Talk:Rheumatoid arthritis

EGCG vs GTE

Per my undo (of the deletion), the reviews provided specifically refer to EGCG (not just Green Tea Extracts) and even name it as such in their titles. Here's another separate review on EGCG for RA again that can be added too: . I'm fine for the text to be modified to "Green tea extract and EGCG" if preferred, since EGCG is one of the components of green tea extracts. There's no point in just deleting it, since there's a vast number of studies and reviews all showing the same thing. Just update the wording if it's so concerning. The vast majority of other non-EGCG specific studies of GTEs contain EGCG as well anyway, having most of the same effect (although higher EGC to EGCG ratios result in a bit lower EGCG absorption/bioavailability). Anyway, here's also example of long-term (10 year), repeatedly NIH-funded research programs, where the grants started off on green tea polyphenols and then moved to EGCG specifically for some years (searched by one of the principle investigators in the field as example). If the U.S. NIH alone has spent at least 10 years renewing funding to RA research programs (apart from all the international work), then it's notable enough for an "RA Research" section: . 14.200.91.233 (talk) 09:58, 1 October 2017 (UTC)

Update: I updated the wording to read "green tea extracts and [..]". 14.200.91.233 (talk) 10:02, 1 October 2017 (UTC)

It's been deleted as WP:Crystal, without any explanation of how, even after this Talk section was set up. Please follow WP process and discuss changes before arbitrary opinion edits, especially when a Talk section has explicitly been created. Calling it WP:Crystal is non-sense. There's >17 years of research into EGCG and RA with extensive positive research findings. The results are highly relevant both to understanding of RA processes and identification of treatments. Note, the Zefr and Jytdog cabal have been working in tag-team on the EGCG page too, so no surprise they're burying content as a pack here also. I know the golden age of Encyclopedia Britannica was a few decades ago, but really WP can still creep a little bit into the current century. 120.17.210.246 (talk) 14:02, 1 October 2017 (UTC)

Still waiting on an answer User:Jytdog who deleted and User:Zefr who redeleted. Again, please stop ignoring Talk sections (this Talk existed before your tagteam redeleted it Zefr). Also, stop claiming that they're created against other users (e.g. Cathry), when you know that it regarded your own deletions without explanations. 120.17.83.90 (talk) 03:41, 4 October 2017 (UTC)

I'm re-adding this as after several days, nobody has substantiated their claims, or made any argument here for why it shouldn't be in Wikipedia.

− Multiple reviews of green tea extract and epigallocatechin gallate pre-clinical and animal studies have concluded that it has promising potential for inflammation and rheumatoid arthritis treatment, with one noting the lack of human clinical studies "despite promising pre-clinical findings and the thorough mechanistic insights", as "surprising".

120.17.218.156 (talk) 21:11, 4 October 2017 (UTC)

Posting this here and in the next section, too. I am familiar with all of those references. The first (Ahmed 2010) states: "The efficacy of EGCG or GTE in human RA or OA using the phase-controlled trials is yet to be tested." Wu (2012) likewise "Data for human studies are essentially absent." Reigsecker's 2013 review describes no clinical trials. Granja's 2017 article cited only in vitro literature. A search at clinicaltrial.gov found no clinical trials in progress. Until there are multiple clinical trials published in peer-reviewed journals, properly reviewed as a published article, it is premature to incorporate the EGCG research into this article. David notMD (talk) 13:27, 27 October 2017 (UTC)

Granja's 2017 review, cited literature that included in vivo results including "a rat model of adjuvant-induced arthritis (AIA)" (Singh et.al. 2016), not just in vitro. Granja's review states: "For this reason, new therapies are needed and EGCG may be a promising compound. In fact, EGCG has a high antioxidant activity and also capacity to decrease the inflammation response in the body [116–118]". Results of one cited paper: "Administration of EGCG (50 mg/kg/day) for 10 days ameliorated AIA in rats by reducing TAK1 phosphorylation and K48-linked polyubiquitination", conclusion "findings provide a rationale for targeting TAK1 for the treatment of RA with EGCG.". 120.21.5.180 (talk) 13:46, 2 November 2017 (UTC)

Morinobu et.al., Lee et.al. and several other studies cited in Granja's review show the same EGCG effectiveness in animal models of RA. There's far more than just in vitro theory. 120.21.5.180 (talk) 13:54, 2 November 2017 (UTC)

If there where multiple human clinical trials, it'd just be "Treatment" and specific health claims made, not noted under "Research". Clinical trials aren't necessary to say it's being investigated by an NIH funded program and other teams. 120.17.72.185 (talk) 14:41, 2 November 2017 (UTC)

References

Research is a continuous process, often grounded on in vitro and epidemiology, progressing to animal models, then if a drug, Phases I, II, III, then FDA review and approval. In the U.S., dietary supplement ingredients do not require FDA approval, and are often brought to market based on one, two or multiple clinical trials. Often industry funded rather than government grants (U.S. NIH or other). Wikipedia has its own criteria for inclusion in Research - ideally more than one clinical trial, consistent results, and at least one review that can be used as a citation. Your position is that if there is any research (those references), then it is appropriate to describe the work under "Research." This does not jibe with Wikipedia's definition of "Research." Basically, TOO SOON. See the content on fatty acids for an example of sufficient research, and even there, the reviews concluded that the evidence is not sufficiently consistent to recommend as a treatment. David notMD (talk) 15:28, 2 November 2017 (UTC)

The research cited is not industry funded, so not sure why that's raised in this context. One of the leading teams has in fact been funded repeatedly by U.S. NIH for 10+ years, specifically on GTE, then EGCG for RA. Could you please reference the requirement for (multiple) human clinical trials as prerequisite for inclusion with a Research section. Note, it's not a medical claim and WP:MEDRS has different applications in different contexts. You say 'ideally', but it's also not a requirement if that prevents improving Wikipedia, using otherwise reasonably verifiable information. The primary concern, should be whether there's likelihood for misstatements causing serious detrimental risk to readers. Which should be balanced against positive risk, that it may (and in this case is likely to) have positive outcomes, both due to efficacy in animal models and established safety profile. Importantly, the level of research is made entirely clear to readers, where they can ask their own GP and rheumatologist about it. As for my own (a top professor teaching rheumatology at the largest medical school in my country), he was very comfortable with me increasing green tea and fish oil consumption and giving a hydroxychloroquine prescription, for use in case symptoms persisted. They didn't. Anecdata isn't evidence, but the treatment plan was reasonable when patient informed and was based on available evidence and relative risk analysis (against alternative options). 120.17.50.29 (talk) 04:24, 10 November 2017 (UTC)

Lifestyle changes as treatment or Research

Perhaps add to Research rather than Lifestyle, given modest nature of the evidence for fasting and vegetarian diet. The existing citations in Lifestyle are all Cochrane Reviews. David notMD (talk) 22:55, 4 November 2017 (UTC)

This is common recommendations so IMO it is fine were it is.

Research is more for stuff that is being studied but not really done yet. Doc James (talk · contribs · email) 07:53, 10 November 2017 (UTC)

Beef and milk bacteria a cause of RA?

http://www.dailymail.co.uk/health/article-5337265/Drinking-milk-eating-beef-cause-arthritis.html Someone knowledgeable should look up the original study and see if it is worth adding to this Wiki article. Phantom in ca (talk) 05:18, 1 February 2018 (UTC)

The study itself is a primary source, not WP:MEDRS. The Daily Mail is good for the nail on the outhouse door. -Roxy, Zalophus californianus. barcus 05:22, 1 February 2018 (UTC)

Removal of top image

I removed the top image, which showed an advanced case of RA in an elderly patient who did not have access to the medications we have today. It is no longer reflective of the disease and its progression and its placement on this page means it's one of the first images that pops up when you search for RA on the internet. I can tell you from personal experience that's a very upsetting thing to see, so why subject people to it when there are more representative images to use? — Preceding unsigned comment added by Thisnotnpov (talk • contribs)

You have a point, but the image can be highly illustrative. I agree that severe deformity is now unusual apart from in those who somehow do not receive timely treatment. Nevertheless, for most of history this was the ultimate fate of someone with RA. Medical textbooks contain similar images. If anything needs improving it is the caption under the image - this should emphasise that severe deformity is now the exception rather than the rule. JFW | T@lk 21:58, 23 May 2019 (UTC)

Lots of older people still look like this. But sure. Doc James (talk · contribs · email) 08:28, 24 May 2019 (UTC)

So keep the image in the entry, but not make it the top image? Why make the worst case scenario of a disease the illustration of it? — Preceding unsigned comment added by Thisnotnpov (talk • contribs) 23:16, 30 May 2019 (UTC)

This image does not show the condition.[1] It is just a drawing and IMO is not as good.

People who do not have access to modern treatments still end up with significant deformity. We do not want people believing that RA is not serious. Doc James (talk · contribs · email) 11:03, 3 June 2019 (UTC)

Disagree. The drawing shows how the disease works, whereas the photo shows its effects on one person who is not reflective of all sufferers of the disease. The photo is still in the article, it's just not being used as the image that represents the disease. Please stop reversing my edits because you want to catastrophize an illness.