Abatacept: Better Fix for Rheumatoid Arthritis

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Better Fix for Rheumatoid Arthritis

Updated: 1/19/2006 5:25:00 AM

By: Ivanhoe Newswire

http://rdu.news14.com/content/headlines/?ArID=79369 & SecID=2

Rheumatoid arthritis is a painful, chronic disease that affects about 2

million Americans. There are some drugs available to help the pain, but not

all patients will benefit. Now a new treatment works differently.

For 35 years, just walking was a struggle for Barbara D'Amico. She has

rheumatoid arthritis, a disease where her immune system attacks her joints.

" Physically, I feel like it's a broken bone that never heals. It's just a

constant ache, " she says.

D'Amico used to take up to 20 pain pills a day. But today, she's is feeling

better than ever thanks to a new treatment she received as part of a

clinical trial. That treatment is called abatacept and it's given through an

IV. The drug works by stopping a signal that activates the body's T cells.

Rheumatologist Mark Genovese, M.D., says standard treatments can lose their

benefit over time, but abatacept works when others have failed.

" For many patients, it means they'll have a better quality of life. They'll

be able to function better. They'll have a better emotional state, " Dr.

Genovese, of Stanford University School of Medicine in Palo Alto, Calif.,

tells Ivanhoe.

In a clinical study, half of the patients who took abatacept reported

relief. Dr. Genovese says, " It's a huge benefit to believe that you can get

50 percent of your patients to have a significant improvement in their

disease when in affect, they have tried and failed existing therapies in the

past. "

It's the only therapy that worked for D'Amico. A few months ago, exercise

was painful, but not today. " I couldn't make a fist, you know. Now, I can

make a fist. I can move my arms, " she says. And now she can be as active as

she wants.

Abatacept is not yet FDA approved, but Dr. Genovese hopes that will happen

in the next couple of months. There is a risk of infection with the

treatment. Researchers are also testing the drug on patients with lupus.

Background information:

BACKGROUND: About 2 million Americans suffer from rheumatoid

arthritis or RA for short. RA is a process where the immune system attacks

the body's joints. The disease can lead to long-term joint damage, resulting

in chronic pain, loss of function and disability. Because it is a chronic

disease, RA may never go away. Frequent flares in disease activity can

occur. RA is a systemic disease, which means it can affect other organs in

the body. Early diagnosis and treatment of RA is critical for patients to

live productive lives. Studies show early aggressive treatment of RA can

limit joint damage, which in turn, limits loss of movement, decreased

ability to work, higher medical costs and potential surgery.

SYMPTOMS: RA can start in any joint, but it most commonly begins

in the smaller joints of the fingers, hands and wrists. Joint involvement is

usually symmetrical, meaning that if a joint hurts on the left hand, the

same joint will hurt on the right hand. Symptoms of rheumatoid arthritis

include fatigue, stiffness, weakness, swelling, flu-like symptoms, pain,

loss of appetite, depression and weight loss.

STANDARD TREATMENTS: There are many different medications

available to treat RA. Some of those include:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) -- These drugs are

used to reduce inflammation and relive pain. These are medications such as

aspirin, ibuprofen, indomethacin and COX-2 inhibitors such as valdecoxib

(BEXTRA) and celecoxib (Celebrex).

Analgesic Drugs -- These drugs relieve pain but don't

necessarily have an effect on inflammation. Examples include acetaminophen,

propoxyphene and morphine.

Glucocorticoids or Prednisone -- These are prescribed in low

maintenance doses to slow joint damage caused by inflammation.

Disease Modifying Antirheumatic Drugs (DMARDs) -- These are used

with NSAIDs and/or prednisone to slow joint destruction. Examples include

methotrexate, injectable gold and penicillamine.

Biologic Response Modifiers -- These drugs directly modify the

immune system by inhibiting proteins called cytokines, which contribute to

inflammation. Examples are etanercept, infliximab, adalimumab and anakinra.

Protein-A Immunoadsorption Therapy -- This is not a drug, but a

therapy that filters your blood to remove antibodies and immune complexes

that promote inflammation.

A NEW APPROACH: While current therapies may work for some

patients, they don't work for all. Also, some of the therapies can lose

their effectiveness. Now, researchers from Stanford University Medical

Center in Palo Alto, Calif., are studying a new treatment. The treatment is

called abatacept and it's given through an IV infusion. In a clinical study,

the treatment was given every two weeks and then once a month for six

months. Mark Genovese, M.D., says: " It is what we call a selective

co-stimulatory modulator. It is a protein. It's designed to specifically

inhibit one of the signals that's used to communicate with the immune system

.... It down-regulates the immune system, so you get less activation of a

certain type of T-cell. "

GOOD RESULTS: In a study published in the New England Journal of

Medicine, researchers found patients, on average, experienced a 50-percent

improvement over six months. Dr. Genovese says, " It is a huge benefit to

believe that you can get 50 percent of your patients to have a significant

improvement in their disease when, in affect, they had tried and failed

existing therapies in the past. " So far, only mild side effects such as the

risk of infection have been noted with abatacept. Dr. Genovese says the drug

is currently awaiting FDA approval. If it does receive approval, he says it

may be on the market in 2006.

For more information, contact:

Stanford Medical Referral Center

Stanford University School of Medicine

(800) 756-9000