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 Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM

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: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Fighting drug resistant tuberculosis – InfectoGnostics meets MYCO-NET² partners in Peru

28.04.2017 | Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

 
Latest News

Wireless power can drive tiny electronic devices in the GI tract

28.04.2017 | Medical Engineering

Ice cave in Transylvania yields window into region's past

28.04.2017 | Earth Sciences

Nose2Brain – Better Therapy for Multiple Sclerosis

28.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>