Posted on Fibromyalgia

New Ground-Breaking Treatment for Fibromyalgia Now Available

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“Research shows that fibromyalgia has low credibility in healthcare, leading to poor treatment, lack of knowledge and disinterest from medical professionals.”[

This statement will come as no surprise to many fibromyalgia sufferers, who frequently feel as though they are being fobbed off by doctors, with scepticism and disregard for the seriousness of their illness. Considering that this condition affects up to 6.6% of the population, it is time that this changed.

Lack of Treatment Options
Having finally been given a diagnosis to explain their symptoms of widespread pain, fatigue, brain fog, sleep disturbances and more, patients are then subjected to the news that there is no cure for this condition, and very few treatment options to relieve their suffering. A 2021 change to the NICE guidelines even means that painkilling medication is no longer routinely offered, further reducing the available help.

A New Approach
Fibromyalgia is notoriously difficult to detect, with blood tests and other examinations often failing to show any abnormalities. However, advances in brain imaging led to the discovery that the areas of the brain responsible for processing sensory information from the body, including pain, were overactive in people with the condition[].

This is where Transcranial Magnetic Stimulation (TMS) comes in.

TMS has been used for over 20 years to treat a variety of mental health issues. It works by either stimulating or inhibiting specific regions of the brain, helping to return the activity levels of these areas back to normal[. At TMS London, they use this technology to target the overactive pain-processing region of people with fibromyalgia, and reduce this activity back to healthy levels, enabling them to help their patients to feel less pain, and have an improved quality of life[].

Non-invasive and Medication Free
The best part about this new treatment; it requires no medication or anaesthetic, it is incredibly safe[5], and many of their patients even report the sessions to be relaxing and enjoyable. Their team of experts love nothing more than talking about all things TMS and fibromyalgia, so please get in contact with them if you would like to hear more about this revolutionary new approach.

Posted on Rheumatoid arthritis

Ultra-Low Dose Rituximab Controls Disease Activity for Most RA Patients in New Study

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 New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that in one study, the majority of rheumatoid arthritis patients on an ultra-low dose of the drug rituximab maintained low disease activity for up to four years, and rarely needed to switch to other biologic drugs or glucocorticoids to control their disease (Abstract #1443). 

Rheumatoid arthritis (RA) is the most common type of autoimmune arthritis. It is caused when the immune system (the body’s defense system) is not working properly. RA causes pain and swelling in the wrist and small joints of the hands and feet.The optimal dose of rituximab for RA treatment remains unclear, and both 1,000 and 2,000 milligram doses every six months have been shown to be equally effective in previous studies. In another recent trial, six-month efficacy of ultra-low rituximab doses of 200 mg and 500 mg were compared to the 1,000 mg dose. Patients in that trial were invited to participate in this new extension trial to follow their progress on ultra-low doses of rituximab for up to four years. “We conducted this extension (study) to build on the results of the original trial. In that study, the effects of 200 and 500 mg appeared to be similar to those of 1,000 mg, but we could not yet show that statistically,” says Nathan den Broeder, MSc, a PhD student at Sint Maartenskliniek in the Netherlands and the study’s co-author. “There was also a concern that the lower doses might work for a limited time, but then lose their effect on a longer time frame.” Data was collected on patients’ disease activity through April 2021 measured by disease activity scores, or DAS-28, and C-reactive protein levels, and their use of RA medications, including biologic or targeted disease-modifying anti-rheumatic drugs (DMARDs), conventional synthetic DMARDs and glucocorticoids. The primary outcome for the study was disease activity, and secondary outcomes included rituximab persistence, doses and intervals, as well as use of other RA medications. 

Out of 142 patients in the previous trial, 118 were included in this new extension study, with a mean follow-up period of 3.2 years. Seven patients switched to another biologic or targeted synthetic DMARD and were then removed from the disease activity analyses. Researchers found that patients taking either ultra-low dose rituximab had non-inferior disease activity compared to those on 1,000 mg. The median yearly rituximab dose was 978 mg. The final rituximab dose per infusion was 200 mg in 37 patients, 500 mg in 47 patients, and 1,000 mg in 34 patients. The median final interval between infusions was 6.0 months for those on 200 mg, 6.2 months for those on 500 mg, and 6.4 months for those on 1,000 mg. The need for glucocorticoid treatment, typically required with patients’ disease flares, was low: 0.38 steroid injections per patient-year and 0.05 initiations or dose increases of oral glucocorticoids per patient year. The study’s results show that most patients in the trial who were treated with ultra-low dose rituximab remained on these doses, in some cases for up to four years, maintained low disease activity, and their disease activity did not differ in any relevant way between doses. Patients on ultra-low doses of rituximab rarely needed to switch to other disease-modifying drugs or use glucocorticoids. 

“Ultra-low dose rituximab is effective in many patients who already responded well to higher doses. The benefits are significant: we showed in the original trial that ultra-low dose rituximab results in fewer infections compared to the standard 1,000 mg dose, something that is especially relevant in the current pandemic,” says den Broeder. “Another benefit is that the duration of the infusion, which can normally take several hours, can be shortened with administering these lower doses. Finally, there are important cost-savings with using ultra-low dose rituximab, a relatively expensive drug. In short, by using ultra-low dose rituximab, patients can expect fewer infections as side effects, shorter infusion times, and lower treatment costs.”

Posted on Autism

Unhealthy patterns of diet, exercise, and sleep linked to high risk of cardiovascular disease in autistic people

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Autistic people have far greater risks of long term physical health conditions than others, but the reasons for this remain unclear. New research from the University of Cambridge suggests that unhealthy lifestyle habits may be an important contributing factor. 

These findings help us to better understand the experiences of autistic adults, and have wider implications for quality of life. We need to understand the reasons for restricted diet, limited exercise, and lack of sleep, to provide better supportElizabeth Weir

The results are published today in the journal Molecular Autism.

Earlier research suggests that autistic people die 16-35 years younger than expected, and that greater health problems may contribute to this risk. The present study is the first to consider the diet, exercise, and sleep patterns of autistic adults and how these patterns may relate to health outcomes.

The team at the Autism Research Centre in Cambridge developed an anonymous, online survey about lifestyle choices and daily habits, personal medical history, and family medical history. The final study included 1,183 autistic adults and 1,203 non-autistic adults aged 16-90 years.

The results showed that autistic adults were far less likely than non-autistic adults to meet very minimal health recommendations for diet, exercise, and sleep. Autistic adults were also far more likely to have atypical eating patterns (including limited diet) and sleep disturbance. They were more likely to be underweight or obese than non-autistic individuals.

These poor lifestyle habits were associated with greater risk of cardiovascular conditions such as high blood pressure, heart disease, and stroke among autistic males, and this was a stronger association even than a family history of a cardiovascular condition. Though it is not possible to say conclusively that a poorer lifestyle led to cardiovascular problems, the findings provide the first indication that promoting healthy choices regarding diet, exercise, and sleep may help to reduce the excess risks of health conditions in autistic adults. 

While the results indicate that there may be other biological or environmental factors that leave autistic individuals at greater risk of health conditions, they also provide a clear target for intervention. Difficulties with maintaining a healthy lifestyle may also have knock-on effects beyond physical health, including limiting opportunities for social interaction (which may centre around mealtimes or exercise), and could contribute to worsening mental health, and affect employment or education.

The lead researcher of the study, Elizabeth Weir, a PhD student at the Autism Research Centre in Cambridge, said: “These findings help us to better understand the experiences of autistic adults, and have wider implications for quality of life. We need to understand the reasons for restricted diet, limited exercise, and lack of sleep, to provide better support. This may include programmes for health education, and additional mental health support or supported living and working schemes.”

Dr Carrie Allison, Director of Research Strategy at the Autism Research Centre and a member of the research team, said: “The challenges we see among autistic children regarding lifestyle behaviours extend into adulthood. Given the implications for risk of chronic disease and length of life, it is critical that we work to identify effective strategies for supporting health choices by autistic people of all ages.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: “The wider picture suggests that autistic adults experience vulnerability in a variety of contexts, and this is just one new area that we should consider. Seeing that autistic adults are having such a hard time comparatively with healthy lifestyle habits has clear healthcare and policy implications: we need to create new and better support systems tailored to the specific needs of autistic people.”

Posted on Autism

Autism rates have increased and show differences in ethnic minorities and links to social disadvantage

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Around one in 57 (1.76%) children in the UK is on the autistic spectrum, significantly higher than previously reported, according to a study of more than seven million children carried out by researchers from the University of Cambridge’s Department of Psychiatry, in collaboration with researchers from Newcastle University and Maastricht University.

It is important that we safeguard the rights of children to access diagnostic services and education, tailored to their needsSimon Baron-Cohen

Black and Chinese pupils were 26% and 38% more likely to be autistic respectively and autistic children were much more likely to face significant social disadvantage. The results are published today in JAMA Pediatrics.

The team drew on data from the School Census from the National Pupil Database, collected by the Department for Education from individuals aged 2-21 years old in state-funded schools in England. Of more than seven million pupils studied, 119,821 pupils had a diagnosis of autism in their record in the English state educational system, of whom 21,660 also had learning difficulties (18.1%). Boys showed a prevalence of autism of 2.8% and girls showed a prevalence of 0.65%, with a boy-to-girl ratio of 4.3:1.

Prevalence was highest in pupils of black ethnicity (2.1%) and lowest in Roma/Irish Travellers (0.85%), with these estimates being the first to be published for these populations. Pupils with a record of autism in schools were 60% more likely to also be socially disadvantaged, and 36% less likely to speak English. The findings reveal significant differences in autism prevalence, as recorded in formal school systems, across ethnic groups and geographical location.

The lead researcher of the study, Dr Andres Roman-Urrestarazu from the Autism Research Centre (ARC) and Cambridge Public Health at the University of Cambridge, said: “We can now see that autism is much more common than previously thought. We also found significant variations in autism diagnosis in different ethnic minorities, though the reason why this should be the case isn’t clear and warrants further research.”

Previous estimates of the prevalence of autism in the UK by the same research group in Cambridge, and based on a school-based survey, suggested that one in 64 children (1.57%) were autistic. The new study, based on school records that usually underestimate the actual proportion of children who meet diagnostic criteria, shows a considerable increase in the autism prevalence in England. The researchers say the increase is likely to be because autism has become better recognised by both parents and schools in recent years.

Professor Carol Brayne, Co-chair of Cambridge Public Health and Professor of Public Health Medicine, said: “This study shows how we can draw on large datasets in a way that is rigorous and valuable for our understanding of autism.”

Professor Fiona Matthews from Newcastle University added: “This study highlights the need for more attention to the unrecognised and differing needs of autistic children from disadvantaged and diverse backgrounds.”

Professor Simon Baron-Cohen, Director of the ARC, said: “We can now see a snapshot of how many autistic children there are, and can drill down into local and ethnic variation, and reveal links with vulnerability. It is important that we safeguard the rights of children to access diagnostic services and education, tailored to their needs.”

This research was made possible by a generous donation for a Global Public Health Leadership programme by Dennis and Mireille Gillings Fellowship awarded to Dr Andres Roman-Urrestarazu. This study was also supported by the Autism Research Trust, the Wellcome Trust, the Innovative Medicines Initiative 2 Joint Undertaking (JU), the NIHR Cambridge Biomedical Research Centre and the NIHR Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust.

Posted on Diabetes

Increased consumption of whole grains could significantly reduce the economic impact of type 2 diabetes


Increased consumption of whole grain foods could significantly reduce the incidence of type 2 diabetes and the costs associated with its treatment in Finland, according to a recent study by the University of Eastern Finland and the Finnish Institute for Health and Welfare. The findings were published in Nutrients.

“Our study shows that already one serving of full grains as part of the daily diet reduces the incidence of type 2 diabetes at the population level and, consequently, the direct diabetes-related costs, when compared to people who do not eat whole grain foods on a daily basis. Over the next ten years, society’s potential to achieve cost savings would be from 300 million (-3.3%) to almost one billion (-12.2%) euros in current value, depending on the presumed proportion of whole grain foods in the daily diet. On the level of individuals, this means more healthier years,” says Professor Janne Martikainen from the University of Eastern Finland.

Type 2 diabetes is one of the fastest-growing chronic diseases both in Finland and globally. Healthy nutrition that supports weight management is key to preventing type 2 diabetes. The association of daily consumption of whole grain foods with a lower risk of diabetes has been demonstrated in numerous studies.

“According to nutrition recommendations, at least 3–6 servings of whole grain foods should be eaten daily, depending on an individual’s energy requirement. One third of Finns do not eat even one dose of whole grains on a daily basis, and two thirds have a too low fibre intake,” Research Manager Jaana Lindström from the Finnish Institute for Health and Welfare says.

The now published study utilised findings from, e.g., national follow-up studies, such as the FinHealth Study, to assess the health and economic effects of increased consumption of whole grain foods on the prevention of type 2 diabetes.

“By combining population-level data on the incidence of type 2 diabetes and the costs of its treatment, as well as published evidence on the effects of how consumption of whole grain foods reduces the incidence of type 2 diabetes, we were able to assess the potential health and economic benefits from both social and individual viewpoints,” Martikainen says.