Re: Cytokines as Therapeutic Targets

[Guest guest]

I've been following some testimonies from people who have ankylosing spondylitis and they seem to be having some great results with Enbrel (etanercept). From what I have heard it is less expensive (although still expensive) and easier to give than Remicade. You can continue with NSAID and DMARD while on enbrel. The drug company is in their 3rd clinical trial.

<<80 percent of patients receiving ENBREL® (etanercept) achieved a clinical response compared to 30 percent of patients receiving placebo (primary endpoint of the study), as measured by a composite measure. ENBREL was generally well-tolerated with no differences in rates of adverse events between the two groups. There were no serious adverse events and no withdrawals due to adverse events. A large, multicenter Phase 3 clinical study of ENBREL for the treatment of ankylosing spondylitis has been initiated. For information about enrolling in the study, call toll-free: 1-800-IMMUNEX (1-800-466-8639).>>

Scientists have also been studying another drug that has been with us for many years, but was taken off the market for causing birth defects. It is again being studied for ankylosing spondylitis and other auto-immune diseases:

<<Recently, researchers have discovered that the inflammatory cytokine tumor necrosis factor or alpha (TNF-alpha) may be involved with ankylosing spondylitis. TNF-alpha is a cytosine produced by immune cells in the blood stream. When these cytokines are chronically overproduced, inflammatory conditions occur as seen in multiple sclerosis, septic shock, leprosy, tuberculosis, and of course--rheumatoid arthritis. In the study of the effects of thalidomide, researchers have found that if TNF-alpha can be inhibited or blocked, then they would be able to reduce or eliminate the inflammatory conditions. Thalidomide inhibits TNF-alpha by amplifying the degradation of messenger RNA (mRNA), and decreases the production of interluking-12, which is involved in immunity responses, the stimulation of inflammation, and suppression of certain cytokines. In a study with two patients diagnosed with ankylosing spondylitis, thalidomide treatment/therapy was administered. The result of that study revealed: dramatic relief from pain, decrease in inflammation, notable weight gain. However, the study also yielded a couple of unexpected results, such as 1.) dramatic decrease in erythrocyte sedimentation rate (ESR), which is a test that determines erythrocyte cells levels in blood 2.) a decrease in C-reactive protein, which eventually normalized in about 3 months One patients' withdrawal from thalidomide resulted in granulocytopenia. The 200mg/day dosage was discontinued, which caused the patient's symptoms of ankylosing spondylitis to worsen. The 200mg/day dosage was later resumed, and then gradually weaned down to 150mg/day. Recently, the Food & Drug Administration approved thalidomide in the U.S. for the use of treatment with patients afflicted with leprosy (aka: Hansen's disease). However, this treatment comes with stipulations and quide lines for both, the physician and the patient. Among other rules and regulations, Celegene Corporation, the company now manufacturing this new thalidomide variation has developed a registry called STEPS, System for Thalidomide Education and Prescribing Safety program. Only physicians registered can administer and prescribe thalidomide. Both male and female patients must go undergo rigorous counseling, education, surveys, and frequent follow-up studies in order to be prescribed and continue thalidomide treatment. At this rate, if thalidomide usage and control is successful in the use of treatment for leprosy, or Hansen's disease, the future looks a little brighter for those afflicted with rheumatoid arthritis and its relative, ankylosing spondylitis. In addition, if scientist and researchers, are able to further isolate the enantiomer of thalidomide that successfully inhibits TNF-alpha by enhancing the suppression of mRNA and decreasing the production of interleukin-12, while at the same time creating a way to keep that particular enantiomer of thalidomide from interconverting into the opposing enantiomer during metabolization, then thalidomide usage could prove quite useful to those afflicted with rheumatoid arthritis and ankylosing spondylitis.>>

Best regards to everyone, Connie 66yrs (AS/Chronic uveitis/IBD.)