Featured Research

from universities, journals, and other organizations

New Drug Blocks Rheumatoid Arthritis Early On, With Few Side Effects

Date:
December 6, 2000
Source:
Johns Hopkins Medical Institutions
Summary:
A large nationwide study concludes that a drug called etanercept dramatically slows or even stops the progress of rheumatoid arthritis (RA) at the earliest stages of the disease, helping nearly three-quarters of those taking it. Etanercept also shows fewer side effects than the current best medicine.

A large nationwide study concludes that a drug called etanercept dramatically slows or even stops the progress of rheumatoid arthritis (RA) at the earliest stages of the disease, helping nearly three-quarters of those taking it. Etanercept also shows fewer side effects than the current best medicine.

While the drug has been on the market for several years as a symptom-easing therapy for people with advanced rheumatoid arthritis, this study marks a new use for etanercept as an early treatment. The study compared etanercept with the standard therapy, a drug called methotrexate.

"Both methotrexate and etanercept slow or actually halt the progress of the disease, but etanercept is more effective for more patients and has a low incidence of side effects," says rheumatologist Joan Bathon, M.D. Bathon led the year-long multicenter trials comparing the effect of the two drugs on 632 patients in the earliest stages of RA.

"The major drawback at this point," she adds, "is that etanercept is expensive — some $12,000 per patient per year, as compared with methotrexate's $1,000 a year."

The research, funded by the makers of etanercept and reported this week in the New England Journal of Medicine, forms the basis for new Food and Drug Administration guidelines governing use of the drug for early treatment. Physicians may now prescribe it, not only for symptom relief, but to prevent joint damage in the first place.

Rheumatoid arthritis is marked by an immune system attack on joints — both on bone and on the cartilage that surrounds the bone — bringing permanent joint damage. It affects joints in the hands and feet as well as all large joints. More than 6 million people in this country, most of them women, suffer from the disease. Symptoms include joint stiffness and pain and great fatigue.

Methotrexate, an anti-cancer drug, brought a treatment advance about 15 years ago, Bathon says. "But methotrexate's side effects can be significant, and nearly 50 percent of the patients taking it aren't helped."

Etanercept is a genetically engineered "designer drug" that blocks the action of a hormone-like chemical called tumor necrosis factor (TNF). TNF triggers much of the joint inflammation that comes with the disease, says Bathon, and also prompts cascades of reactions that end in destruction of cartilage in joints, as well as in bone erosion.

In the trial, people suffering from RA for three years or less received a 12-month course of either methotrexate or etanercept. Researchers selected subjects at especially high risk for joint destruction.

Using criteria from the American College of Rheumatology, the scientists looked for a decrease in swollen, tender joints, a drop in the laboratory measures of inflammation, for the improved evaluation of the disease by both patient and physician and — most important — for hard evidence from X-rays, says Bathon.

In the X-ray evaluation, patients were scored on a standard scale that measures how much bone erodes and, indirectly, how much cartilage disappears. At the end of the study, the majority of patients on either drug had no increase in bone erosion, with the progress of the disease completely stopped in 72 percent of the etanercept patients and in 60 percent of the methotrexate group. Patients on either drug also had a minimal increase in cartilage destruction.

The incidence of side effects serious enough to make patients stop taking methotrexate was about double that of the etanercept group, says Bathon. "We followed these patients for two years and it appears that the good effects are holding," she says.

Bathon cautions that neither drug is a cure. "But now if you start someone on methotrexate and see that person doesn't do well, you have an alternative," she says. "Also, combining the drugs seems to have no ill effects." Because TNF is a major immune system player though, physicians must watch patients carefully for increased signs of infection, she explains.

The study was funded by the Immunex Corporation, which makes Enbrel, the trade name for etanercept.

Other researchers were Richard W. Martin, M.D., of Michigan State University, Roy Fleischmann, M.D., of the Metroplex Clinical Research Center, Dallas, John Tesser, M.D., of the Phoenix Center for Clinical Research, Michael Schiff, M.D., of the Denver Arthritis Clinic, Edward Keystone, M.D., of Mt. Sinai hospital, Toronto, Mark Genovese, M.D., of Stanford University, Mary Chester Wasko, M.D., of the University of Pittsburgh Medical Center, Larry Moreland, M.D., of the University of Alabama at Birmingham, Arthur Weaver, M.D.,the Arthritis Center for Nebraska at Lincoln, Joseph Markenson, M.D., at the Hospital for Special Surgery, New York, and Barbara Finck, M.D, of Immunex Corporation, Seattle.

Related Web sites:

For the Arthritis Foundation's page on RA, click on to http://www.arthritis.org/Answers/DiseaseCenter/ra.asp

Also see this site: http://content.health.msn.com/content/dmk/dmk_summary_account_1437


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medical Institutions. "New Drug Blocks Rheumatoid Arthritis Early On, With Few Side Effects." ScienceDaily. ScienceDaily, 6 December 2000. <www.sciencedaily.com/releases/2000/11/001130075112.htm>.
Johns Hopkins Medical Institutions. (2000, December 6). New Drug Blocks Rheumatoid Arthritis Early On, With Few Side Effects. ScienceDaily. Retrieved July 28, 2014 from www.sciencedaily.com/releases/2000/11/001130075112.htm
Johns Hopkins Medical Institutions. "New Drug Blocks Rheumatoid Arthritis Early On, With Few Side Effects." ScienceDaily. www.sciencedaily.com/releases/2000/11/001130075112.htm (accessed July 28, 2014).

Share This




More Health & Medicine News

Monday, July 28, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Deadly Ebola Virus Threatens West Africa

Deadly Ebola Virus Threatens West Africa

AP (July 28, 2014) West African nations and international health organizations are working to contain the largest Ebola outbreak in history. It's one of the deadliest diseases known to man, but the CDC says it's unlikely to spread in the U.S. (July 28) Video provided by AP
Powered by NewsLook.com
$15B Deal on Vets' Health Care Reached

$15B Deal on Vets' Health Care Reached

AP (July 28, 2014) A bipartisan deal to improve veterans health care would authorize at least $15 billion in emergency spending to fix a veterans program scandalized by long patient wait times and falsified records. (July 28) Video provided by AP
Powered by NewsLook.com
Two Americans Contract Ebola in Liberia

Two Americans Contract Ebola in Liberia

Reuters - US Online Video (July 28, 2014) Two American aid workers in Liberia test positive for Ebola while working to combat the deadliest outbreak of the virus ever. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Traditional African Dishes Teach Healthy Eating

Traditional African Dishes Teach Healthy Eating

AP (July 28, 2014) Classes are being offered nationwide to encourage African Americans to learn about cooking fresh foods based on traditional African cuisine. The program is trying to combat obesity, heart disease and other ailments often linked to diet. (July 28) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins