Study Rates New Rheumatoid Arthritis Drugs

Abatacept, rituximab and tocilizumab may offer patients new options, experts say

WEDNESDAY, June 13, 2007 (HealthDay News) -- Three new drugs -- rituximab, abatacept and tocilizumab -- mark a new era in rheumatoid arthritis treatment, according to the authors of a study published online Tuesday in The Lancet medical journal.

Rheumatoid arthritis is a chronic inflammatory joint disease that causes joint pain, stiffness and swelling. Rituximab and abatacept have been approved for treatment of patients with this painful illness. Tocilizumab is currently being tested in phase III clinical trials.

Traditional treatments for rheumatoid arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and disease-modifying anti-rheumatic drugs (DMARDs), which include the widely used Methotrexate. But only DMARDs, and to a certain extent glucocorticoids, can slow or halt rheumatoid arthritis' inflammatory and destructive disease processes, according to background information in the study.

Rituxamab targets the CD20 antigen in certain cells, leading to a reduction in the CD20 cell count. Abatacept interferes with T-cell activation response, believed to play an important role in rheumatoid arthritis. Tocilizumab targets interleukin-6, which activates many cell populations.

In this study, a team led by Dr. Josef Smolen, who is also a professor of medicine at the Medical University of Vienna, Austria, examined a number of aspects of the three drugs, including their use as stand-alone therapies for rheumatoid arthritis or in conjunction with existing treatments.

They concluded that all three new drugs reduce rheumatoid arthritis signs and symptoms, improve patients' physical function and health status, and delay progression of joint damage. They noted that trials of rituximab found that the drug reduced rheumatoid arthritis symptoms by more than 50 percent for a third of patients.

One trial of patients found that 40 percent of those who received abatacept with their existing methotrexate treatment experienced about a 50 percent reduction in symptoms. Another trial found the same results in patients who took tocilizumab combined with methotrexate.

These new drugs offer more treatment options for rheumatoid arthritis patients, but the study authors noted that the "many patients who obtain insufficient responses to established and novel treatments indicate the need to search for further therapies and treatment principles to increase response rates and to achieve high frequencies of remission or even cure in rheumatoid arthritis. The prospects are here."

More information

The Arthritis Foundation has more about rheumatoid arthritis.

SOURCE: The Lancet, news release, June 12, 2007
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