Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

The sustained benefits of very early treatment of rheumatoid arthritis with anti-TNF-alpha therapy

10.01.2005


Promising new evidence for the optimal use of biologic therapies



A major cause of pain and disability, rheumatoid arthritis (RA) is also potentially the most treatable form of chronic arthritis. Researchers, doctors, and patients agree that a group of drugs called disease-modifying antirheumatic drugs (DMARDs) can effectively reduce joint pain and stiffness. Yet, even when prescribed early and aggressively, DMARDs alone do not guarantee the desired outcome: the rapid and prolonged suppression of inflammation needed to induce remission.

Fortunately, there is new hope for treating RA early and experiencing long-lasting gains. Biologic agents that target tumor necrosis factor (TNF)-alpha – a protein known for provoking inflammation – have been successfully used to curtail the activity of rheumatoid arthritis among other chronic inflammatory conditions. Recently, a team of researchers in the United Kingdom set out to test the effectiveness of anti-TNF-alpha therapy on a small sample of patients with very early, poor-prognosis, previously untreated RA. The promising results and practical treatment implications of their pilot study are featured in the January 2005 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis).


Based at Leeds General Infirmary, the research team recruited twenty patients with a diagnosis of RA meeting the American College of Rheumatology’s criteria. On average, the patients had complained of disease symptoms for six months. None had ever been prescribed DMARDs or steroids. At the study’s onset, the patients were randomly divided into two treatment groups. One group received a standard dosage of a TNF-alpha inhibitor, infliximab (also known by the commercial name Remicade), while the other group received the a placebo. Patients in both groups also began a course of escalating DMARD therapy with methotrexate. DMARDs are drugs that improve the signs and symptoms of RA and reduce damage as shown by joint X-rays

All twenty RA patients adhered to their assigned treatment for a full year. To closely monitor the impact of anti-TFN-alpha therapy on synovitis, the inflammation of the membrane lining the joints, as well as bone erosions, every patient underwent magnetic resonance imaging (MRI) scans of the hand at baseline, at four weeks, and then at eight-week intervals until 54 weeks. The MRI scans were repeated a final time at 104 weeks – one year after the patients stopped taking infliximab.

At its one-year culmination, the study achieved its primary goal for RA patients given the advantage of early anti-TNF-alpha therapy: disease remission to avert joint damage. At 14 weeks, according to the MRI findings, patients taking infliximab combined with methotrexate showed a significant reduction in levels of synovitis compared to their baseline scores and to their counterparts. At 24 weeks, the infliximab group had significantly fewer new telltale signs of joint erosions than the placebo group. Throughout the course of the study, up to week 104, remission rates were greater among those patients prescribed infliximab plus methotrexate. 7 out of 10 of the patients had met the ACR response criteria for remission, compared with 2 out of 10 patients in the placebo plus methotrexate group.

One year after withdrawing from anti-TNF-alpha therapy, the patients in this group continued to experience therapeutic benefits. These patients scored significantly higher on measures of function and quality of life than the patients who had been treated with conventional DMARDs alone. "This appears to emphasize the importance of not only adequate disease suppression over time, but also of rapid disease suppression for optimal improvement in these outcomes," notes the study’s author, Mark A. Quinn. "Rapid control of disease activity may prevent patients from entering the ’sick role’ and may avoid the socioeconomic disadvantages associated with chronic illness, which extend beyond the anti-inflammatory nature of the therapy."

Despite the small sample of patients, this study has important implications for the most effective, affordable, short-term use of anti-TNF-alpha therapy, at the very early stages of RA. "Large-scale studies are under way to confirm these findings," Quinn reports.

Amy Molnar | EurekAlert!
Further information:
http://www.interscience.wiley.com/journal/arthritis
http://www.wiley.com

More articles from Health and Medicine:

nachricht Oxygen can wake up dormant bacteria for antibiotic attacks
08.12.2016 | Penn State

nachricht NTU scientists build new ultrasound device using 3-D printing technology
07.12.2016 | Nanyang Technological University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

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

Im Focus: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

Closing the carbon loop

08.12.2016 | Life Sciences

Applicability of dynamic facilitation theory to binary hard disk systems

08.12.2016 | Physics and Astronomy

Scientists track chemical and structural evolution of catalytic nanoparticles in 3-D

08.12.2016 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>