New treatments for arthritis

Discover a revolutionary relief of joint inflammation and pain.

There is a virtual revolution in the management of rheumatoid arthritis (RA). Treatments are being developed at breakneck speed to address the classic RA symptom of inflammation and associated joint pain, soft tissue, swelling, redness, burning and stiffness.

If traditional therapies don’t offer measurable results in curing the disease, your doctor may want to consider one of the four new “biological” and natural methods now available: biological response modifiers (BRMs). As the name suggests, these drugs are created from living tissue. Some DNA is taken from one cell nucleus and placed in another cell nucleus. Since DNA carries genetic information, the combination of the two creates a new biological agent.

Discovering natural biological products

These biologics can selectively alter, eliminate or diminish the chemical element in the cell or other element in the body’s immune system that destroys joint tissue. These drugs represent the next generation of smart weapons used to fight RA.

MRBs target a chemical in the body called tumour necrosis factor (TNF, or lymphotoxin). Lymphotoxin is one of the main hormones that attack other hormones that cause inflammation, a symptom of RA and many other diseases. Blocking lymphotoxin can reduce pain and swelling in the joints, slow the progression of the disease and even prevent permanent damage.

Another biological response modifier, Kineret, blocks interleukin-1 (IL-1), a chemical naturally secreted by the immune system to try to fight infection. IL-1 acts as a chemical messenger, causing inflammation and tissue damage.

All of these drugs are quite effective and their costs are quite similar, between $15,000 and $25,000 each year.

More on the risks of biologic treatment of arthritis on page 2.

In terms of safety concerns, there are risks with any new medication, and new biologics are no exception. One of the most important risks is an increased risk of infection, especially in patients with latent TB (non-active carriers). For this reason, all patients are tested for TB and, if necessary, treated before starting treatment with these drugs. These new drugs are just the beginning of a new trend in RA treatment.

On the road to further advances

According to Dr Edward Keystone, director of the Rebecca MacDonald Centre for Arthritis and Autoimmune Disease at Mount Sinai Hospital in Toronto, about 145 new drugs are in pre-clinical trials and another 80 are already being tested in humans. This explosion of new therapies has been made possible by the new knowledge that researchers have about RA, so they are proposing improved ways and means of treating the disease.

One area of interest is developing new ways to eliminate or lower the fairly high levels of TNF, IL-1 and other types of interleukin found in inflamed joints.

For example, one of the drugs soon to be evaluated for approval blocks the ability of targeted cells to communicate with each other. This signal interference prevents the release of hormones that excite the cells, which in turn secrete chemicals that destroy tissue.

Existing drug therapies

In addition, an existing drug may already be able to offer many benefits in treating RA. Rituxan has been used to combat lymphoma (cancer of the lymphatic system) in over 400,000 patients worldwide. In the past year, researchers found that 70 per cent of RA patients who received two injections two weeks apart experienced profound relief for at least a year.

And finally, several types of selective small-molecule inhibitors are being developed that, if they work, could make injections and infusions unnecessary. A simple pill taken at lunchtime would be enough to replace them. To quote Keystone: “It’s a great time to be a rheumatologist; it’s an even better time to be a patient.”