News September 2004 Issue

In the News: 09/04

Rituximab Seen As RA Breakthrough
A recent clinical study has revealed that rituximab (marketed as Rituxan), a therapeutic antibody that selectively targets the body’s B-cells, which are thought to play a key role in inflammatory rheumatoid arthritis, may be a significant breakthrough for RA sufferers.

The study encompassed 11 countries and included 161 patients with moderate-to-severe, long-standing (average duration 10.4 years) RA who had failed to respond to methotrexate or various disease-modifying antirheumatic drugs (DMARDs). Two doses of rituximab, administered two weeks apart, improved symptoms in RA patients for up to 48 weeks when combined with methotrexate, compared to methotrexate alone. Many experts have praised the study, claiming its results have opened “a new era” in targeted biological RA therapies.

How it works: Rituximab depletes the body’s B-cells, which produce auto-antibodies and secrete cytokines that inflame the synovia (joint lining), leading to chronic inflammation that destroys healthy tissue in the joint. Although there is no cure for rheumatoid arthritis, this latest development promises to not only relieve the pain and stiffness of RA but to free patients from the burden of long-term drug treatment.

Already marketed for use in lymphoma, rituximab is also being considered for its potential in treating other autoimmune diseases.

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Knee Patients Prefer To Play It Safe
When selecting an anti-pain medication for their knee osteoarthritis, many older people rank lower risk of side effects more important than treatment effectiveness. Researchers at Yale University recently interviewed 100 patients (79 percent female, average age 70) with knee OA about their preferred medications and found that 44 percent preferred a topical medication (capsaicin) to non-steroidal anti-inflammatory drugs (NSAIDs), COX-2 inhibitors, opioid derivatives, and glucosamine and/or chondroitin sulfate. Researchers concluded that many older patients with knee OA are willing to accept less effective pain treatments in exchange for a lower risk of gastrointestinal side effects. Non-selective NSAIDs, the most widely prescribed medications for arthritis patients, were found to be the least preferred option among all the patients interviewed.

Meanwhile, the World Health Organization (WHO) has determined that duration of treatment is more important than specific drugs when assessing the risk of gastrointestinal (GI) complications. WHO, which considers NSAID-related GI damage a major worldwide health problem, found that gastrointestinal problems are believed to affect up to half of chronic NSAID users. Previous studies have estimated that a patient’s exposure to NSAIDs triple the risk of ulcers or intestinal bleeding.

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Pass The Floss: Gum Disease Higher in RA Patients
Two recent studies, conducted more than 7,000 miles apart, have found that patients with rheumatoid arthritis are more likely to develop periodontitis (gum disease) than healthier individuals. An Australian study, conducted jointly at the University of Queensland and Royal Brisbane Hospital and involving 130 subjects, 65 of whom had rheumatoid arthritis, found that those with RA were twice as likely to have periodontal disease. An Egyptian study, conducted by researchers at the University of Alexandria, examined 50 RA patients and found periodontal disease in 37 (or 74 percent) of the subjects. Both studies concluded that there is substantial evidence of a direct association between periodontitis and RA, both of which have similar pathologies—damage caused by the immune system and chronic inflammation are key factors in both diseases. An RA patient’s limited dexterity, said the Egyptian researchers, may also lead to a decrease in oral hygiene, making matters worse. Both studies recommend that RA patients pay greater attention to their dental health and get regular dental check-ups.