There was a huge amount of groundbreaking research and news to choose from.  So I have grouped my choices into categories, rather than a standard top ten list.  These are my choices, including the ones I think are the most exciting, the hottest topics, or the most thought provoking.

New drugs in development

• In August, Pipex Pharmaceuticals, Inc. acquired dnaJP1, an oral, once-daily RA medication that is currently in clinical trials.  DnaJP1 is a biologic drug, like Humira and Remicade that inhibits inflammation by reducing T-cells ability to produce tumor necrosis factor (TNF).  The difference is that the oral form eliminates the need for injections and infusions.  A Phase II clinical trial involving 160 rheumatoid arthritis patients showed progressive improvement in patients taking dnaJP1 and more patients succeeded on dnaJP1 compared to those taking placebo. In addition, improvement continued after treatment with dnaJP1 was discontinued. In addition, laboratory tests have found that oral dnaJP1 results in an 80% reduction in the production of tumor necrosis factor (TNF) by T-cells. Researchers are hopeful that oral dnaJP1 may be less toxic than the injectable biologics, meaning less likely to result in serious infections. They are also hopeful that the staying power of the drug within the body may mean that the drug rewires the immune system in a lasting way so the body does not attack itself causing inflammation.

• The maker of Actemra released clinical trial data this fall showing that the interleukin-6 inhibitor was able to slow structural joint damage by 85% after one year when combined with methotrexate.  This was compared 67% when methotrexate alone. Actemra also improved physical function, and 47% of patients in the study achieved clinical remission, compared to an 8% remission rate found when patients take only methotrexate.  In another international study of Actemra, more than 50% the patients receiving the drug achieved a 20% reduction in RA symptoms compared to just 26.5% who were taking the placebo plus methotrexate; and almost 44% of patients receiving the combination therapy reached at least a 50% reduction in symptoms compared to 10.8% of patients receiving placebo plus methotrexate.

Positive clinical trials for drugs already on the market.  There were many clinical trials and studies completed regarding the safety and effectiveness of drugs that are already on the market.  Some of the highlights include:

• UCB, the maker of Cimzia, released positive results from several Phase III clinical trials this year, finding that Cimzia is effective both when taken alone and in combination=2 0with methotrexate. Either way, the results showed that Cimzia can significantly reduce signs, symptoms and pain associated with RA, and improved physical function. The combination treatment trial showed rapid, lasting improvements in both physical function and pain when Cimzia was used in combination with methotrexate, with positive results within as little as one week of treatment. The trials also showed that Cimzia inhibits progression of long-term joint damage with results for up to one year after ending the course of medication.

• Results of a large clinical trial for Rituxan, involving 2,578 patients showed that twice as many patients with RA achieved clinical remission when given three successive courses of Rituxan in combination with methotrexate. Only 8.8% achieved clinical remission if methotrexate was the sole treatment.  When comparing patients who were given three courses of Rituxan versus one course, twice as many achieved a 70% improvement in their symptoms and progression of joint damage over the period of two years was significantly reduced. 

• One study of hydroxychloroquine found that people who take it to treat their RA symptoms are half as likely to develop diabetes as people who do not take it.  This study built on previous research and could mean that physicians might consider prescribing it more often.  Hydroxychloroquine has been used as a DMARD to treat rheumatoid arthritis for decades, though it was originally developed as an anti-malaria drug.  Researchers think that since people with RA are at higher risk of developing diabetes, use of this drug alone or in combination with others might be beneficial both for treatment of RA and preventing diabetes in those at especially high risk.