Rheumatoid Arthritis Research Update

Exciting new research is expanding the understanding and treatment of rheumatoid arthritis (RA). Early and aggressive treatment is today’s philosophy, and results show researchers and doctors are on the right track.

What Is Rheumatoid Arthritis?
For reasons still not understood, the autoimmune system, which is the body’s defense against infection, attacks tissue around the joints, causing pain and inflammation.

In addition, tumor necrosis factor, or TNF — a blood protein that seeks out cancerous cells — attracts the T-cells (lymphocytes) that cause inflammation. This results in swelling and pain in joints. TNF also produces an enzyme that destroys the joints.

What Causes Rheumatoid Arthritis?
Research indicates that there is no single cause (or trigger) for RA. Extreme stress, trauma and even some viruses can trigger the disease. While work continues in this area, much of the current research concentrates on stopping the autoimmune response once it is set off.

What Are the Latest Treatments?
Drugs that selectively attack the causes of RA symptoms are producing results. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Celebrex and Vioxx — which work on the inflammation-causing Cox-2 enzyme without destroying the beneficial Cox-1 enzyme — are proving extremely effective in reducing inflammation and pain from RA and osteoarthritis (OA).

The disease modifying anti-rheumatic drugs (DMARDs) Enbrel and Arava, on the market since 1998, are in the news for new reasons. Both drugs inhibit or “soak up” excess TNF, which causes pain and inflammation, and attracts inflammatory T-cells. They also prevent joint damage, which is an unexpected benefit.

Arava and Enbrel, usually given in conjunction with methotrexate (a popular treatment for RA that can produce severe side effects), are proving effective when given alone. To avoid the side effects of methotrexate, many rheumatologists are initially trying Arava or Enbrel alone.

Doctors had feared that eliminating TNF and T-cells would result in an increase in opportunistic diseases or cancers, which are possible side effects with less selective drugs. However, more than four years of studies show that these fears are unfounded.

According to Michael Pickrell, M.D., a rheumatologist with the Austin Diagnostic Clinic in Texas, “Rheumatology used to be the Rip Van Winkle field. You could sleep for 20 years and still practice medicine, because there had been no progress in treatment.” That certainly is no longer the case.

April 10th, 2012 - Posted in Medicines | | Comments Off

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