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Psoriasis Drug Helps Rheumatoid Arthritis

Amevive Significantly Improves Pain in Combination With Methotrexate

WebMD Health News

Nov. 7, 2003 (Orlando) -- Patients with rheumatoid arthritis may look forward to relief from a drug that is already on pharmacy shelves.

Researchers tested Amevive in combination with methotrexate to ease the pain of rheumatoid arthritis. Currently, there is no other rheumatoid arthritis drug that soothes inflammation in the same way as Amevive.

Amevive is a commonly prescribed drug to treat psoriasis. It controls inflammation by targeting a special kind of immune cell, so-called memory T-cells. Since both psoriasis and rheumatoid arthritis stem from a specific overactivity of the immune system, researchers tested Amevive in combination with the common rheumatoid arthritis drug methotrexate. Methotrexate eases inflammation by reducing formation of white blood cells.

Just as methotrexate is commonly used with other powerful inflammation fighters to treat rheumatoid arthritis, such as Enbrel and Remicade, researchers wanted to see if the combination of Amevive and methotrexate could also pack a powerful one-two punch.

Matthias Schneider, MD, professor of medicine at Heinrich Heine University in Duesseldorf, Germany, presented his study at the 67th annual scientific meeting of the American College of Rheumatology.

In his study, 36 patients were given methotrexate along with either Amevive or placebo. The 28 women and eight men had been afflicted with severe rheumatoid arthritis for an average of 10 years. In order to help determine the true effect of Amevive, neither the researchers nor the patients knew if they were receiving Amevive or the placebo.

Over a 12-week period, each person received methotrexate along with Amevive -- given as a weekly injection -- or placebo injections. Treatment with Amevive or placebo was stopped after 12 weeks and the patients were then evaluated several times over the following 24 weeks.

Overall, 67% of the patients on methotrexate and Amevive had an improvement in their arthritis at any point during the course of the trial, compared with only 17% on methotrexate and placebo.

Schneider called the responses to Amevive "superior."

"What I see as most important is that even when we stopped the medication after a 12-week trial, we still had response in more than 40% after the initial 12 weeks, without giving any further medication," he tells WebMD. "We don't see major side effects and, what's great, no opportunistic infection, which is a great risk with these medications."

Opportunistic infections are those that occur when the immune system's ability to fight infection has been impaired -- either by medication or disease.

Stanley Cohen, MD, of the University of Texas Southwestern Medical School in Dallas, is involved in his own research on rheumatoid arthritis treatments. He says that the initial findings on Amevive look very good for improving symptoms of rheumatoid arthritis.

But he is still concerned about Amevive's potential effects on the immune system. He says time will tell if blocking T-cells significantly impairs the body's ability to fight infection in rheumatoid arthritis patients.

"It seems to be relatively safe. However, we are concerned about the issue of T-cell depletion; it's something that needs to be closely monitored in those patients. It remains to be seen what that would mean long term for the patients. But at this point, it would be certainly indicated for patients who are treatment failures -- patients who have not done well with other medication or conventional therapy," Cohen tells WebMD.

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