Re: how much do doctors study? / Jan

[Guest guest]

Wow! I wish I was a professional! I am actually learning all this from the

list, Internet research, and reading mags. This particular article is in

February's Arthritis Today magazine. You know, I would actually urge those

with arthritis to get a subscription to that magazine. It really is very good.

This was posted to the list back in November. The nurse I was talking to the

other day looked up the drug that is used bcs we were both curious as to

whether it would make you bald, just like chemo. But it said nothing about

hair loss. Which is excellent! ~Rainy Sue

Subj:     [ ] NEW ARTHRITIS TREATMENT - BRITISH ARTICLES

Date:    11/7/00 1:16:34 PM Pacific Standard Time

From:    cdx7159@... (Joan)

Reply-to:     egroups

    egroups

FROM SKY TELEVISION NEWS WEBSITE (29.10.00)

(http://www.sky.com/news/home/index.html)

ARTHRITIS BREAKTHROUGH CLAIMED

A CURE MAY HAVE BEEN FOUND FOR ARTHRITIS.

A British research team claimed to have identified drugs that can improve the

debilitating condition in just one treatment.

The breakthrough by the scientists from University College, London, was to be

announced at a conference on Monday.

Glutch, spokesman for voluntary group Arthritis Care, said the

Government may have to allocate substantial resources.

He said: " Anything which results in pressure on health budgets is obviously

problematic but we would say look at this in the long term and consider the

savings which could be made if people could live more independently and be

less dependent on benefits and carry on working and living a full life. "

ATTACKS

The cure focuses on the way the body's defences mistakenly attack healthy

joints when rheumatoid arthritis strikes.

Normally, a type of white blood cell, known as B-cells, fights viruses and

bacteria by making antibodies.

But in arthritis sufferers, a genetic mistake creates rogue antibodies that

go accidentally for healthy tissue.

The new treatment seeks out and destroy B-cells. After one dose the body then

appears to respond by making new ones - with the chances of replacement

B-cells making the same mistake being minimal.

Speaking to the Sunday Telegraph, Professor , who led the

team, said: " If our explanation is right, auto-immune diseases may be like

bugs in a computer programme.

" If you happen to press certain keys in a particular order it crashes. The

solution is to turn everything off and start up afresh - which in this case

means using drugs to eliminate all the B-cells. "

______________________________________________________________________________

__

FROM THE GUARDIAN NEWSPAPER (30.10.00)

(http://www.guardian.co.uk)

ARTHRITIS IS BEATEN, UK TEAM HOPES

EARLY DRUGS TRIALS GIVE EXCITING RESULTS,

DOCTORS SAY

Guardian

Monday October 30, 2000

British scientists say they have a radical treatment that could end the pain

of more than 750,000 people with rheumatoid arthritis in the United Kingdom.

Researchers at University College London have identified drugs they believe

give unprecedented results in stopping the debilitating disease, which is

caused by the body mistakenly attacking healthy joints and tissue.

The treatment, which has been tested on 20 sufferers who had failed to

respond to conventional medication, is due to be announced today at the

annual meeting of the American College of Rheumatology in Philadelphia by

, leading the team at UCL.

Professor said yesterday from Philadelphia that after 18 months the

first five patients - who had had the disease an average of 20 years - had

only residual pain.

" They have returned to leading a more or less normal life, with one going to

the gym and one taking up gardening. So far, of 20 patients only two have had

no benefit at all. We have one who after two years looks as though she has

got herself out of the arthritis cycle. She has had no inflammation and the

rheumatoid arthritis antibodies have disappeared.

" It is early days and it is only a few patients, but the results are so much

better than even I had expected that it really is quite exciting. "

The next tests are due to be in progress by Christmas, with 150 patients from

around the world. Arthritis charities and doctors reacted yesterday with

enthusiasm tempered by caution. " The treatment is at a very early stage, but

if it proves to be as good as it sounds it is tremendous news, " said

Gutch, chief executive of Arthritis Care.

The treatment centres on B-cells - white blood cells that defend the body

against viruses and bacteria by making antibodies. Due to a genetic mistake

they occasionally make rogue antibodies that attack healthy tissue. The

antibodies can trigger the production of copies of themselves, which the UCL

team says leads to a huge self-sustained attack on joints and tissue.

" It probably takes just one genetic mistake in a lifetime to trigger this

reaction but once it gets going it becomes a vicious circle, " said Prof

.

" Unlike with other cells in the immune system, most people can live without

any B-cells for a while. By the time we reach adulthood we have already made

most of the antibodies we need. "

After one treatment to wipe out all the B-cells the body responds by making

fresh ones. According to Prof , the chances of new B-cells making the

same mistake and thereby triggering a return of rheumatoid arthritis was very

small.

e, medical director of the Royal National hospital for rheumatic

diseases in Bath, was enthusiastic. " In broad terms the idea that you could

safely take out of the inflammatory process those cells that are driving it

without affecting others is very attractive. Rheumatoid arthritis is a very

unpleasant condition, [and] up until now we have only been able to treat the

symptoms or keep it off the boil with drugs that can have very unpleasant

side effects, so this is potentially very exciting. "

Dr e warned that it could be two or three years before the drug was

generally available. " There is no point in anyone going to their doctor

tomorrow morning, " he said. " It needs to be tested on a far larger group to

make sure it can be used safely and without side effects. Those are the sort

of things that have to be looked at carefully before it can be licensed. "

Mr Gutch called on the government to make funds available if it did prove

successful. " Two of the issues now will be: is it very expensive and will the

drug budgets be increased so the treatment can be prescribed? We would argue

it would be a good investment - enabling people to stay at work and not be on

social security, as well as relieving the terrible pain and suffering. "

Prof believes the therapy could help other auto-immune diseases, from

multiple sclerosis to Crohn's disease. " If our explanation is right,

auto-immune diseases could be like bugs in a computer programme. The solution

is to turn everything off and start up afresh. "

THE VICTIMS OF JOINT DISORDER

.. More than 3 m people in the UK are significantly disabled by rheumatic

diseases.

One child in every thousand has arthritis. Around 20% of all visits to the

doctor are arthritis related.

Rheumatoid arthritis, which affects more than 750,000 people, is a common

inflammatory disease of the joints.

It is the one rheumatic disease most associated with severe physical handicap

and is three times more common among females than males.

There is currently no cure although treatments can help reduce the symptoms,

but often with unpleasant side effects.

Surgery, physiotherapy and occupational therapy can also help damaged joints

work better.

Rheumatoid arthritis costs the taxpayer more than £1.3bn a year in

treatments, care and disability benefits.

______________________________________________________________________________

__

FROM THE INDEPENDENT NEWSPAPER (30.10.00)

(http://www.independent.co.uk)

MEDICAL EXPERT GIVES ARTHRITIS CURE BREAKTHROUGH A CAUTIOUS WELCOME

By Arthur, Technology Editor

30 October 2000

Experts reacted cautiously yesterday to news that a team of British

scientists may have developed a cure for the crippling disease rheumatoid

arthritis and possibly other " auto-immune " diseases.

Scientists from University College London (UCL) will announce today, at an

international conference, that they have had success in small-scale trials to

treat people suffering from the painful disease, which affects 750,000 people

in Britain.

The treatment consists of drugs which destroy the body's own " B-cells " , part

of the immune system which defends the body against disease. Sometimes these

B-cells attack the body's own tissue, leading to rheumatoid arthritis.

But, commenting on the reports, Dr e, medical director at the

Royal National Hospital for Rheumatoid Diseases, said details on the

treatment were " sketchy " and it was too early to hail it as a wonder cure. He

said: " Eighteen patients have shown benefits but for any new drug you have to

put it through a long, testing process to make sure early promise proves to

be correct and to make sure it is safe. " Such testing can take five to ten

years from the first human successes.

The UCL team's work looked at the role of the B-cells, the white blood cells

that defend the body against viruses and bacteria by making antibodies that

attack the hostile microbes. B-cells often accidentally make antibodies that

attack healthy tissue; some of those errant antibodies then also trigger the

production of copies of themselves. In that case, rheumatoid arthritis can

follow, as the collagen which normally allows the joints to move smoothly

becomes shredded and rough.

The rheumatoid form is only one version of arthritis; the disease generally

appears in old age as the collagen becomes worn naturally and is not

replaced. The UCL team's treatment will have no effect on that.

The new treatment uses drugs that seek out and destroy B-cells. The body

responds to the destruction of all its B-cells by making fresh ones. The

chances are small that these new B-cells will make the same mistake as their

predecessors and trigger a return of rheumatoid arthritis.

Of 20 patients who underwent 18 months of treatment, five now have only some

residual pain from the damage already done.

Professor said: " They have returned to leading a more or less normal

life. So far, of the total of 20 patients only two have had no benefit at

all. "

The patients have had rheumatoid arthritis for an average of 20 years, he

added. The B-cell-based therapy might also offer hope to patients with other

auto-immune diseases, such as Crohn's disease, lupus and even multiple

sclerosis, as it suggests ways of stopping the destructive cycle in which the

immune system turns on the body's own tissues.

The team will announce the results of its research today at the annual

scientific meeting of the American College of Rheumatology in Philadelphia.

The findings will be also published in the leading journal Rheumatology.

Glutch, spokesman for voluntary group Arthritis Care, has told the

Government that it will have to allocate substantial resources to pay for any

drugs that emerge from the new treatment.

______________________________________________________________________________

__

FROM THE TIMES NEWSPAPER (30.10.00)

(http://www.thetimes.co.uk)

MONDAY OCTOBER 30 2000

NEIL MUNNS / PA

BRITISH SCIENTISTS IN BREAKTHROUGH ARTHRITIS THERAPY

BY NIGEL HAWKES HEALTH EDITOR

BRITISH scientists are to announce a major advance in the treatment of

rheumatoid arthritis at a conference in the United States this week.

Five patients who have had the disease for an average of 22 years, and who

have failed to show any benefit from five drugs, have experienced a 70 per

cent reduction in symptoms from the new treatment.

Professor of University College London (UCL), who is leading

the research, said that 18 months after treatment of the patients began they

were still doing well and the residual pain they now suffered was the result

of long-standing damage to the joints.

" They have returned to leading a more or less normal life, " he said. Of a

further 15 patients treated for a shorter period, only two had failed to show

some benefit, he said.

Other experts were reluctant to hail the new treatment a cure. Dr

e, medical director at the Royal National Hospital for Rheumatoid

Diseases, said the treatment's details were " sketchy " .

" Eighteen patients have shown benefits, but for any new drug you have to put

it through a long testing process to make sure early promise proves to be

correct and to make sure it is safe, " he said. " Only until we do all this and

make sure we can produce sufficient quantities to use it will it be available

on the market. "

A potential drawback of the treatment is that it involves suppressing part of

the immune system by using a drug developed to treat lymphomas, a form of

cancer.

But in a presentation on Wednesday to the American College of Rheumatology

conference in Washington DC, Professor will say that knocking out

this part of the immune system does not lead to other diseases gaining a

foothold and that the drug has proved safe in lymphoma.

Rheumatoid arthritis is caused by the killer cells of the immune system

turning on the body itself, creating damage to the joints. Professor

and his colleagues, Geraldine Cambridge and Leandro, tried to counter

it by knocking out white blood cells called B-lymphocytes using the drug

rituximab.

Discovered by IDEC Pharmaceuticals in San Diego, California, and developed in

co-operation with Genentech of South San Francisco, rituximab is marketed in

Europe by Hoffman La Roche under the brand name Mabthera. Roche helped fund

the UCL work.

The drug works by latching on to a protein found only on the outside of

B-cells, and suppressing their activity. In the arthritis treatment it was

given together with the arthritis drug prednisolone and the cancer drug

cyclophosphamide.

There has been earlier evidence that suppression of the immune system can

help relieve arthritis. The UCL team hopes that if they can kill all the

B-cells which have been programmed to attack the patient's body, fresh

B-cells created later will be normal.

Of the first five patients treated, three showed no relapse a year after

treatment. The other two did relapse as soon as new B-cells appeared, but a

second treatment at a lower dose proved effective.

The team estimates that about half the patients treated with this method

could expect at least a 50 per cent reduction in symptoms, and 70 per cent if

re-treatment were included. The cost per treatment would be about £5,000.

> Rainey Sue:

>

> Pls explain B cells to me, never heard of it. I am sure am getting an

> education from all of this. Do you learn all of this from research or are

> you a professional in the field.

>

> Jan

>

>

>

[Guest guest]

Rainy Sue,

I just made a donation to the Arthritis Foundation and if you make a donation

over $25.00 you get a free subsribition to Arthritis Today. I am looking

forward to getting it.

shelly