Rheumatoid Arthritis Treatments

Mark Borigini, M.D. Health Pro
  • On May 20, 2006, The Wall Street Journal (WSJ) ran a story about the drug choices available to people with RA. To read the story, visit WSJ, "New Treatments for Rheumatoid Arthritis." You will need a subscription to read the article. Read Dr. Borigini's blog below for his opinion on the new and existing RA drugs.


    Up until the last several months, the three main biologic agents used in the treatment of rheumatoid arthritis have been tumor necrosis factor inhibiting drugs, including Humira, Enbrel and Remicade. But now these agents have some competition from Rituxan and Orencia--two biologics which have been on the market for only the last few months. Today I will discuss Rituxan, a medication which targets B lymphocytes.
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    B lymphocytes are cells of the adaptive immune system which express cell surface receptors which can cause cells to react against themselves if not for our immune system's ability to exhibit B cell tolerance. But if this tolerance fails, we produce antibodies against our own tissues, resulting in autoimmune disease, including rheumatoid arthritis.

    Rheumatoid arthritis is associated with antibodies and if B cells could be removed, or at least disabled, the production of these auto-antibodies could be blocked, and perhaps the disease course altered.

    Clinical trials with Rituxan--alone or in combination with either methotrexate or cytoxan showed a response after six months, similar to the response seen with the tumor necrosis factor inhibiting drugs. In fact, there was a persistent response seen after one year. Another study showed similar promising results. There have been no major safety concerns during the follow up of these study patients. In particular, we have not seen recurrent infections with Rituxan use; however, since it is fairly new on the market, both doctor and patient must watch for any ill effects as the use of the drug continues in the general rheumatoid arthritis population.

    Additionally, more studies must be done to determine which traditional rheumatoid arthritis treatments (for example, methotrexate) are most effective in combination with Rituxan.

    The treatment of rheumatoid arthritis remains a challenge, but the continued research in novel ways of treating this illness continues to give physicians and patients hope that someday there will be an outright cure.

    Learn more about treatment for RA.

    HealthCentral Talks to Dr. Borigini about TNF Blocking Drugs
Published On: June 21, 2006