Combining new biologic drugs with an older treatment can stop joint damage in patients with rheumatoid arthritis, according to new research.
The benefits are seen when drugs designed to block an inflammation-causing protein called tumor necrosis factor are combined with the immunosuppressant methotrexate, according to three studies presented on Monday at a San Antonio meeting of the American College of Rheumatology. Both Enbrel, the rheumatoid arthritis drug sold by Amgen Inc. and Wyeth, and Humira, made by Abbott Laboratories Inc., were shown to stop joint damage when given in combination with methotrexate for two years. Data was also presented at the conference showing that methotrexate in combination with Remicade, made by Johnson & Johnson, prevented joint erosion in 79 percent of patients who began a one-year study with undamaged joints. The TNF-blockers have been among the most successful of all biotechnology drugs, with combined sales of $4.1 billion in 2003. An Amgen-sponsored study found that 74 percent of patients with early-stage rheumatoid arthritis who were given Enbrel and methotrexate saw their disease progress halted, compared to around 60 percent in the single drug groups. “Doctors can see that the therapy controls signs and symptoms of rheumatoid arthritis, but they can now have ‘peace of mind’ that joints are being protected,” said Laura Hamil, general manager of Amgen’s inflammation business. In a separate two-year study, 61 percent of patients treated with Humira and methotrexate experienced no further joint damage, compared with 45 percent on Humira alone and 34 on methotrexate alone. Both trials also showed that patients treated with the drug combination had greater improvement in physical function scores than either drug alone. Hamil said Amgen’s launch this week of a syringe pre-filled with a weekly dose of Enbrel that patients can inject themselves erases any marketing advantage that Humira has had in the past. Amgen said its study also showed a mean reduction in damage, meaning that the combination therapy may offer a way for the body to repair joint erosion. The company hopes to answer that question during the trial’s four-year period, Hamil said. “These data … underscore the importance of aggressive treatment to help prevent long-term disability,” study investigator Dr. Desiree van der Heijde, said in a statement. Rheumatoid arthritis is an inflammatory disease causing pain, swelling, stiffness and loss of function in the joints. (Source: Reuters, Oct 2004)