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 Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

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: Attoseconds break into atomic interior

A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.

In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...

Im Focus: Good vibrations feel the force

A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.

By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...

Im Focus: Developing reliable quantum computers

International research team makes important step on the path to solving certification problems

Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Basque researchers turn light upside down

23.02.2018 | Physics and Astronomy

Finnish research group discovers a new immune system regulator

23.02.2018 | Health and Medicine

Attoseconds break into atomic interior

23.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>