June 24, 2003 -- Early treatment of rheumatoid arthritis patients with a relatively new class of drugs appears to prevent the progression of the crippling disease.
New research about tumor necrosis factor (TNF) inhibitor drugs was presented last week at an international meeting of rheumatologists.
The findings are evidence that the drugs Remicade, Enbrel, and the newest drug in the class, Humira, should be used earlier in rheumatoid arthritis treatment, says one expert who took part in the European League Against Rheumatism (EULAR) annual meeting in Lisbon, Portugal.
"Most rheumatologists would tell you that somewhere around 20% to 25% of their patients with rheumatoid arthritis are on these medications," Arthur Kavanaugh, MD, tells WebMD. "We haven't really known if this was too many or too few, but the latest findings indicate that in people with severe disease they should probably be used more often and earlier."
'I Am Back to Normal'
Rheumatoid arthritis patient Betty Timms-Ford, 62, says she was virtually crippled by her disease before starting on Humira three years ago. Today she injects herself with the TNF inhibitor twice a month and also takes the drug methotrexate. She says the treatment has given her back her life.
"Getting up and taking a shower was a struggle," she tells WebMD. "I would come home from work at night and go straight to bed. I couldn't get out of a chair without my husband's help, and I had to have adapters for my toothbrush and car keys because I couldn't close my hands enough to grip them."
The Centennial, Colorado woman cannot conceal the excitement in her voice when she talks about her improvement since starting Humira. She can now enjoy old hobbies like gardening and skiing, and can keep up with her six grandchildren and three step-great-grandchildren.
"I am back to normal," she tells WebMD. "I go to the gym as many nights a week as I can, and I walk on my lunch hour. It is just wonderful."
Treat Early, and Long
Denver rheumatologist and clinical researcher Michael Schiff, MD, says Timms-Ford's experience is not unusual, and is even common, among rheumatoid arthritis patients put on TNF inhibitors. Some of his patients have been on the drugs for as long as six years with little evidence of disease progression.
Schiff, who is director of clinical research at the Denver Arthritis Clinic, cited three presentations at the EULAR meeting, which highlight the promise of TNF inhibitors:
- Patients with both early and late rheumatoid arthritis responded well to combination treatment with Humira and methotrexate, but it seemed to work better in patients with early disease. The drug therapy improved signs and symptoms of rheumatoid arthritis in both groups as well as stopped the progressive bone destruction seen in X-rays of the joints. Researchers concluded that early, aggressive treatment of patients should lead to better outcomes.
- Combination therapy with Enbrel and methotrexate improved disease symptoms and stopped disease progression among patients taking it for up to six years.
- Another group of researchers reported similar results among patients treated with the combination of Remicade and methotrexate.
"The take-home message from these studies is that anti-TNF therapy is here to stay. It works, and it slows, if not stops, progression of this disease," Schiff tells WebMD.