Three New Drugs Effective Against Rheumatoid Arthritis

Three new genetically engineered drugs show promise for treating, even halting, the crippling and painful effects of rheumatoid arthritis, say doctors meeting in Florida.

The studies are to be presented Saturday at the national meeting of the American College of Rheumatology in Orlando.

Nearly 800 patients were involved in the three separate studies. Most of those who received one of the drugs reported improvements in their swollen and tender joints and only minor side effects, such as a rash.

The drugs interfere with the inflammatory cycle of rheumatoid arthritis.

“Clearly, additional testing will be required,” said Dr. William Koopman, president-elect of the American College of Rheumatology and chairman of the department of medicine at the University of Alabama in Birmingham.

“But these are far enough along in the testing that I think we’re very optimistic that these or related agents will find their way into the clinic in the not-too-distant future,” Koopman said Friday.

More than 2 million Americans, mostly women, suffer from rheumatoid arthritis, a chronic inflammatory disease that causes pain, swelling, stiffness and loss of function in the joints. The disease also can result in eye problems and inflammation of blood vessels, lungs and heart.

While the cause of the disease is unknown, recent studies show that certain people inherit a tendency to develop rheumatoid arthritis. There is no known cure; the goal of treatment, therefore, is to achieve remissions or near remissions without serious side effects.

Two of the new drugs are genetically engineered versions of naturally occurring, hormone-like molecules associated with inflammation and tissue damage in joints: interleukin-1 receptors and tumor necrosis factor receptors. The third is a monoclonal antibody derived from monkey and human proteins.

Immunex Corp. of Seattle administered varying doses of its tumor necrosis factor receptor twice-weekly for three months late last year. The study involved 180 men and women across the country with fairly advanced symptoms of rheumatoid arthritis, some of whom received a placebo.

Of the 44 patients who received high doses, 42 noted improvements in their joints, said Dr. Ann Hayes, vice president of clinical development for Immunex.

In the interleukin-1 receptor study by Amgen Inc. of Thousand Oaks, Calif., 472 patients in Europe received daily injections of the drug or a placebo for six months. Improvement among those who received the drug was noted as early as two weeks.

“I’m cautiously optimistic,” Dr. John Lipani, group director of inflammation and tissue repair for SmithKline Beecham, said Friday. “We have shown minimal safety problems with it, and it’s very encouraging.”