With the prayer mill
Pilgrims walk around Jokhang
Holy smoke rising
Butter lamps lighting
The dark halls of the
temple
Pilgrims keep moving
Holy smoke rising
In front of busy Jokhang
Pilgrims prostrating
Wednesday, January 6, 2016
Tuesday, January 5, 2016
Fish oil in knee osteoarthritis?
“Fish oil in knee
osteoarthritis?” is an interesting question. I’ve already mentioned a study
here on this blog:
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
The researchers sit
predominantly in the area of Adelaide (University of Adelaide) and I’ve been in
contact with them. In different groups they research fish oil in rheumatoid
arthritis and other diseases.
Now, they’ve published two
year data on Fish oil in knee osteoarthritis (OA). 202 patients with knee OA were
randomised 1:1 to high-dose fish oil (4.5 g omega-3 fatty acids) 15 ml/day or low-dose
fish oil (blend of fish oil and sunola oil; ratio of 1:9, 0.45 g omega-3 fatty
acids) 15 ml/day. “The primary endpoints were Western Ontario and McMaster
Universities Arthritis Index (WOMAC) pain score at 3, 6, 12 and 24 months, and
change in cartilage volume at 24 months. Secondary outcomes included WOMAC function,
quality of life, analgesic and non-steroidal anti-inflammatory drug use and
bone marrow lesion score.” Results: “…the low-dose fish oil group had greater
improvement in WOMAC pain and function scores at 2 years compared with the
high-dose group …” Other endpoints didn’t reach statistical significance. The
authors concluded: “In people with symptomatic knee OA, there was no additional
benefit of a high-dose fish oil compared with low-dose fish oil. The
combination comparator oil appeared to have better efficacy in reducing pain at
2 years, suggesting that this requires further investigation.”
Maybe, maybe not. The
study didn’t have a placebo arm. Maybe omega-3 fatty acids like in fish, fish
oil or flax oil will have a place in the treatment of rheumatoid arthritis or
other auto-inflammatory diseases, but knee osteoarthritis might not benefit.
However, I don’t want to sound too apodictical – please go on with your
research.
References:
CL Hill et al.: Fish oil
in knee osteoarthritis: a randomised clinical trial of low dose versus high
dose. Ann Rheum Dis. 2016 Jan;75(1):23-9. doi: 10.1136/annrheumdis-2014-207169.
http://www.ncbi.nlm.nih.gov/pubmed/26353789
Carpe Diem Haiku No. 891 joy of living
Into the marshlands
The wanderer bursts with joy
White herons fly up
Sprawling green pasture
Grass drilling through the harsh ground
Sparrows flying by
Monday, January 4, 2016
Biomimics
What are biomimics, you
might ask. I did the same thing. Well, with the proliferation of biosimilars,
we should be able to tell the one from the other.
Dr.Martínez (@MtzReuma) already has tweeted about a
year ago: “… Biosimilars are NOT "biomimics" (AKA intended copies) …”
(https://twitter.com/mtzreuma/status/569270634057871360).
I won’t leave you with this statement though it already tells you what biomimcs
are, but I’ll try to go a little deeper in the subject. “Biomimics, also known
as intended copies, are non-originator biologicals that have received marketing
approval before biosimilar regulations were put in place. They are currently
available in some Asian and Latin American countries.” Link: http://www.gabionline.net/layout/set/print/Biosimilars/Research/Approval-of-biosimilars-in-rheumatology.
Yisaipu (益赛普) is an
etanercept biomimic from China which is also sold as Etanar/Etart/Etacept in
Colombia, Mexico, and India. Yisaipu wasn’t compared to innovator Etanercept. Infinitam
is another etanercept biomimic, manufactured and marketed by Probiomed, a
Mexican company.
Reditux® is biomimic marketed
by Dr Reddy's Laboratories in Bolivia, Chile, India, Iran, and Peru; Wikipedia
uses the classification as a “non-comparable biologic (NCB) version of rituximab”;
link: https://en.wikipedia.org/wiki/Reditux.
Also marketed in Paraguay by Farmasa as Tidecron®. Kikuzubam®, another biomimic
of rituximab, is marketed by Probiomed in Bolivia, Chile, Mexico, and Peru.
A biosimilars must demonstrate equivalent efficacy and safety in
head-to-head clinical studies with the originator biological. Biomimics fail to prove biosimilarity. Maybe Reditux®
could prove to be a biosimilar to originator rituximab, but hasn’t done so as it
has been approved in 2007 in India and won’t try to go to European or Northern
American markets; until then it should be called a biomimic (I wouldn’t use the
term “non-comparable biologic (NCB)”).
Take away message: Biomimics,
also known as intended copies, are non-originator biologicals, that failed to
prove biosimilarity.
Link:
Gilberto
Castañeda-Hernández and colleagues: Biosimilars in rheumatology: what the
clinician should know. http://rmdopen.bmj.com/content/1/1/e000010.full
Monday, December 21, 2015
Carpe Diem Haiku No. 884 on our way home: the scent of early rice, the tomb also shakes, autumn coolness, red more red, a lovely name, how pitiful
This cool evening
Suddenly the crickets’ song
Reflects early snow
Small space of the grave
For the warrior to rest
Big space for a bow
Sunday, December 20, 2015
Carpe Diem Haiku No. 883 journey through the rough north of Honshu: a rough sea; in one house
Water gushing down
Stones clatter in the ravine
Lovers in slumber
Walking at the shore
The stones calm, not trembling
Soon the flood rolls in
Weihnachten und Frühling
Dieser Tage kam die Meldung, dass die Haselnusspollen so aktiv sind wie sonst im April. Heute gehe ich durch Köln und Meerbusch und es sieht nach Frühling aus. Auch von der Temperatur her. Ich habe einige Fotos geschossen:
Weidenkätzchen
Ich gebe zu, diese Blüten machen nicht viel her
Dafür diese frischen Efeublätter
Oder diese Blüten, die so herrlich duften
Die KVB hat alles neu gemacht, sieht also nach Winter aus
Also so einen Vorfrühling beschrieb ich 2014 hier:
Early spring in the Rhineland / 莱茵兰春早
http://rheumatologe.blogspot.com/2014/02/vorfruhling-im-rheinland.html?spref=tw
Und im letzten Jahr sah es so aus:
Spring is approaching
http://rheumatologe.blogspot.com/2015/02/spring-is-approaching.html?spref=tw
Aber bislang war es zwischendurch immer Winter gewesen. Das aber kann es ja noch werden..
Nachträge zum Jahreswechsel (05.01.2016):
In der Eifel, wo es sonst sehr, sehr kalt ist
Auch in der Eifel
Aber das ist in Köln
Subscribe to:
Posts (Atom)