Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Adalimumab plus methotrexate effective for long-standing rheumatoid arthritis

16.08.2005


For people with long-standing rheumatoid arthritis, combined treatment with the new “biologic” drug adalimumab and methotrexate is about five times more effective than methotrexate alone, according to a new systematic review of studies.

In six randomized controlled trials, comprising 2381 people with at least 10 years of the disease, the authors report that adalimumab (Humira) plus methotrexate decreased pain and swelling in patients who fail to respond to standard treatment.

Adalimumab “is even more active when used combined with methotrexate,” according to lead reviewer Federico Navarro-Sarabia, M.D., chair of rheumatology at the Hospital Universitario Virgen Macarena in Seville, Spain, and colleagues. “More people had improved symptoms with adalimumab alone than with fake injections, but the improvement was not as much as when adalimumab was taken in combination with methotrexate.”



The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The reviewers found that after six months, 43 percent of all subjects on adalimumab plus methotrexate had achieved a 50-percent improvement in symptoms, compared with 9 percent of all subjects receiving placebo plus methotrexate.

In the longest-running study, X-rays showed that adalimumab injections slowed progression of joint damage more than placebo.

Adalimumab was given in injections of 40 milligrams every other week or 20 milligrams per week.

The reviewers determined clinical effectiveness of each drug by measuring patients’ improvement using a symptom scale devised by the American College of Rheumatology. They measured disease progression using European League Against Rheumatism radiologic criteria.

They found that the rate of side effects was not significantly different between the adalimumab and placebo groups, but noted that the long-term side effects of adalimumab treatment have not yet been determined.

Adalimumab works by preventing a protein called tumor necrosis factor (TNF) from signaling the release of joint-damaging substances. The other FDA-approved TNF blockers are etanercept (Enbrel) and infliximab (Remicade). Adalimumab is approved for the treatment of moderate to severe rheumatoid arthritis in adults who do not respond to other treatments.

Methotrexate is the most widely used of “disease modifying antirheumatic drugs” among rheumatoid arthritis patients. Although DMARDs play an important role in arthritis treatment, only one, leflunomide, was developed specifically for rheumatoid arthritis treatment. Methotrexate was developed as a cancer treatment.

“What we might be seeing here is a synergistic effect,” said Scott Zashin, M.D., coauthor of a book on TNF blockers for arthritis, and clinical assistant professor at the University of Texas-Southwestern Medical School in Dallas. “Doctors and patients need to know, and this review supports the claim, that combination therapy will generally have a more robust effect, though some patients will do well on either drug alone. For patients with long-standing disease, this review affirms combination therapy as the standard of care.”

Addressing future research priorities, the reviewers wrote, “The available clinical trials with adalimumab are short-term studies (six-months duration) and there is only one twelve-month study. Long-term efficacy and safety studies are needed.”

Rheumatoid arthritis is an autoimmune disease which develops when certain cells of the immune system malfunction and attack healthy joints. The cause of rheumatoid arthritis is unknown. The primary focus of the inflammation is in the synovium, the lining tissue of the joint. Inflammatory chemicals released by the immune cells cause swelling and damage to cartilage and bone.

More than 2 million Americans suffer from rheumatoid arthritis, according to the American College of Rheumatology. About 75 percent of those affected are women. While the disease appears most commonly between the ages of 40 and 60, it can develop at any age.

Navarro-Sarabia F, et al. Adalimumab for treating rheumatoid arthritis. The Cochrane Database of Systematic Reviews 2005, Issue 3.

Federico Navarro-Sarabia | EurekAlert!
Further information:
http://www.hbns.org
http://www.cfah.org

More articles from Studies and Analyses:

nachricht Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung

nachricht Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

New bioimaging technique is fast and economical

21.08.2017 | Medical Engineering

Silk could improve sensitivity, flexibility of wearable body sensors

21.08.2017 | Materials Sciences

On the way to developing a new active ingredient against chronic infections

21.08.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>