WebMD - Drugs Usher in Era of Hope for Rheumatoid Arthritis Sufferers

[Guest guest]

Drugs Usher in Era of Hope for Rheumatoid Arthritis Sufferers

New Drugs May Even Prevent Joint Damage

By Alison Palkhivala

WebMD Medical News

Reviewed by Dr. Charlotte E. Grayson

Nov. 29, 2000 -- Until recently, fairly toxic drugs were the only viable option

to relieve the pain from rheumatoid arthritis. But according to two new studies,

all of that has changed with the availability of newer drugs that target not

only the symptoms of the arthritis, but can protect the joints from further

damage.

Rheumatoid arthritis is a common and extremely debilitating chronic autoimmune

condition that affects more than two million Americans. The disease is called

'autoimmune' because the body's own immune system attacks the joints, and

sometimes other organs, mistaking them as foreign objects. Most sufferers are

women in their 30s and 40s who often have young children to care for, and the

disease can leave them wheelchair bound.

In the studies, published in the Nov. 30, 2000 issue of The New England Journal

of Medicine, two drugs -- Enbrel and Remicade -- were compared to a

cancer-fighting drug called methotrexate, which is currently the standard

therapy for rheumatoid arthritis.

Both Enbrel and Remicade are members of a new class of drugs. Like methotrexate,

they target the part of the immune system that attacks the joints in patients

with rheumatoid arthritis. These new drugs, however, target a specific part of

the immune system vs. the broader action of methotrexate.

" We're talking about a major advance in the therapy of rheumatoid arthritis, "

H. Klippel, MD, tells WebMD. " We're using the science base that has been

developed around rheumatoid arthritis to develop drugs that can be used to treat

the disease, and we hope this is just the beginning. " Klippel is medical

director of the Arthritis Foundation based in Atlanta and author of an editorial

that accompanied the two studies.

" One of the real goals has been to try to develop therapies that prevent damage

to the joint, and we're now seeing therapies that do that. ... So, it is

critically important that people with suspected rheumatoid arthritis see

physicians who are knowledgeable about [these] new treatment approaches, " he

adds.

Armitage from Ridgefield, Conn. tells WebMD about how rheumatoid arthritis

has affected her life. " It started about nine years ago, " she says, " with

general, all over achiness, which settled in my ankle. For me, that was bad

because my big passion is tap dancing. " She tried several drugs only to have the

symptoms disappear for a while and then reappear stronger than before. Pain also

gradually showed up in her elbows and knees.

In the first study, scientists led by Joan M. Bathon, MD, treated about 630

patients in the early stages of rheumatoid arthritis -- described as having the

disease for less than three years -- with either a high dose of Enbrel, a low

dose of the drug, or a standard dose of methotrexate for a year. Those taking

the high dose of Enbrel improved more rapidly and to a higher degree than those

taking methotrexate with respect to symptoms. They also showed improvements in

joint damage as seen on X-rays. And, importantly, patients taking any dose of

Enbrel experienced fewer side effects and infections than those taking

methotrexate.

" This study asked this question: If [Enbrel] is begun early in the disease,

could it successfully slow or stop the structural damage to the joints? The

answer is 'yes', " Bathon tells WebMD. With Enbrel, patients with rheumatoid

arthritis " can now be assured that their treatments aren't just 'covering up the

pain' but are actually stopping or slowing the progress of the disease. " Bathon

is an associate professor of medicine in the division of rheumatology at s

Hopkins University School of Medicine in Baltimore.

Similarly, a study comparing methotrexate alone to Remicade with methotrexate in

a group of over 400 patients showed that, after one year, those taking both

drugs together had more improvement of symptoms and a higher quality of life.

Again, X-rays revealed that damage to the joints stopped in patients on

combination therapy but not necessarily in patients taking methotrexate alone.

Yocum, MD, who was involved in this study says, " patients are very happy

because about one-third of them, even with the first [dose of Remicade], can

tell immediately the effect on the joints. They feel the decrease in swelling

and pain within minutes to hours after the infusion is done. ... I had one

patient who couldn't even squeeze the toothpaste out onto her toothbrush in the

morning, ... and now she's out driving her car and out of a wheelchair, " he

says.

Yocum adds, " The beauty of these [new drugs] is they're as effective the first

day as they are the 20th year. ... It's having a real impact across the board. "

Yocum is a professor of medicine and director of the arthritis center at the

University of Arizona in Tucson.

Armitage, who will be 60 in March, has been taking Remicade with methotrexate

for about three years. She says that almost all her symptoms disappeared within

two to three weeks of taking this combination. Today, she is able to dance, take

care of her two-year-old grandchild, and enjoy life without pain.

© 2000 WebMD Corporation. All rights reserved.

http://my.webmd.com/content/article/1728.65254

[Guest guest]

We are really and truly, I am told, and as I read this( thanks,a) I know

it even more so: we are really on the cusps of a huge new era of tremendous

medical breakthroughs on RA, the likes of which treatment for this horrid

affliction has never yet seen.

Good times are ahead, they say.

As they say Way Down Yondah in Naw'lins( New Orleans):

L'aissez le bon temps roullez!

Jon

----- Original Message -----

From: a <aA@...>

<egroups>

Sent: Thursday, November 30, 2000 4:49 PM

Subject: [ ] WebMD - Drugs Usher in Era of Hope for Rheumatoid

Arthritis Sufferers

Drugs Usher in Era of Hope for Rheumatoid Arthritis Sufferers

New Drugs May Even Prevent Joint Damage

By Alison Palkhivala

WebMD Medical News

Reviewed by Dr. Charlotte E. Grayson

Nov. 29, 2000 -- Until recently, fairly toxic drugs were the only viable

option to relieve the pain from rheumatoid arthritis. But according to two

new studies, all of that has changed with the availability of newer drugs

that target not only the symptoms of the arthritis, but can protect the

joints from further damage.

Rheumatoid arthritis is a common and extremely debilitating chronic

autoimmune condition that affects more than two million Americans. The

disease is called 'autoimmune' because the body's own immune system attacks

the joints, and sometimes other organs, mistaking them as foreign objects.

Most sufferers are women in their 30s and 40s who often have young children

to care for, and the disease can leave them wheelchair bound.

In the studies, published in the Nov. 30, 2000 issue of The New England

Journal of Medicine, two drugs -- Enbrel and Remicade -- were compared to a

cancer-fighting drug called methotrexate, which is currently the standard

therapy for rheumatoid arthritis.

Both Enbrel and Remicade are members of a new class of drugs. Like

methotrexate, they target the part of the immune system that attacks the

joints in patients with rheumatoid arthritis. These new drugs, however,

target a specific part of the immune system vs. the broader action of

methotrexate.

" We're talking about a major advance in the therapy of rheumatoid

arthritis, " H. Klippel, MD, tells WebMD. " We're using the science base

that has been developed around rheumatoid arthritis to develop drugs that

can be used to treat the disease, and we hope this is just the beginning. "

Klippel is medical director of the Arthritis Foundation based in Atlanta and

author of an editorial that accompanied the two studies.

" One of the real goals has been to try to develop therapies that prevent

damage to the joint, and we're now seeing therapies that do that. ... So, it

is critically important that people with suspected rheumatoid arthritis see

physicians who are knowledgeable about [these] new treatment approaches, " he

adds.

Armitage from Ridgefield, Conn. tells WebMD about how rheumatoid

arthritis has affected her life. " It started about nine years ago, " she

says, " with general, all over achiness, which settled in my ankle. For me,

that was bad because my big passion is tap dancing. " She tried several drugs

only to have the symptoms disappear for a while and then reappear stronger

than before. Pain also gradually showed up in her elbows and knees.

In the first study, scientists led by Joan M. Bathon, MD, treated about 630

patients in the early stages of rheumatoid arthritis -- described as having

the disease for less than three years -- with either a high dose of Enbrel,

a low dose of the drug, or a standard dose of methotrexate for a year. Those

taking the high dose of Enbrel improved more rapidly and to a higher degree

than those taking methotrexate with respect to symptoms. They also showed

improvements in joint damage as seen on X-rays. And, importantly, patients

taking any dose of Enbrel experienced fewer side effects and infections than

those taking methotrexate.

" This study asked this question: If [Enbrel] is begun early in the disease,

could it successfully slow or stop the structural damage to the joints? The

answer is 'yes', " Bathon tells WebMD. With Enbrel, patients with rheumatoid

arthritis " can now be assured that their treatments aren't just 'covering up

the pain' but are actually stopping or slowing the progress of the disease. "

Bathon is an associate professor of medicine in the division of rheumatology

at s Hopkins University School of Medicine in Baltimore.

Similarly, a study comparing methotrexate alone to Remicade with

methotrexate in a group of over 400 patients showed that, after one year,

those taking both drugs together had more improvement of symptoms and a

higher quality of life. Again, X-rays revealed that damage to the joints

stopped in patients on combination therapy but not necessarily in patients

taking methotrexate alone.

Yocum, MD, who was involved in this study says, " patients are very

happy because about one-third of them, even with the first [dose of

Remicade], can tell immediately the effect on the joints. They feel the

decrease in swelling and pain within minutes to hours after the infusion is

done. ... I had one patient who couldn't even squeeze the toothpaste out

onto her toothbrush in the morning, ... and now she's out driving her car

and out of a wheelchair, " he says.

Yocum adds, " The beauty of these [new drugs] is they're as effective the

first day as they are the 20th year. ... It's having a real impact across

the board. " Yocum is a professor of medicine and director of the arthritis

center at the University of Arizona in Tucson.

Armitage, who will be 60 in March, has been taking Remicade with

methotrexate for about three years. She says that almost all her symptoms

disappeared within two to three weeks of taking this combination. Today, she

is able to dance, take care of her two-year-old grandchild, and enjoy life

without pain.

© 2000 WebMD Corporation. All rights reserved.

http://my.webmd.com/content/article/1728.65254