One source of new information about rheumatoid arthritis is the yearly American College of Rheumatology meeting. This year’s conference was kept in Atlanta, Georgia from November 7-11.
A few of the intriguing findings ion rheumatoid arthritis are summarized below …
One study described the mix of etanercept (Enbrel) and methotrexate in rheumatoid arthritis. The research study discovered that illness progression is less frequent in patients with rheumatoid arthritis (RA) who haven’t reacted to methotrexate alone if it is continued at the same time the biologic drug etanercept (Enbrel) is begun. After randomizing “151 patients with active RA to etanercept, 25 mg two times a week plus methotrexate 6mg to 8 mg/week, or to etanercept alone,” scientists found the following … Significant differences in joint erosion ratings (joint damage ratings) were seen after two years of combined etanercept plus methotrexate compared to etanercept alone. These outcomes were reported by Hideto Kameda, MD, of Keio University in Tokyo, and colleagues at the yearly conference of the American College of Rheumatology (ACR).
Another hot topic at the American College of Rheumatology conference is an investigational compound called JAK. JAK has actually attracted increasing interest as a drug target in rheumatoid arthritis since it’s critical to the inflammatory reaction. It’s an enzyme that acts as the traffic director for the release of tumor necrosis element and other cytokines (protein messengers) that speed up inflammation in diseases such as rheumatoid arthritis. The weak point of JAK is that it is an enzyme whose impacts can be obstructed by an oral, small-molecule drug.
There are 3 types of JAK just known as JAK 1, JAK 2, and JAK 3. Pfizer has a JAK inhibitor called tasocitinib. Earlier reports from the ACR conference about this substance revealed that it was incredibly reliable along with having an appropriate security profile. Tasocitinib blocks JAK 1 and JAK3.
Tasocitinib is taken two times a day.
Another JAK inhibitor, called INCB028050, is an item from the Incyte company. Incyte has actually partnered with Eli Lilly to manufacture and market this substance. The drug produced ACR20 actions (at least 20% decreases in sign scores) in up to 70% of patients after 24 weeks, and ACR70 responses in nearly 30% of patients, reported Maria Greenwald, MD, of Desert Medical in Palm Desert, Calif. INCB28050 selectively blocks JAK1 and JAK2.
INCB28050 is taken once a day.
Negative effects of the JAK drugs include elevations in both HDL and LDL cholesterol of approximately 25%, depending on the dose.
Other side effects that have actually been seen in the medical trials with these medications consist of a boost in respiratory system infections, viral infections, consisting of shingles, drops in white blood cell count, increases in platelet count, and small problems in both kidney and liver function.
On a more ordinary note, the drug, leflunomide (Arava), may be an appropriate alternative to methotrexate for use in mix with rituximab (Rituxan) in clients with rheumatoid arthritis (RA) who can’t take methotrexate.
Katerina Chatzidionysou, MD, of the Karolinska Institute in Stockholm, reported a study revealing these findings at the American College of Rheumatology conference.
An overall of 29.1% of clients on leflunomide and rituximab had a great response at the 6 month mark. A number of research studies have actually shown that the B-cell targeting antibody drug, Rituxan, is beneficial in RA, and it has actually usually been given in combination with methotrexate.
However a huge concern for physicians has been how to handle patients who have negative effects with methotrexate.
Those of us who see a great deal of rheumatoid arthritis clients discover this information to be “old hat.” However patients with the disease ought to discover some useful nuggets here.