Immune System 'Shock' Fights Rheumatoid Arthritis

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Immune System 'Shock' Fights Rheumatoid Arthritis

Thu Jun 13, 1:33 PM ET

By Woodman

LONDON (Reuters Health) - Patients with severe rheumatoid arthritis that

fails to respond to conventional therapies have been helped by being given a

" short, sharp shock " to their body's immune system, scientists reported on

Thursday.

Rheumatoid arthritis is believed to occur when the immune system attacks the

tissue lining the joints, so researchers have been investigating whether

dampening down the immune system could be an effective treatment of last

resort.

Dr. Bingham, of Leeds General Infirmary in Britain, said results of a

small pilot study in Leeds showed that 60% of those treated improved, though

she stressed the treatment was not a cure.

" It is like giving a short, sharp shock to the immune system to dampen it

down, " she said in an interview after presenting her findings to the

European League against Rheumatism congress in Stockholm.

" The results so far are encouraging. Patients notice an improvement the next

day. One of my patients had absolutely no disease activity at all. She has

since relapsed quite badly but she says that just for those 9 months it was

worth it. "

Bingham estimated up to 10% of rheumatoid arthritis patients fail to respond

to drug therapies. Those offered the new treatment were patients who had

" really badly swollen joints and a terrible quality of life. "

The treatment involves the use of cyclophosphamide chemotherapy to damage

but not completely destroy the immune system. The immune system is then

" rescued " by transplanting back some of the patient's own stem cells.

Bingham said a total of 73 patients with severe rheumatoid arthritis that

did not respond to conventional treatment were known to have undergone the

novel therapy at different centres around the world. Results showed 67%

achieved at least a 50% improvement at some point after their transplant.

Most patients were re-started on conventional drug therapies within 6 months

for persistent or recurrent disease activity. However, disease control was

achieved in about half the cases whereas conventional medication had

previously been ineffective.

She concluded that the new procedure was a " relatively safe form of salvage

treatment. " Although not a cure, the hope was that if the disease came back

it could be kept under control by drugs.

The meeting heard that the European League against Rheumatism and the

European Group for Blood and Marrow Transplantation are now starting a trial

to compare the safety and efficacy of smaller doses of cyclophosphamide with

transplant against cyclophosphamide and conventional drugs.