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Editor's e-Note
It’s critical for providers to recognize which medications used to treat patients with chronic inflammation are less likely to exert a negative impact on bone health. The use of corticosteroids, commonly used to control the inflammation that characterizes rheumatoid arthritis (RA), can result in significant bone loss and increase the risk of fractures.

Early and aggressive treatment of RA with biologic drugs, specifically biological disease-modifying antirheumatic drugs, may be most effective in halting progressive bone loss in patients with RA. A recent scientific review presents the best evidence for the use of biologic therapies for the treatment of RA.

In addition to reading our e-newsletter, be sure to visit Today’s Geriatric Medicine’s website at, where you’ll find news and information that’s relevant and reliable. We welcome your feedback at Follow Today’s Geriatric Medicine on Facebook and Twitter, too.

— Barbara Worthington, editor
e-News Exclusive
Biologic Therapies for Rheumatoid Arthritis
May Protect Against Rapid Bone Loss

A new review by the International Osteoporosis Foundation Chronic Inflammation and Bone Structure Working Group concludes that early and aggressive treatment of rheumatoid arthritis (RA) with biologic drugs, specifically biological disease-modifying antirheumatic drugs (DMARDs), may be most effective in halting progressive bone loss in patients with RA.

Coauthor Cristiano Zerbini, MD, director of the Centro Paulista de Investigação Clinica in São Paolo, Brazil, says, “Bone loss is one of the most harmful effects induced by chronic inflammation as well as by medications taken to treat rheumatoid arthritis, such as glucocorticoids. It is therefore important that we gain a better understanding of which medications used to treat patients with chronic inflammation are less likely to impact negatively on bone health.”

The progressive bone loss in RA has a number of causes. The development of chronic inflammation impacts the immune system, and this leads to signs and symptoms that may enhance bone loss. Anorexia, malnutrition, muscle wasting, cachexia, and depression are directly or indirectly related to chronic inflammation. Decreased functional capacity and lack of exercise associated with joint pain and deformities further contribute to progressive bone loss. Most importantly, the use of corticosteroids during RA treatment, even a dose of prednisone as small as 5 mg/day or equivalent for more than three months, is associated with rapid and persistent loss of bone. One study has shown that continuous treatment with prednisone at 10 mg/day during 90 days or more increased the risk of vertebral fractures 17-fold and hip fractures seven-fold.

Full story »
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GSA Conference Wrap-Up
The Big Easy Provides New Lens on Aging
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The Gerontological Society of America Annual Scientific Meeting, hosted by the New Orleans Marriott and Sheraton Hotels, featured presentations abounding with information on aging-related research, issues, and concerns. The meeting’s theme, “New Lens on Aging: Changing Attitudes, Expanding Possibilities,” included scientific sessions, interest group meetings, poster sessions, and mentoring sessions.

More than 4,000 attendees populated the many scientific sessions on health policy, social issues, the geriatric workforce, cultural and diversity concerns, physical activity, mobility, caregiving, long term care, nutrition, frailty, technology, and environmental influences on aging. Additionally, numerous sessions focused on a multitude of medical and biological issues, such as enhancing cognitive performance, cardiovascular diseases, chronic health disorders, and neurodegenerative disease.

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Geriatrics Consult With Rosemary Laird, MD
No Heartburn (or Heart Attacks) for the Holidays

Your elderly patients are just like the rest of us: We all want to enjoy ourselves at the holidays. Parties and family gatherings often bring with them an abundance of food and drink that is a bit richer and sweeter than the usual fare. Though festive, these foods increase the chance of gastroesophageal reflux disease (GERD). The resulting heartburn can really dampen the party spirit. This is especially true for older adults since the aging process itself, along with other illnesses and medications, create increased risk for GERD. Here are some strategies you can use to help your patients understand their risk and how they can decrease it, as well as dealing with symptoms if they should develop heartburn.

Aging contributes to increased heartburn in several ways. First, the aging process itself includes changes to the key apparatus keeping stomach fluids in place. Next, older adults are more likely to have chronic illnesses including diabetes, COPD, congestive heart failure, and depression, which can create increased risk by virtue of their pathophysiology. Finally, older adults may be at increased risk from the medications they need to take for management of other conditions.

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Tech & Tools
BIOSORB, a dressing from Acelity, forms a gel when it meets an exuding wound. Considered appropriate for pressure ulcers, diabetic foot ulcers, or traumatic wounds, it’s able to hold its shape, making dressing changes less painful for the patient. The dressing is made of carboxymethylcellulose fibers, which allow it to absorb many times its own weight in fluid, protecting the wound edge and surrounding skin. Its cellulose fibers reinforce the dressing, allowing it to remain strong and intact when wet. The product is designed to provide ease of application for the clinician, as well as pain-free removal to create a more comfortable option for patients compared with many other fiber dressings. It’s available in the nonsilver format (nonantimicrobial), with the silver version (antimicrobial) expected to follow in early 2017. Learn more »

Medi-Dose Inc/EPS Inc has released a new tamper-evident cap for metric-only oral syringes designed to help pharmacists and nurses better administer oral medication. Each cap contains a white syringe cap protected by a bright red tamper-evident break-away sleeve. Once attached to the syringe, the cap can be removed only when the outer sleeve is broken. The product is considered ideal for morphine or other oral anesthetics, including controlled substances. Learn more »
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