Top Rheumatoid Arthritis Stories of 2008

Genetic Research

• In September, scientists at Brigham and Women s Hospital and colleagues announced that they uncovered six specific locations on chromosomes (loci) linked to RA. Variations in the genetic sequence at these locations imply a risk of developing RA.  They hope that the new discovery will help researchers determine how variations on these loci affect the immune system and will help focus future prevention and treatment on these areas.  Previously, seven other loci had been linked to RA if variations occur.

Food and Drug Administration Actions in 2008

• In February, the FDA approved Humira to treat children 4 years and older with moderate to severe polyarticular juvenile idiopathic arthritis (JIA).
• In April, FDA also approved Orencia (abatacept) to treat children 6 years and older with moderate to severe polyarticular juvenile idiopathic arthritis (JIA).
• Then in June, FDA announced that it would be conducting a safety review of the TNF blockers (Enbrel, Humira and Remicade) for a possible association with development of lymphoma and other cancers in children and young adults.
• On September 04, 2008, the United States Food and Drug Administration (FDA) announced that those drug companies who manufacture the tumor necrosis factor (TNF) blocking drugs, Cimzia, Enbrel, Humira, and Remicade must add additional warnings to the packaging of the drugs in order to clearly disclose to patients the risk of developing severe fungal infections.  While the fungal infections are very common, and most people's immune systems are able to fight them off naturally, several patients taking the immunosuppressant TNF agents have died from such invasive fungal infections, often because the infections were not recognized and treated early enough.  The warnings are to inform patients and also to encourage physicians and health care workers to be able to recognize the signs and symptoms of fungal and bacterial infections earlier.
• Also in September, the FDA delayed the release of Actemra's, asking that Roche Holding, AG submit extra product manufacturing and product label information.

Obesity, Diabetes and RA linked

• In the U.S. the rates of obesity, diabetes and metabolic syndrome are increasing and this has a negative impact on those who suffer from rheumatoid arthritis.  Several studies published this year have discussed the various impacts that these three conditions have on each other.
• One study of rheumatoid arthritis patients found that the risk of having moderate to high rheumatoid arthritis d disease activity was 9 times higher in those patients who also suffered from metabolic syndrome compared to those rheumatoid arthritis patients who did not have metabolic syndrome. Metabolic syndrome is a combination of conditions that can increase the risk of heart disease and diabetes, among other problems. Metabolic syndrome is characterized by abdominal obesity as well as elevated triglycerides, reduced HDL ("good") cholesterol, elevated blood pressure and elevated blood sugar
• Other studies have found that obesity can cause or be caused by RA.  Obesity is a risk factor for both RA and cardiovascular disease.  Both obesity and cardiovascular disease are associated with an increased risk of death.  However, obesity does not only result from inactivity and unhealthy dietary habits.  Obesity can also be caused by taking prednisone or TNF-inhibitors.  Studies have also found that obese patients are less likely to respond to disease modifying drugs such as methotrexate.  
• Studies published this year have differed on the link between RA and diabetes.  Some believe20that inflammation due to RA may result in insulin resistance and the increased risk of developing Type 2 diabetes.