New advance against crippling arthritis

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Rheumatoid arthritis (RA) an autoimmune disease in which the body s immune system attacks healthy tissue, mainly in and surrounding joints but in other regions as well affects an estimated 1.5 million Americans, with an estimated 30 to 40 percent of them beyond the help of available drugs. Now however, new hope may be on the horizon as a team of Austrian researchers has reported that adding rituximab (Rituxan), an antibody which inhibits the inflammatory reaction, to methotrexate the current standard treatment of RA slowed joint damage progression in patients with RA regardless of the level of disease activity.

Researchers led by Daniel Aletaha, MD from the Medical University of Vienna monitored 188 patients on methotrexate monotherapy and 204 patients receiving methotrexate plus Rituxan. After a year of treatment, significant benefits were seen in the combination therapy group as compared to the methotrexate monotherapy group. These benefits were seen in assessment of multiple endpoints, including tender joint counts, patient and physician global assessments, pain, CRP levels (an index of inflammation), disease activity scores in 28 joints, and health assessment questionnaire.

When the researchers analyzed patients' x-ray changes in relation to disease activity, they found remarkable differences for the moderate and high disease groups, respectively, with impressive reductions in joint and cartilage narrowing and damage, they reported in the Annals of the Rheumatic Diseases.

ACSH s Dr. Gilbert Ross, formerly a practicing rheumatologist, was quite impressed with this study. RA is a devastating disease when it is not well controlled. Rituxan is another in the modern pharmaceutical miracle of immune modulating drugs which have been of such help in reining in progressive joint pain, swelling, and disability.