JointHealth™ express June 16, 2006
Tremendous advances in the treatment of rheumatoid arthritis (RA) have occurred over the past four years with the arrival of biologic response modifiers - adalimumab (Humira®), etanercept (Enbrel®) and infliximab (Remicade®). These three medications target specific molecules in the immune system called TNF-alpha that partly cause and promote inflammation in RA and have proven to be "breakthrough" medications.
However, research shows that there is still a significant unmet need for new treatments. Approximately 60% of the people who have tried one or several of the three biologic response modifiers currently on the market have not responded (or responded well enough) to them.
Two new medications to treat RA are currently under review by Health Canada - abatacept (Orencia®) and rituximab (Rituxan®). Both have already been approved by the Food and Drug Administration in the United States, and both target different cellular mechanisms within the immune system than the other three biologic response modifiers currently on the market. Through randomized controlled clinical trials, both abatacept and rituximab proved effective at controlling signs and symptoms of RA and improving quality of life in people with the disease.
Abatacept works by interfering with the interaction between immune cells that create and spread inflammation and damage to joints. If approved in Canada, the medication will be used, in combination with methotrexate, a commonly used medication, to treat people with RA who responded partially or poorly to either methotrexate alone or to a biologic response modifier targeting the TNF-alpha molecule.
Rituximab works by targeting and reducing a specific type of immune cell, called B cells. Although scientists do not fully understand how the medication works in the body, the result is a significant decrease in inflammation. If approved in Canada, this medication will be used, in combination with methotrexate, to treat people with RA who have failed on or been intolerant to a biologic response modifier targeting the TNF-alpha molecule.
Because both abatacept and rituximab act through different mechanisms and are different from the biologic response modifiers that target TNF-alpha, they will be a significant treatment advance for people with RA. It is also exciting that the preliminary research suggests they may also benefit those with systemic lupus erythematosus. However, further studies in large groups of persons with lupus are needed to confirm this.
If you are interested in reading a more detailed scientific review of abatacept and rituximab, visit the American College of Rheumatology's website.
Tremendous advances in the treatment of rheumatoid arthritis (RA) have occurred over the past four years with the arrival of biologic response modifiers - adalimumab (Humira®), etanercept (Enbrel®) and infliximab (Remicade®). These three medications target specific molecules in the immune system called TNF-alpha that partly cause and promote inflammation in RA and have proven to be "breakthrough" medications.
However, research shows that there is still a significant unmet need for new treatments. Approximately 60% of the people who have tried one or several of the three biologic response modifiers currently on the market have not responded (or responded well enough) to them.
Two new medications to treat RA are currently under review by Health Canada - abatacept (Orencia®) and rituximab (Rituxan®). Both have already been approved by the Food and Drug Administration in the United States, and both target different cellular mechanisms within the immune system than the other three biologic response modifiers currently on the market. Through randomized controlled clinical trials, both abatacept and rituximab proved effective at controlling signs and symptoms of RA and improving quality of life in people with the disease.
Abatacept works by interfering with the interaction between immune cells that create and spread inflammation and damage to joints. If approved in Canada, the medication will be used, in combination with methotrexate, a commonly used medication, to treat people with RA who responded partially or poorly to either methotrexate alone or to a biologic response modifier targeting the TNF-alpha molecule.
Rituximab works by targeting and reducing a specific type of immune cell, called B cells. Although scientists do not fully understand how the medication works in the body, the result is a significant decrease in inflammation. If approved in Canada, this medication will be used, in combination with methotrexate, to treat people with RA who have failed on or been intolerant to a biologic response modifier targeting the TNF-alpha molecule.
Because both abatacept and rituximab act through different mechanisms and are different from the biologic response modifiers that target TNF-alpha, they will be a significant treatment advance for people with RA. It is also exciting that the preliminary research suggests they may also benefit those with systemic lupus erythematosus. However, further studies in large groups of persons with lupus are needed to confirm this.
If you are interested in reading a more detailed scientific review of abatacept and rituximab, visit the American College of Rheumatology's website.
Arthritis Consumer Experts
ACE thanks Arthritis Research Canada (ARC) for its scientific review of ACE and JointHealth™ information and education programs.