From
news.bbc.co.uk/1/hi/health/6747421.stm
Rhematoid arthritis effects 400,000 people in the UK
A new generation of drugs could revolutionise treatment for people with rheumatoid arthritis, experts believe.
Austrian researchers said trials show MabThera, Tocilizumab and Orencia slowed progression of the disease and reduced symptoms, the Lancet reported.
They work by targeting the immune system, but have side effects, the Medical University of Vienna said.
Two of the drugs are licensed for use, but NHS advisers have yet to give doctors the green light to use them.
All three new drugs diminish signs and symptoms of rheumatoid arthritis and improve physical function and health status and retard progression of joint damage
Josef Smolen, lead researcher
Rheumatoid arthritis is a painful and often crippling auto-immune disease which affects an estimated 400,000 patients in the UK - 4,000 of them seriously. There is no cure.
It occurs when the immune system attacks the joints, causing swelling and damage of cartilage and bone.
The researchers, who have undertaken work for some of the manufacturers of the new class of drugs in the past, said current treatments, including anti-inflammatory drugs, have limited effectiveness.
They said some patients may benefit from the new generation of drugs.
Lead researcher Josef Smolen said: \"The many patients who obtain insufficient responses to established and novel treatments indicate the need to search for further therapies.
\"The prospects are here. All three new drugs diminish signs and symptoms of rheumatoid arthritis and improve physical function and health status and retard progression of joint damage.\"
Reduced symptoms
The drugs work by either destroying or preventing the activation of cells which lead to the condition.
MabThera is also used to treat lymphoma cancers.
Trials of the drug showed that it reduced symptoms by over 50% for more than a third of arthritis patients.
A trial combining Orencia with normal methotrexate treatment also found a 50% reduction of symptoms in some 40% of patients. A similar effect was also seen with Tocilizumab, which is still being tested in clinical trials, when it was used in such a way.
But the researchers said there were some side effects, with patients reporting higher rates of serious infection when being treated with MabThera or Orencia.
Some patients taking Tocilizumab experienced headaches, skin eruptions, fevers and increased cholesterol levels.
The National Institute for Health and Clinical Excellence, which issues guidelines on which medicines should be available on the NHS, is looking at the use of MabThera and Orencia for treating rheumatoid arthritis.
Professor Alan Silman, medical director of the Arthritis Research Campaign, said the treatments would offer hope to about a third of patients who do not benefit from current treatments.
\"The results for these three drugs in such treatment-resistent patients are useful though not staggering.\"
