News May 2005 Issue

In the News: 05/05

An RA Drug That Really Works?
Though it hasnít yet received U.S. Food and Drug Administration approval, two recent clinical trials of abatacept have showed it to be of significant benefit for people with rheumatoid arthritis. Developed by Bristol-Myers Squibb, abatacept is the first in a new class of biologic agents called T-cell costimulation modulators. The studies focused on two RA patient populations: those who had not responded adequately to methotrexate and those who had not responded satisfactorily to tumor necrosis factor (TNF) inhibitors.

In both studies, patients given abatacept in addition to methotrexate or TNF inhibitors showed dramatic improvement in both physical function and disease progression. After one year, 48.3 percent of the 385 patients in the methotrexate/abatacept group showed a 50 percent improvement in function, while 30.5 percent of the 258 patients in the TNF/abatacept group showed an improvement of 50 percent or more in just six months. Additionally, 23.8 percent of the methotrexate/abatacept group was in remission after one year (compared to 1.9 percent of patients on placebo) and 10 percent of patients in the TNF/abatacept group (compared to 0.8 percent on placebo) were in remission after just six months.

How abatacept works: Activated T-cells in the body orchestrate the autoimmune response that leads to joint destruction and inflammation. Abatacept selectively controls T-cell activation, thereby interrupting the inflammatory process that leads to RA.

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Hard Arteries = Weak Bones
A study involving 2,348 women has revealed a significant relationship between atherosclerosis (hardened arteries) and osteoporosis (weakened bones). The study, recently reported in the Journal of Clinical Endocrinology and Metabolism, was conducted to determine whether increases in atherosclerosis and bone loss in postmenopausal women progress in parallel. Researchers determined that aortic calcifications were indeed related to eroding bone density and directly related to fractures. A subgroup of 228 women studied over an eight-year period also showed that yearly increases in aortic calcification accounted for 47 percent of the variance in bone loss.

According to the study, women in the highest group for gains in aortic calcification had four times greater yearly bone loss than women in the lowest group. Conclusion: The shape of your arteries can be a strong predictor of bone health and the likelihood of fractures.

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Back Pain Linked To Brain Shrinkage
Researchers conducting a study of 26 patients with chronic back pain (lasting for more than a year) have discovered that significant brain changes occur as a result of chronic pain. The patients, when compared to a similar number of control-group subjects without back pain, showed a 5-11 percent atrophy of cortical gray matter per year compared to normal brain-aging atrophy of 0.5 percent per year, or the equivalent of 10 to 20 years of normal aging.

The findings, reported in The Journal of Neuroscience, were confined to two regions of the brainóthe thalamus and lateral prefrontal cortex, both of which are involved in the perception of pain.

The prefrontal cortex is involved in decision-making and rational thought. Researchers determined that atrophy in this region might explain why patients with chronic pain become more emotional and are less able to deal rationally with pain. The thalamus, on the other hand, acts as a conduit for sensory input and may explain the reason for sensory abnormalities, such as increased sensitivity to touch. Authors of the study concluded that this pattern of brain atrophy, unlike that seen in chronic depression or anxiety, is directly related to chronic back pain and that the brainís inability to function at its best under these circumstances reflects brain-tissue shrinkage. The authors also concluded that early and aggressive treatment of back pain could reverse the atrophy of brain tissue.