Success of arthritis trial puts cure on the agenda

[Guest guest]

Success of arthritis trial puts cure on the agenda

By Steve Connor Science Editor

26 October 2002

Clinical trials of a drug for treating rheumatoid arthritis have been so

successful that a cure for the debilitating disease is on the horizon,

British scientists have said.

The drug, rituximab, promises to become one of the most effective treatments

for the 350,000 people in the UK who suffer from the disease, Professor

of University College London told the American College of

Rheumatology conference in New Orleans yesterday.

" An arthritis cure is now firmly on the agenda, " he said. " This study proves

the scientific validity of the benefits of rituximab to rheumatoid arthritis

sufferers. It's like having a bug in your computer. Rituximab re-boots part

of your immune system and when you switch it back on the bug is gone. "

Professor presented the interim results of a phase-two trial on the

first 121 patients out of 161 in the study. Half of the patients achieved at

least a 50 per cent improvement in symptoms six months after the start of

the treatment and more than eight of 10 patients had an improvement of at

least 20 per cent.

More interesting was the finding that about one in five of the patients had

achieved a 70 per cent improvement, a " brilliant response " rarely obtained

with existing therapies, Professor said. " We are expecting final

study data this year. While we are still investigating rituximab in

rheumatoid arthritis, these early results indicate it could be an effective

and convenient treatment. "

Three of the patients in the study still showed the signs of a significant

improvement one year after taking the drug with no signs of a relapse, but

two others relapsed at seven and nine months.

Rituximab works by limiting the number of B cells, one of the class of white

blood cells of the immune defences. The drug appears to disrupt the process

leading to autoimmunity, when the immune system attacks tissues to cause

painful swelling of the bones and joints in rheumatoid arthritis.

Patients are normally treated with simple painkillers, such as paracetamol,

and anti-inflammatory drugs such as steroids to reduce the swelling and

pain. " While the signs and symptoms of rheumatoid arthritis may appear to be

under control, it is important to note that damage to the joints and bones

may be continuing and progressing, " Professor said. " Rituximab looks

to be as good as the best drugs available. Its benefits are that it lasts

much longer, on average a year. "

The study, at centres in Europe, Australia, Israel and Canada, compared

several treatment options including rituximab combined with other drugs.

The most encouraging results were obtained when rituximab was given with

another anti-arthritis drug called methotrexate. Rituximab is approved for

the treatment of non-Hodgkin's lymphoma, a type of lymphatic cancer.

A spokeswoman for the Arthritis Research Campaign said: " This is a very

exciting time in rheumatoid arthritis research. The interim results of the

phase two study of rituximab look extremely positive, and are very

encouraging for patients with severe rheumatoid arthritis, although we're

talking about remission here rather than a 'cure'.

" Most, but not all, patients who were given two infusions of rituximab with

methotrexate were in remission after six months. But it is still unclear how

long the remission lasts. "

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