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American College of Rheumatology, Nov. 14-19

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By Beth Gilbert HealthDay Reporter

The annual meeting of the American College of Rheumatology was held this year from Nov. 14 to 19 in Washington, D.C., and attendees included rheumatology specialists, physicians, scientists, and other health professionals. The conference featured presentations focusing on the latest advances in the diagnosis and treatment of arthritis as well as other rheumatic and musculoskeletal diseases.

During one presentation, Chuan-Ju Liu, Ph.D., of the Yale University School of Medicine in New Haven, Connecticut, discussed how the sodium channel Nav1.7 represents a novel and actionable target to preserve joint structure and slow osteoarthritis progression, addressing not only pain but also structural deterioration.

Liu highlighted recent discoveries linking sodium channel Nav1.7 to the regulation of joint structure in osteoarthritis. He outlined how sodium channels in chondrocytes play a critical role in maintaining cartilage integrity and how targeting these channels could mitigate cartilage degeneration.

“Preclinical studies demonstrated that modulating Nav1.7 can prevent joint deterioration, suggesting a promising therapeutic approach,” Liu said. “Although still in the early stages, this research points toward the potential for developing sodium channel inhibitors or modulators as disease-modifying treatments for osteoarthritis. Over time, this approach may complement or reduce reliance on existing treatments like nonsteroidal anti-inflammatory drugs, which primarily address symptoms and often have side effects.”

In another presentation, Daniel Clauw, M.D., of the University of Michigan in Ann Arbor, discussed cannabis therapy for chronic pain among patients with rheumatic diseases.

Currently, there are very few randomized clinical trials evaluating the effectiveness and safety of cannabis products. In addition, the results of these studies can vary based on dose, mode of administration, and an individual’s metabolism. It is also difficult to determine how much cannabidiol (CBD) and tetrahydrocannabinol (THC) are contained within cannabis products. However, Clauw stressed that cannabis can still be a relatively safe and effective option for the treatment of chronic pain.

“Cannabis products likely have a role in treating pain but more research needs to be done regarding what cannabis products work for what types of pain,” Clauw said. “We know that CBD is quite safe and legal in all of the United States and people should try that before venturing to THC, which may be helpful in some but has far more potential side effects.”

Lihi Eder, M.D., of the Women’s College Hospital and University of Toronto, discussed how understanding sex-related differences in psoriatic arthritis is critical to developing approaches that consider the sex of the patient in disease management.

Male and female patients with psoriatic arthritis may present differently, with female patients having more pain and disability and a lower response to biologic therapies compared with their male counterparts. Eder said that the mechanisms behind these findings remain unclear, but the differences could be related to biological mechanisms such as pain processing, immune function, and the pharmacokinetics of drugs. They could also be due to sociocultural factors, including coping mechanisms, support systems, and access to care.

“Considering sex/gender in patient care could improve outcomes. For example, use of more sensitive imaging such as ultrasound to investigate the source of pain may be more important in females and could provide insights about the cause of pain and inform therapy,” Eder said. “More research is needed to identify mechanisms for the observed differences.”

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