Current Arthritis News and Research » TNF

How Early Should Psoriatic Arthritis be Treated?

awesome — Mon, 17 Jan 2011 22:46:19 +0000

A recent review of treatments for Psoriatic arthritis (PsA) found that the benefit of different therapies depended how widespread the disease was.

Psoriatic arthritis is the second most common cause of joint inflammation. It involves the skin and joints, but may also affect fingers and toes, eyes and the spine. The effect on the skin is seen as red, scaly patches on the skin. Erosion of the joints may occur within the first two years in nearly 50% of PsA patients. Furthermore, an erosion rate of 11% per year has been reported.

The researchers found that mild anti-inflammatories were only helpful if the disease was mild or localized. In cases were the joint involvement is more wide spread the more beneficial therapy is with disease-modifying antirheumatic drugs (DMARDs), such as methotrexate.

Further, in cases of extra-articular or spinal disease in which DMARDs have not shown significant benefit, biologic therapy (anti-Tumor Necrosis Factor or TNF) may be more effective.

This study suggests that optimal therapy with a combination of biologics and DMARDs may produce remission rates of up to 60%.

Findings of the review were published in the June 1st issue of Current Opinion in Rheumatology.

Originally posted 2010-06-05 19:46:03. Republished by Blog Post Promoter

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Biogen Pulls Rheumatoid Arthritis Drug

awesome — Mon, 17 Jan 2011 22:45:01 +0000

Biogen Idec Inc. announced on October 9th that it was discontinuing development of its investigational rheumatoid arthritis (RA) drug baminercept after it failed to meet Phase II study endpoints.

Baminercept was being investigated for use in RA patients who did not respond to treatment with conventional disease modifying anti-rheumatic drugs (DMARD), such as methotrexate. The primary endpoint was the measurement of patients who achieved a 50% improvement in the number of swollen, tender joints, as well as other clinical measures at week 14.

The secondary endpoints were defined as the proportion of patients with a 20% improvement and a 70% improvement in the number of swollen and tender joints as well as other quality of life measures.

The first Phase II study, known as 104RA202, included 380 patients with active rheumatoid arthritis did not have and adequate response to conventional DMARD therapy. This was a double-blind, placebo-controlled, multicenter trial designed to assess the efficacy of 5 different dosages of baminercept in combination with methotrexate over a 12 week period.

The second Phase II study, known as 104RA203, included about 120 patients with active RA that did not have an adequate response to tumor necrosis factor (TNF) inhibitors. This was also a randomized, double-blind, placebo-controlled, multicenter trial. It was designed to assess the efficacy of a 200 mg dose of baminercept over a 12 week period in combination with methotrexate.

Based on the results of these 2 trials, Biogen has decided to discontinue development of baminercept for treating rheumatoid arthritis. However, the company indicated that baminercept did have potential uses for treating other inflammatory diseases, such as Crohn’s disease and multiple sclerosis. As of now, there are no clinical trials scheduled for these conditions.

Originally posted 2008-10-23 11:36:26. Republished by Blog Post Promoter

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TNF Response May Hold Key for Rheumatoid Arthritis

awesome — Mon, 17 Jan 2011 22:44:51 +0000

Tumor necrosis factor (TNF) has been identified as having a key responsibility in many inflammatory diseases, including rheumatoid arthritis (RA). There has been substantial research into the early signaling pathways activated by TNF, but there is not much known about the delayed and chronic TNF responses.

In addition, cells called macrophages (cells within the tissues that originate from specific white blood cells) produce TNF, but the effect of TNF on the macrophages themselves is not understood.

But a study published March 16th in the online journal Nature Immunology, researchers disclose the discovery of a new mechanism involved in the development of inflammatory diseases. This new mechanism may also provide insight into problems in gene therapy experiments that use adenoviruses to deliver genes to humans.

This study utilized human blood and mice to assess macrophages responses for 2 days after being stimulated with TNF. The researchers found that macrophages secreted TNF and then the TNF activated surface receptors on the macrophages themselves which caused the cells into a low, continued production of the protein interferon-beta.

The interferon-beta acted with TNF signals to induce sustained production of genes encoding inflammatory molecules and delayed production of genes encoding interferon-response molecules.

“The striking thing about many of these genes that came to our attention first was that there were these classic interferon response genes which had previously not been associated with TNF,” said Lionel Ivashkiv, M.D., director of Basic Research at Hospital for Special Surgery, who led the study. “It suggests a new mechanism by which TNF can drive and sustain inflammation.”

According to Dr. Ivashkiv’s team, the results of this, and related studies, may lead to development of new treatments for preventing bone destruction that is linked with some diseases. “So, what it does is sets up the next series of studies, in animal models, to try to determine whether this induction of interferon is beneficial or not.”

Originally posted 2008-03-19 18:46:35. Republished by Blog Post Promoter

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RA Drugs may also Reduce Cardiovascular Risk

awesome — Wed, 08 Dec 2010 14:00:13 +0000

A - Right cartoid artery; B - Normal artery; C - Plaque buildup in artery

Studies have indicated that people with rheumatoid arthritis (RA) also have higher risks for developing cardiovascular disease and strokes than the general population. The reasons for this have not been clear. But a recent study does seem to shed some light on a potential culprit.

Researchers believe that inflammation, such as experienced in RA, may contribute to atherosclerosis, a build-up of plaque in arteries. They also found that drugs currently used to treat RA may also reduce RA patient’s risk of artery plaque build up and heart disease.

This study included 158 RA patients who were given an ultrasound exam of the carotid arteries to assess the thickness of the artery walls at the start of the study. Another ultrasound was given about three years later.

For this study, researchers gave 158 RA patients two ultrasounds three years apart to assess the thickness of their carotid artery walls. (Two common carotid arteries, one on each side of the neck, branch off into smaller internal and external arteries that deliver blood to the brain and face.) About two-thirds of the participants in the study were female, and the average age was 59 years at the beginning of the study.

The differences between the scans showed that 82 percent of the participants had some thickening in their common carotid artery, while 70 percent had thickening in the internal carotid artery. Those participants who were treated with anti-Tumor Necrosis Factor (TNF) medications, such as adalimumab (Humira) or infliximab (Remicade), had a 37 percent lower rate of thickening in their common carotid artery compared to people not on the medication.

The researchers also found that not all medications were helpful. People who took corticosteroids, such as prednisone, had an increased risk of carotid thickening, unless they were also taking a cholesterol-lowering medication known as a statin. Statin use seemed to counter the negative effect of the steroid, according to the study.

“One key finding of our study was that RA patients had to have both high levels of inflammation and higher numbers of traditional cardiovascular risk factors, like high blood pressure, diabetes, etc., in order for inflammation to be a risk factor for carotid plaque progression” – Dr. Jon T. Giles, lead investigator and assistant professor of medicine in the division of rheumatology at Johns Hopkins University in Baltimore

Giles also noted that high levels of inflammation in the body were associated with increased plaque deposits.

The study results were presented at the annual scientific meeting of the American College of Rheumatology in Atlanta in November.

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Arthritis Drugs Do Not Increase Cancer Risk

awesome — Sun, 06 Jun 2010 02:46:37 +0000

Earlier this year British researchers reported in the New England Journal of Medicine the case of a woman who was being treated for Crohn’s disease with anti-tumor necrosis factor (TNF) medications and developed lung cancer. They raised a concern that anti-TNF drugs, as a result of their action in depressing the immune system, may increase the overall risk of cancer.

Spanish researchers who are presenting their research at the American College of Rheumatology’s annual meeting in San Francisco say their studies do not support that conclusion.

The researchers, from the Fundacion Espanola de Reumatologia in Madrid, Spain based their findings on two studies which used health data extracted from two Spanish databases of patients.

The first study involved almost 4,500 people who had been taking anti-TNF drugs between 2001 and 2007. The second study included data collected between 1999 and 2005 on 800 people with rheumatoid arthritis who were not taking anti_TNFs.

Ultimately they determined there were only 70 cases of cancer among those that were taking the drugs compared to 29 cases among those that did not take the drugs.

“Despite foreseen fears, blocking the tumor necrosis factor does not make patients more prone to develop cancer,” said Dr. Loreto Carmona of the Fundacion Espanola de Reumatologia.

Originally posted 2008-10-27 12:50:46. Republished by Blog Post Promoter

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