Rheumatology: International Leaders in Patient Care and Research

March 29, 2010

Rheumatoid arthritis is an increasingly important concern for those approaching retirement. This chronic disease is characterized by the swelling of the joints, which can eventually lead to loss of function and disability. Women are more likely to be affected than men.

However, there is good news for patients who seek treatment for rheumatoid arthritis early. If managed well, most patients are able to lead normal and productive lives.

"Prognosis for patients newly diagnosed with rheumatoid arthritis is excellent if therapy is started early," said Dr. James O'Dell, MD, chief of the University of Nebraska Medical Center and Omaha VA sections of rheumatology and immunology. UNMC Physcians Rheumatology

O'Dell and his section are national and international leaders in rheumatology, thanks in large part to the research they conduct in order to improve patient care.

Physicians specializing in rheumatology practice at the Durham Outpatient Center located on 42nd and Dodge streets as well as at the Brentwood clinic in LaVista.

O'Dell's dedication to improving the treatment of rheumatoid arthritis has enabled him to direct the Rheumatoid Arthritis Investigational Network (RAIN), which was formed at UNMC in 1989. Centered in Omaha and under the direction of the section of rheumatology at UNMC, RAIN is a nationally and internationally renowned clinical research program that focuses solely on investigator-initiated, as opposed to pharmaceutical-initiated, clinical trials.

In the most recent recent clinical trial comparing treatment options for rheumatoid arthritis, O'Dell worked with Dr. Larry Moreland, MD, of the University of Pittsburgh Medical Center to co-author a study.

"Unfortunately, many pharmaceutical-sponsored rheumatoid arthritis studies are unethical - subjecting patients to placebos when effective therapies are available," O'Dell said.

O'Dell's experience with clinical trials has led him to support a step-up approach to treating rheumatoid arthritis. This approach calls for a mild form of treatment, depending on the patient, to be administered until it has proven to be ineffective.

At that time, more potent treatments will be considered. This short delay in stepping up treatment (within three to six months) does not seem to affect how well the disease is ultimately controlled.

"Patients who didn't respond to initial therapy with one drug were switched to combination therapy and were doing as well, after two years, as those who got combinations from the beginning," O'Dell said.

O'Dell encourages those concerned about rheumatoid arthritis to monitor early warnings signs and to consider seeing a specialist in rheumatology if those signs appear.

"Look for early-day swollen joints and joint stiffness - particularly in the joints of the fingers and toes. The stiffness will occur early in the day and will improve with exercise as the day goes along," he said.

O'Dell has served on numerous American College of Rheumatology committees, and he is currently the chair of an effort to develop a national registry of rheumatic diseases.

"The most important thing is to discover the safest and most cost-effective treatment for our patients," he said.

More about O'Dell's recent clinical study.



Rheumatology: International Leaders in Patient Care and Research March 29, 2010 Rheumatoid arthritis is an increasingly important concern for those approaching retirement. This chronic disease is characterized by the swelling of the joints, which can eventually lead to loss of function and disability. Women are more likely to be affected than men. However, there is good news for patients who seek treatment for rheumatoid arthritis early. If managed well, most patients are able to lead normal and productive lives. "Prognosis for patients newly diagnosed with rheumatoid arthritis is excellent if therapy is started early," said Dr. James O'Dell, MD, chief of the University of Nebraska Medical Center and Omaha VA sections of rheumatology and immunology. O'Dell and his section are national and international leaders in rheumatology, thanks in large part to the research they conduct in order to improve patient care. Physicians specializing in rheumatology practice at the Durham Outpatient Center located on 42nd and Dodge streets as well as at the Brentwood clinic in LaVista. O'Dell's dedication to improving the treatment of rheumatoid arthritis has enabled him to direct the Rheumatoid Arthritis Investigational Network (RAIN), which was formed at UNMC in 1989. Centered in Omaha and under the direction of the section of rheumatology at UNMC, RAIN is a nationally and internationally renowned clinical research program that focuses solely on investigator-initiated, as opposed to pharmaceutical-initiated, clinical trials. In the most recent recent clinical trial comparing treatment options for rheumatoid arthritis, O'Dell worked with Dr. Larry Moreland, MD, of the University of Pittsburgh Medical Center to co-author a study. "Unfortunately, many pharmaceutical-sponsored rheumatoid arthritis studies are unethical - subjecting patients to placebos when effective therapies are available," O'Dell said. O'Dell's experience with clinical trials has led him to support a step-up approach to treating rheumatoid arthritis. This approach calls for a mild form of treatment, depending on the patient, to be administered until it has proven to be ineffective. At that time, more potent treatments will be considered. This short delay in stepping up treatment (within three to six months) does not seem to affect how well the disease is ultimately controlled. "Patients who didn't respond to initial therapy with one drug were switched to combination therapy and were doing as well, after two years, as those who got combinations from the beginning," O'Dell said. O'Dell encourages those concerned about rheumatoid arthritis to monitor early warnings signs and to consider seeing a specialist in rheumatology if those signs appear. "Look for early-day swollen joints and joint stiffness - particularly in the joints of the fingers and toes. The stiffness will occur early in the day and will improve with exercise as the day goes along," he said. O'Dell has served on numerous American College of Rheumatology committees, and he is currently the chair of an effort to develop a national registry of rheumatic diseases. "The most important thing is to discover the safest and most cost-effective treatment for our patients," he said. More about O'Dell's recent clinical study.
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