Drugs cut severe arthritis pain

Two studies have raised hopes that medication will be able to reduce the crippling pain of rheumatoid arthritis more effectively.

Two studies have raised hopes that medication will be able to reduce the crippling pain of rheumatoid arthritis more effectively. A team from University College London has tested a drug which targets specialised immune system cells. The results suggest one dose of rituximbab may be enough to relieve symptoms by up to 70%. And a separate study in The Lancet has found that cholesterol-lowering statin drugs may also ease symptoms. Rituximbab works by targeting B-cells, which are produced by the immune system to fight infection. The UCL team has produced evidence to suggest a malfunction in these cells may trigger rheumatoid arthritis by turning them against the body’s own tissues. In a study of 161 patients published in the New England Journal of Medicine, the researchers found rituximbab successfully reduced symptoms such as joint pain, swelling and stiffness by more than half in 43% of those who took the drug. This compared to just 13% who took conventional drugs. The study was designed to assess improvement over six months but it was found in many cases improvement was maintained for at least a year. It is hoped the drug will eventually be refined to provide years of protection from a single dose. However, the researchers have to find a way to do this without weakening the immune system, and raising the risk of infection. Lead researcher Professor Jonathan Edwards said: “This study provides clear evidence for the importance of B-cells in rheumatoid arthritis, heralding a major shift in our understanding of the disease. “The cycle underlying autoimmune diseases such as rheumatoid arthritis may be similar to a bug in a computer that makes it loop and crash. “B-cell targeted therapy is like rebooting the computer of your immune system to sidestep the bug. “As is often the case, if you have not removed the bug completely the computer system may crash again. “This seems to be where we are at present, possibly because the current treatment does not remove more than 80% to 90% of B-cells, where the ideal treatment would knock out 100% of cells.” Statins In separate research a team from Glasgow Royal Infirmary found that treatment with a statin called atorvastatin produced a small, but statistically significant improvement in arthritis symptoms when compared to a treatment with a dummy drug. However, researchers warn more work is needed to pinpoint what effect statins have on the immune system. A spokeswoman for the Arthritis Research Campaign said it was an “exciting time” for research. “After years of having to put up with inadequate therapies, patients with rheumatoid arthritis will soon have a choice of increasingly effective drugs that keep their symptoms under control. “Rituximab looks enormously promising for people with severe rheumatoid arthritis who have failed on older drugs. “It’s been known for some time that statins reduce cholesterol levels and therefore heart disease – which people with rheumatoid arthritis are particularly at risk of. “This latest Glasgow research shows that these drugs can also reduce inflammation and other symptoms of rheumatoid arthritis too. “We believe there is a strong case for rheumatoid arthritis patients to be routinely prescribed statins to counter the risk of developing heart disease, which doesn’t happen at the moment.” (Source: BBC Health, June 2004)