New injectable drugs for rheumatoid arthritis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Arthritis treatments aim to relieve pain, reduce inflammation, and slow or stop joint damage to maintain or restore the patient's functional ability and quality of life.

Biological Response Modifiers for Rheumatoid Arthritis

Biologic response modifiers are drugs used for the treatment of rheumatoid arthritis. They can help reduce inflammation and structural damage to the joints by blocking the action of cytokines, immune system proteins that trigger inflammation. Five of these drugs, etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), certolizumab (Cimzia), and golimumab (Simponi)reduce inflammation by blocking TNF-á molecules. TNF is naturally produced by the body and is involved with normal inflammatory and immune responses. Many patients with rheumatoid arthritis have high circulating levels of TNF. The extra TNF plays an important role in both the pathologic inflammation and the joint destruction that are hallmarks of RA.

Kineret (anakinra)

This drug works by blocking a protein called interleukin 1 (IL-1) that is seen in excess in patients with rheumatoid arthritis.

It is administered as a daily subcutaneous injection.

The most common side effect is injection site reaction.

Precautions are similar to that for the anti-TNF drugs although infections seem to occur less frequently.

Three other intravenous medications that have been approved by the FDA for the treatment of RA are:

Abatacept (Orencia):

This is drug that inhibits T-cell activation through a unique co-stimulatory pathway blockade.

It is administered intravenously monthly by a physician.

Potential side-effects have to do with injection reactions and increased susceotib ility to infection.

It is not yet FDA approved.

Rituximab (Rituxan):

This drug has been used for many years as a treatment for B-cell lymphoma. It has been submitted to the FDA as a treatment for RA patients who have failed anti-TNF therapy. It acts by depleting B cells which appear to play a significant role in the perpetuation of RA.

It is administered intravenously over a three to four hour period in a physician’s office. The infusion is repeated two weeks later. The effect lasts 6 to 12 months.

Concomitant methotrexate is required. Patients may also receive intravenous steroids as well.

Side effects include infusion reactions which may be severe. Increased susceptibility to infection is also possible.

It has not yet been approved by the FDA.

Tocilizumab (Actemra) is adrug that blocks a cytokine called interleukin-6. It is administered intravenously.

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