New RA Drugs Show Promise
Pipeline Is Packed With New Rheumatoid Arthritis Treatments
June 15, 2007 (Barcelona, Spain) --The pipeline is bursting with promising
new treatments for rheumatoid arthritis (RA), say researchers.
RA is an autoimmune disease in which the body attacks its own joints,
resulting in pain and inflammation.
Though the advent of medications known as biologic agents have
revolutionized the treatment of RA, the next generation also may have a lot to
offer the 2.1 million people who live with rheumatoid arthritis, according to
experts speaking here at the annual meeting of the European League Against
Rheumatism (EULAR) in Barcelona, Spain.
Biologic agents such as Enbrel, Humira, Kineret, and Remicade reduce
inflammation by blocking substances that cause or worsen joint inflammation in
RA. They copy the effects of chemicals made by the immune system, which
block inflammatory substances such as TNF (tumor necrosis factor).
“The pipeline is rich and there are a lot of new possibilities,” Iain
McInnes, MRCP, PhD, a professor of experimental medicine and rheumatology at
the University of Glasgow in Scotland, tells WebMD. “The challenge is to work
out which ones to use and when.”
New Rheumatoid Arthritis Drugs
Cimzia. In people with RA who do not respond well to treatment with
an older drug called methotrexate, adding the experimental TNF-blocker Cimzia
may do the trick, says Edward Keystone, MD, a rheumatologist at the University
of Toronto in Ontario.
People in the study who took the Cimzia with methotrexate were more likely
to feel better than those who took methotrexate alone. What’s more, people
taking Cimzia improved quicker than what has traditionally been seen with the
other TNF-blockers on the market such as Enbrel, Remicade, or Humira.
This drug has a different chemical structure than the currently available
anti-TNF drugs, which allows it to remain active in the body for longer periods
of time and may allow it to go directly to the inflamed joint.
Among other potential perks, it may be cheaper to manufacture than other
TNF-blockers. It also works faster and appears to be safer for women of
childbearing age, which could put it ahead of the pack, he says.
Denosumab. This drug works differently than TNF-blockers. Denosumab
targets a protein involved in the destruction of joints known as RANK ligand.
But it doesn’t have any effect on the symptoms of RA.
“It is just affecting RANK ligand, and RANK ligand is involved in the bony
erosions, not the overall process that leads to signs and symptoms,” explains
Desiree van der Heijde, MD, a rheumatologist at the Leiden University Medical
Center in the Netherlands.
Ofatamumab (HuMax-CD20). Another new agent, ofatamumab, targets
B-cells, which are cells of the immune system that are believed to play a role
in causing inflammation in rheumatoid arthritis. This drug binds to the
surface of B-cells, effectively killing them off.