MedicineWorld.Org
Your gateway to the world of medicine
Home
News
Cancer News
About Us
Cancer
Health Professionals
Patients and public
Contact Us
Disclaimer

Medicineworld.org: Tailoring treatment for rheumatoid arthritis

Back to rheumatology news Blogs list Cancer blog  


Subscribe To Rheumatology News RSS Feed  RSS content feed What is RSS feed?

Tailoring treatment for rheumatoid arthritis




Investigators have identified a biomarker that could help doctors select patients with rheumatoid arthritis who will benefit from treatment with drugs such as Enbrel, a tumor necrosis factor (TNF)-antagonist drug. The study, led by scientists at Hospital for Special Surgery in collaboration with rheumatologists at University of Southern California, appears in the recent issue of the journal Arthritis & Rheumatism.



Tailoring treatment for rheumatoid arthritis

"While our study waccording toformed on a relatively small group of patients and will need to be confirmed in a larger cohort, the data are promising and appears to be clinically significant for the medical management of patients," said Mary K. Crow, M.D., director of Rheumatology Research and co-director of the Mary Kirkland Center for Lupus Research at Hospital for Special Surgery. "Treatment with these drugs is very expensive; the drugs can cost around $16,000 or so per year. If you are going to use them, you would like to know that they are likely to work in your patient." Other well-known TNF-antagonists include Humira and Remicade.

While TNF antagonists have brought relief to thousands of people with rheumatoid arthritis, the drugs are not highly effective in 30 percent to 50 percent of patients. Clinicians thus run the risk of providing a treatment to patients that doesn't work well, is expensive and is potentially toxic. Patients taking TNF antagonists, which have been available for roughly ten years, can run the risk of developing bacterial or fungal infections.

While studies have identified factors linked to poor response to these drugs such as expression of certain genes, none of the factors has as yet provided doctors with a tool that will help select patients who are likely to respond to the drugs or identify those less likely to respond. Investigators at HSS hoped to remedy this and turned their attention to the type I interferon proteins, specifically a type called interferon beta (IFN-beta). Prior studies have revealed that levels of IFN-beta, a protein that can limit cell division, is present in the joint tissue of some patients with rheumatoid arthritis. The scientists wondered if variable levels of this protein could play a role in how patients respond to TNF-antagonist drugs. To test this hypothesis, the researchers set out to determine the relationship between levels of type I interferon activity in the blood previous to beginning treatment and the ability of the drug to control rheumatoid arthritis in patients. They studied the role of IFN-beta, and because they knew that IFN-beta induces interleukin-1 receptor antagonist (IL-1Ra), another protein, they also tested levels of IL-1Ra.

The study involved three cohorts of patients: patients who had rheumatoid arthritis and received a TNF antagonist (n=35), arthritis patients who received no drug (12), and healthy volunteers (n=50). Patients received their care at the Los Angeles County and University of Southern California Medical Center Rheumatology Clinics. Outcomes were reviewed during a window of treatment consisting of more than three months but fewer than nine months, allowing for sufficient time for clinicians to determine clinical response. Doctors used a tool usually employed to gauge the severity of arthritisthe Disease Activity Score in 28 jointsto deem whether patients had a moderate, good, or no response to the drug.

The researchers observed that patients with higher baseline levels of type I IFN were more likely to respond to treatment with TNF antagonists. Patients who had an increased IFN-beta/alpha ratio, meaning they had more IFN-beta, were also more likely to respond to treatment. They also observed significantly higher baseline levels of IL-1Ra in plasma samples from good responders as compared with those from nonresponders or moderate responders.

"We have drawn attention to a potential biomarker that, if our results are supported by additional future studies in other patient populations, might provide a tool to predict who might be a responder to this class of biologic rheumatoid arthritis therapies, the TNF antagonists, and who might be less likely to be a responder," Dr. Crow said. "For those who demonstrate low levels of blood interferon activity, that information might be useful to guide patients to alternative therapys that might be more likely to work for them." This could include the use of other drugs such as Rituximab, which is not a TNF antagonist.


Posted by: Mark    Source




Did you know?
Investigators have identified a biomarker that could help doctors select patients with rheumatoid arthritis who will benefit from treatment with drugs such as Enbrel, a tumor necrosis factor (TNF)-antagonist drug. The study, led by scientists at Hospital for Special Surgery in collaboration with rheumatologists at University of Southern California, appears in the recent issue of the journal Arthritis and Rheumatism.

Medicineworld.org: Tailoring treatment for rheumatoid arthritis

Asthma| Hypertension| Medicine Main| Diab french| Diabetes drug info| DruginfoFrench| Type2 diabetes| Create a dust free bedroom| Allergy statistics| Cancer terms| History of cancer| Imaging techniques| Cancer Main| Bladder cancer news| Cervix cancer news| Colon cancer news| Esophageal cancer news| Gastric cancer news| Health news| Lung cancer news| Breast cancer news| Ovarian cancer news| Cancer news|

Copyright statement
The contents of this web page are protected. Legal action may follow for reproduction of materials without permission.