Earlier in November, the American College of Rheumatology held its 71st annual scientific meeting. Among the many research studies discussed and presented at the meeting, several made the news recently which may offer some hope or comfort to RA sufferers, especially those in the early stages of the disease or who have seropositive RA.
First, scientists at the University of California, San Diego found that anti-TNF inhibitor therapy may provide lasting benefits for up to a year for patients, especially those who have had the disease for less than 3 years. The researchers studied data from a national rheumatology database called CORRONA (Consortium of Rheumatology Researchers of North America). Using this large set of data, the researchers focused on 1300 RA patients who had tried and discontinued TNF-alpha inhibitor therapy. These patients were similar to the database population of 18,000 patients in that the average age of the patients was in the late 50's and almost 80% were women. Almost 75% were seropositive for rheumatoid factor and the average length of TNF-alpha inhibitor therapy was almost 9 months. Previous studies had come up with mixed results, some finding that people who stop this treatment have disease flares after ending the treatment, and some finding that patients may remain in remission for 6-12 months after ending treatment. These researchers found that these drugs were likely to provide patients with the prolonged benefit of lower disease activity or remission, but those most likely to receive that benefit were patients with RA for less than 3 years. Those with more established disease activity of more than three years were more likely to experience flares after treatment ended.
In more good news for newly diagnosed RA patients, a study funded by Wyeth Pharmaceuticals found that after 1 year of treatment, 50% of patients treated with a combination of etanercept and methotrexate had achieved remission versus 28% who took only methotrexate. Some important things to note about this study are that Wyeth Pharmaceuticals and Amgen are the makers of etanercept, marketed as Enbrel. The drug has been available on the market since 1998. Also, these results are from the first year of a two-year, Phase IV (post-marketing) study of 542 patients. Patients must have had RA for more than 3 months, but less than 2 years to qualify for participation. About half received etanercept plus methotrexate and the other half received methotrexate plus placebo.
Finally, in a study funded by Genentech inc. and Biogen Idec, Inc., researchers presented preliminary data showing that rituximab (Rituxan) is effective in slowing down joint destruction in patients who do not respond well anti-TNF inhibitor therapy. The researchers were trying to pinpoint certain groups who may benefit more than others. They performed various groupings of the data used, such as looking at levels of C-reactive protein at the beginning point, disease activity scores and the number of patients' swollen and tender joints. They found that rituximab generally benefited most patients, except those that had a seronegative rheumatoid factor had a less noticeable benefit. Rituximab is different from TNF-inhibitor drugs in that it targets a certain type of B-cells.
It was originally developed as a treatment for non-Hodgkin's B-cell lymphoma and it was approved by the FDA in 2006 for use with RA patients.
Even though two of these three studies were funded by the manufacturers of the drugs involved, I think the results should be a positive note both for people who are in early phases of treatment and people who have had RA for a while and aren't responding to other treatments. Especially promising for new patients is the finding that anti-TNF inhibitor therapy seems to be especially beneficial for them.
Published On: December 05, 2007