Pain

In 134 patients with moderate-to-severe osteoarthritic pain, weekly low-dose buprenorphine patches resulted in clinically meaningful reductions in pain comparable with those achieved by twice-daily tramadol therapy. In addition, adverse events were similar between the two groups, and patients in both groups reported a preference for the weekly patches rather than daily tablets for future pain relief.

Karlsson, M. & Berggren, A. -C. Efficacy and safety of low-dose transdermal buprenorphine patches (5, 10, and 20 µg/h) verses prolonged-release tramadol tablets (75, 100, 150, and 120 mg) in patients with chronic arthritis pain: a 12-week, randomized, open-label, controlled, parallel-group, noninferiority study. Clin. Ther. 31, 503–513 (2009).

Complementary and alternative therapy

A study from Turkey is the first to suggest that the use of woolen products can significantly improve symptoms of fibromyalgia. Woolen undergarments covering the body from the shoulder to the thigh and bedding used for 6 weeks significantly reduced pain, tender joints and Fibromyalgia Impact Questionnaire scores in 25 patients with fibromyalgia compared with a control group.

Kiyak, K. A new nonpharmacological method in fibromyalgia: the use of wool. J. Altern. Complement. Med. 15, 399–405 (2009).

Bone diseases

Bone quality could be more important than bone mineral density in predicting fracture risk in male patients with glucocorticoid-induced osteoporosis. Investigators found no association between spinal bone mineral density and the prevalence of vertebral fracture in 86 patients taking prednisolone for at least 6 months, even after adjusting for age and BMI.

Hayashi, K. et al. Bone fragility in male glucocorticoid-induced osteoporosis is not defined by bone mineral density. Osteoporos. Int. doi:10.1007/s00198-009-0901-6

Rheumatoid arthritis

A 25-year study of over 2,000 patients with RA in Finland and the US has revealed that a considerable proportion of patients in both regions have normal measures of disease activity at presentation. Although test results were abnormal in the majority, more than 37% had an erythrocyte sedimentation rate <28mm/h, normal C-reactive protein levels, or negative rheumatoid factor tests. The similarities found across the two regions suggest these findings are generalizable.

Sokka, T. & Pincus, T. Erythrocyte sedimentation rate, C-reactive protein, or rheumatoid factor are normal at presentation in 35%–45% of patients with rheumatoid arthritis seen between 1980 and 2004: analyses from Finland and the United States. J. Rheumatol. doi:10.3899/jrheum.080770