Featured Research

from universities, journals, and other organizations

The Promise Of A B-cell Biologic Therapy For Rheumatoid Arthritis

Date:
April 28, 2006
Source:
John Wiley & Sons, Inc.
Summary:
The results of a study featured in the May 2006 issue of Arthritis & Rheumatism, indicate the promise of low-dose rituximab to achieve remission for RA patients, without serious side effects and without the need for prescribing harsh steroids.

Drugs aimed at suppressing inflammation-provoking cytokines--specifically those linked to T-cells--have improved the treatment of rheumatoid arthritis (RA), a chronic, inflammatory autoimmune disease. Still, the frequency of remission achieved by these biologic agents remains below 50 percent. To increase the success rate of biologic therapy for RA patients, researchers have honed in on a new target: the B cell.

Related Articles


Rituximab, a biologic agent that selectively depletes B cells, has been successfully used to treat non-Hodgkin's lymphoma. It has also been shown to improve disease symptoms for RA patients, when injected at aggressive levels for a two-week period. To investigate this biologic's potential long-term therapeutic value, an international team of scientists set out to compare the effectiveness and safety of different rituximab doses over a 24-week period, with and without steroids. Their study focused on 465 RA patients with moderate to severe symptoms resistant to disease-modifying antirheumatic drugs (DMARDs), including other biologics. The results, featured in the May 2006 issue of Arthritis & Rheumatism, indicate the promise of low-dose rituximab to achieve remission for RA patients, without serious side effects and without the need for prescribing harsh steroids.

Drawn from outpatient populations in California, Texas, Arizona, Switzerland, Sweden, Poland, and England, the subjects were randomly divided into nine treatment groups. Three groups received a 1,000 mg. dose of rituximab--two infusions two weeks apart--with either intravenous steroid, oral steroid, or placebo. Three groups received a 500 mg. dose of rituximab--two infusions two weeks apart--with either intravenous steroid, oral steroid, or placebo. Three groups received a placebo with either intravenous steroid, oral steroid, or another placebo. All subjects received the DMARD methotrexate (MXT). All subjects were evaluated every four weeks for changes in the Disease Active Score (DAS), a 28-joint assessment for swelling and tenderness, as well as for overall disease improvement, with the goal of meeting the American College of Rheumatology (ACR) 20 percent improvement criteria.

At the 24-week culmination, 54 percent of the subjects in three rituximab 1,000 mg. X 2 groups and 55 percent of the subjects in the three rituximab 500 mg. X 2 groups had achieved the desired ACR20 response, compared with 28 percent of the subjects in the three placebo groups. The different dosages of rituximab did not have a statistically significant impact on the odds of achieving an ACR20 response, and analyses of the proportions of patients who achieved higher ACR improvement scores--50 percent and 70 percent--showed similar patterns. Changes in DAS28 at week 24 reflected the ACR response findings, as did the subjects reports of relief from joint pain and stiffness. What's more, subjects in the rituximab groups showed gains toward disease remission earlier in the course of treatment than subjects in the placebo group.

Steroids, whether received intravenously or orally, showed no significant correlation with disease improvement scores among the rituximab groups. Intravenous steroid, however, showed a positive correlation to improved tolerability during the first rituximab infusion in both dosage groups. Overall, adverse events associated with rituximab were mild and easily managed. Headache was the most common complaint.

Confirming the role of B cells in the inflammatory processes behind RA, this study demonstrates the effectiveness and safety of a unique biologic therapy, in moderate doses and independent of steroids. Yet, as its leading author, Dr. Paul Emery, notes, further studies are needed before applying the results to the routine treatment of RA patients. "Both doses of rituximab explored in this study warrant further differential exploration and longer-term followup," he stresses.

Article: "The Efficacy and Safety of Rituximab in Patients With Active Rheumatoid Arthritis: The Results of a Phase IIb Double-Blind, Placebo-Controlled, Dose-Ranging Trial," Paul Emery, Roy Fleischmann, Anna Filipowicz-Sosnowska, Joy Schechtman, Leszek Szczepanski, Arthur Kavanaugh, Artur J. Racewicz, Ronald F. van Vollenhoven, Nicole F. Li, Sunil Argarwal, Eva W. Hessey, and Timothy M. Shaw, for the Dose-Ranging Assessment: International Clinical Evaluation of Rituximab in Rheumatoid Arthritis (DANCER) Study Group, Arthritis & Rheumatism, May 2006, 54:5, pp. 1390-1400.


Story Source:

The above story is based on materials provided by John Wiley & Sons, Inc.. Note: Materials may be edited for content and length.


Cite This Page:

John Wiley & Sons, Inc.. "The Promise Of A B-cell Biologic Therapy For Rheumatoid Arthritis." ScienceDaily. ScienceDaily, 28 April 2006. <www.sciencedaily.com/releases/2006/04/060428135016.htm>.
John Wiley & Sons, Inc.. (2006, April 28). The Promise Of A B-cell Biologic Therapy For Rheumatoid Arthritis. ScienceDaily. Retrieved November 26, 2014 from www.sciencedaily.com/releases/2006/04/060428135016.htm
John Wiley & Sons, Inc.. "The Promise Of A B-cell Biologic Therapy For Rheumatoid Arthritis." ScienceDaily. www.sciencedaily.com/releases/2006/04/060428135016.htm (accessed November 26, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Wednesday, November 26, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com
From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
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:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

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