Rheumatoid arthritis drugs in development - MayoClinic.com

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Rheumatoid arthritis drugs in development



By Mayo Clinic staff

Researchers are working hard to better understand what triggers the

symptoms of rheumatoid arthritis and what can be done to relieve

these symptoms. Despite developments, there's still no cure.

But don't let that get you down. Researchers are discovering new ways

to treat arthritis. And promising developments in rheumatoid

arthritis treatment may soon allow your arthritis to be treated

earlier, more effectively and with fewer side effects. Research is

focusing on several areas:

Biological response modifiers

Biological treatments target the parts of your body's immune system

that might trigger joint damage and inflammation. TNF-alpha

inhibitors are one type of biological treatment approved for

rheumatoid arthritis. Other biological response modifiers being

investigated include:

Tacrolimus (Prograf). Tacrolimus is an immunosuppressant that blocks

the action of T cells — certain white blood cells that play a role

in activating other cells in your immune system. Tacrolimus is

already approved for people who've had liver or kidney transplants to

keep their bodies from attacking their new organs. Researchers hope

tacrolimus can help people with rheumatoid arthritis by stopping T

cells from causing inflammation.

Rituximab (Rituxan). Rituximab reduces the number of B cells in your

body. B cells are involved in inflammation, though it isn't clear

how. Rituximab is approved for use in people with non-Hodgkin's

lymphoma. But it appears that rituximab may play a role in treating

rheumatoid arthritis, as well. Studies have examined rituximab alone

and in combination with other arthritis drugs.

Interleukin-6 blockers. Interleukin-6 (IL-6) is a protein that's

overproduced in the joints of people with rheumatoid arthritis, where

it's believed to be responsible for joint damage and swelling. IL-6

may also be a cause of fever and excess blood platelets

(thrombocytosis) in people with rheumatoid arthritis. Researchers

hope that blocking IL-6 can reduce the damage it does. Early research

has shown promise.

Costimulation blockers. T cells, which play a part in activating your

immune system, require two signals to turn them on, and researchers

hope blocking one of those signals will render the T cells inactive.

Researchers have done some preliminary trials of drugs in this

category, both alone and along with methotrexate (Rheumatrex). A

phase III trial of abatacept, one costimulation blocker, found

abatacept useful in people with severe rheumatoid arthritis who

weren't helped by TNF-alpha inhibitors. The Food and Drug

administration is considering abatacept for approval, which would

make the drug available by prescription in the United States.

TNF-alpha inhibitors: Treatment for inflammatory diseases

Tacrolimus (Systemic)

Rituximab (Systemic)

Antibiotics

Researchers continue to explore the possibility that some form of

infection may trigger the onset of rheumatoid arthritis. If an

infectious agent can be found, taking an antibiotic might prevent the

disease. Antibiotics might also help stop the progression of the

disease or relieve symptoms once rheumatoid arthritis has developed.

Results from clinical trials using antibiotics have been mixed.

Gene therapy

Specific genes in your body might direct cells to manufacture

substances that help reduce inflammation or protect your joints. The

goal of gene therapy is to increase the production of these

protective substances. It might mean supplying your body with a

healthy gene to replace a defective one. Or it might involve blocking

the action of a harmful gene. Though researchers have identified some

helpful genes, they have yet to figure out the best method for

delivering the genes' protective benefits. Very small studies

performed in people have shown some promise, but gene therapy is

still many years from being used for arthritis treatment.

New drug development: Research, approval processes take years

It takes several years for drugs to move from a new idea, through

research and development and, eventually, to approval. Some drugs

that seemed promising in small studies won't pan out in larger

clinical trials and may never receive approval. Though new

developments may provide hope for the future, know that nothing is

certain. Talk to your doctor as new drugs come on the market.

Together you can decide what's best for you.

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