschwung sind die Hände angeschwollen. Mehr Müdigkeit. Träger. So das Übliche, wenn das Wetter umschwingt.“ (weibl., SLE)

„Bei dem Wetterumschwung letzte Woche habe ich eine Handschiene getragen, weil die ganze rechte Hand sehr wehgetan hat. Ich habe die dann sofort ruhig gestellt. Am nächsten Tag ist es dann wieder in Ordnung. Ich kann Ihnen sagen, wenn’s warm wird, denn dann steht mein rechter kleiner Finger von der Hand nach außen weg.“ (weibl., RA)

„Wenn es regnet oder wenn das Wetter wechselt, werden die Schmerzen stärker.“ (männl., AS)

„Mit dem Regen ist es schlechter. Ich habe mehr Schmerzen, wenn es feucht ist. (weibl., RA/SLE)

„Ich hatte zum ersten Mal das Gefühl, dass es mit dem Wetter zusammenhängt. Das habe ich sonst nie so erlebt. Der Regen.“ (weibl., RA)

„Die Feuchtigkeit muss es sein. Am Samstag war meine Termin für die Spritze, ich habe das zwei bis drei Tage vorher gemerkt.“ (weibl, RA)

„Ich werd’ immer wetterfühliger. Mehr Probleme bei feuchtem und kaltem Wetter. Aber auch in klimatisierten Räumen. Laufen fällt schwerer und das Atmen und mein Herz rast.“ (weibl., RA plus Lungenbeteiligung)

„Seit Donnerstag habe ich wieder mehr Beschwerden. Der Regen, die Kälte.“ (weibl. RA)

„Immer wieder mal Beschwerden. Sobald Feuchtigkeit draußen in der Luft ist.“ (weibl., AS)

„Bei Regenwetter schmerzen alle Gelenke. Bei nassem Wetter merke ich es sofort, dann kann ich nicht Laufen. Im Sommer ist es besser. Jetzt tut es überall weh.“ (weibl, RA)

„Vor allen Dingen jetzt bei dem Wetter [wir es wieder schlimmer]. Bevor der Umschwung kommt. Den anderen Tag haben wir Regen. Dann kann ich auch nicht Schlafen.“ (männl., PsoA)

„Wenn der Wetterwechsel kommt, wenn es feucht wird, wenn der extreme Wetterwechsel kommt, dann ist Steifigkeit wesentlich länger; dann will man den Ellenbogen gar nicht irgendwo auflegen. Egal, ob es von schön auf schlecht oder umgekehrt umschlägt.“ (männl., RA)

„Letzter Wetterumschwung vor 14 Tagen führte zu einer Schwellung unter dem rechten Fuß, die 2 bis 2 ½ Tage anhielt. Kühlen mit Eis halfe auch nicht. Rechte Hand von der Außenkante ausgehen, bis es die ganze Hand überzog.“ (männl., RA)

„Wenn es jetzt so kalt wird, habe ich immer kalte Hände; Füße auch.“ (weibl, RA)

(RA – rheumatoide Arthritis, PsoA – Psoriasisarthritis, AS – ankylosierende Spondylitis, SLE systemischer Lupus erythematodes)


Beim Wetter scheint besonders regnerisches und kaltes Wetter Gelenkschmerzen und Steifigkeit zu erhöhen. Aber es trifft nicht auf alle gleichermaßen zu. Wahrscheinlich fühlen sich auch nicht Erkrankte weniger gut als Patienten mit entzündlich-rheumatischen Erkrankung. Ich nehme an (Hypothese), dass die Empfindlichkeit gegenüber Wettereinflüssen durch die Erkrankung verstärkt wird – leider kann ich das nicht mit einer Studie belegen. Für mich trifft es eine Patientin am ehesten: „Es gibt eine Wohlfühltemperatur. Es darf nicht zu heiß und nicht zu kalt sein.“ Und ich darf ergänzen: feucht sollte es auch nicht sein.