New arthritis drugs mark new treatment era, says study

Professor Josef Smolen, Division of Rheumatology at the Medical University of Vienna, Austria and colleagues did a comprehensive study of the three new drugs – rituximab, abatacept and tocilizumab – and their effects as sole therapies or working in conjunction with existing treatments.

The researchers explored the pathogenesis of rheumatoid arthritis (RA) and the various routes for targeting treatments, including new therapeutic strategies, and also provide a comprehensive overview on ways to assess treatment response.

The authors said: “The enormous consequences of RA for the individual and for health-care and socioeconomic systems can only be prevented by effective treatments.”

Traditional treatments for RA include non-steroidal anti-inflammatory drugs, glucocorticoids, and disease-modifying antirheumatic drugs (DMARDs). Only DMARDs, and to some extent glucocorticoids, can impede or stop the inflammatory and destructive disease processes. Methotrexate is the most widely used DMARD and is a cornerstone of most RA treatment regimens.

Of the three new drugs, Roche's rituximab, marketed in the US as MabThera and Bristol-Myers Squibb's abatacept, known as Orencia, have been approved for RA treatment, while the third, tocilizumab, is in phase III trials. Rituximab targets the CD20 antigen in certain cells, and leads to a reduction in the CD20 cell count. Trials of rituximab showed it reduced RA symptoms by more than 50% for more than a third of patients.

RA is the most common of all chronic inflammatory joint diseases, affecting 0•5–1% of the population in the industrialized world. Its typical symptoms are joint pain, stiffness, and swelling due to synovial inflammation and effusion.