'Smart drugs' usher new era of rheumatoid arthritis treatment

Tests on three new treatments show they all help to slow down the progression of the debilitating joint disease and reduce its symptoms by up to 50 per cent.

Rheumatoid arthritis (RA) is a painful and often crippling auto-immune disease which affects an estimated 400,000 people in the UK, 4,000 of them seriously.

The condition, which causes inflammation and swelling of the joints, occurs when the immune system makes antibodies which attacks the body's own tissues.

The new medications target different parts of the immune system, helping to protect the joints from further attack.

Experts predict this latest generation of treatments may help many severe sufferers to regain their independence.

But the drugs rationing watchdog National Institute for Health and Clinical Excellence (Nice) has yet to approve them, casting doubts on their future availability.

Two drugs, MabThera and Orencia, are currently licensed in the UK, while the third, tocilizumab, is still undergoing trials.

The researchers from the Medical University of Vienna in Austria said trial data on the drugs showed all three drugs worked best when combined with standard treatment methotrexate.

Led by Professor Josef Smolen, the team wrote in an online edition of The Lancet medical journal: "The emerging agents show that a new era has started in the treatment of rheumatoid arthritis."

British specialist Paul Emery added: "They are strikingly effective and they work on different targets from the existing drugs, that's the joy of it."

Not all the patients in the trials responded to each of the drugs, but between 40 and 50 per cent felt their condition had improved. Even if one of the medications does not work for a sufferer, they may still respond to the other drugs, allowing doctors to tailor treatment for each patient.

Some patients also experienced some side effects using the new drugs including higher rates of serious infection, headaches, fevers and increased cholesterol levels.

Traditional treatments for rheumatoid arthritis include non-steroidal anti-inflammatory drugs, glucocorticoid steroids, and disease-modifying antirheumatic drugs. All these treatments have limited effectiveness, and even responses to newer medication such as tumour necrosis factor (TNF) inhibitors may be restricted, said the researchers. Further advances and more treatment choices are therefore needed. Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, said: 'It means that we have some choice, and that's very important if you are 22 and facing a lifetime of the disease.' NICE is currently looking at the use of MabThera and Orencia for treating the drugs, and has agreed to review its NHS guidance on three other rheumatoid arthritis drugs.

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