Sunday April 24, 2011
The International League of Associations for Rheumatology defines juvenile idiopathic arthritis (JIA) as "arthritis of unknown etiology that begins before the sixteenth birthday and persists for at least 6 weeks with other known conditions excluded." JIA is among the more common chronic diseases associated with childhood. About 1 child per 1,000 develop some form of juvenile arthritis.
Developing a treatment plan to control the disease was essential. The American College of Rheumatology (ACR) has released their treatment recommendations for juvenile idiopathic arthritis. Learn more in 2011 ACR Recommendations for the Treatment of Juvenile Idiopathic Arthritis.
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Friday April 22, 2011
Pfizer has announced results from the ORAL Scan Phase 3 study of tofacitinib, an oral JAK inhibitor being developed to treat rheumatoid arthritis. The ORAL Scan Phase 3 study is actually a two-year study of patients with moderate to severely active rheumatoid arthritis who had an inadequate response to methotrexate. Patients in the study were randomly assigned 5 or 10 mg tofacitinib twice a day or placebo added to background methotrexate.
The results being reported now are from the one-year interval of the two-year planned study. All primary endpoints of the study were met for the 10 mg dose of tofacitinib -- the drug showed statistically significant changes versus placebo in reducing signs and symptoms of rheumatoid arthritis, in reducing progression of structural damage, and in improving physical function at 6 months. With the 5 mg dose, there was also a statistically significant difference compared to placebo for reducing signs and symptoms -- but there was not a statistically significant reduction in the progression of stuctural damage at 6 months compared to placebo.
Four deaths were reported in the study -- but three of the four were found not to be related to the study drug. One of the deaths involved brain injury following trauma that occurred 22 days after discontinuing the drug. Another death was related to worsening rheumatoid arthritis 42 days after discontinuing the drug. The third death was related to acute heart failure. There was one case of respiratory failure that was related to the study drug, tofacitinib. Pfizer has commented, on their website, that the mortality rate throughout the tofacitinib development program is consistent with the range reported for all biologic therapies for rheumatoid arthritis.
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Thursday April 21, 2011
On April 19, 2011, the United States Food and Drug Administration (FDA) approved Rituxan (rituximab) in combination with steroids for the treatment of Wegener's granulomatosis and microscopic polyangiitis. Both conditions cause vasculitis (inflammation of the blood vessels).
Rituxan is the first approved treatment for the two conditions. Vasculitis, in patients with either of the two conditions, can lead to tissue damage. Wegener's granulomatosis mostly affects the respiratory tract and kidneys. Microscopic polyangiitis typically affects the kidneys, lungs, nerves, skin, and joints. Both of the diseases can affect people of all ages, gender, and ethnicity. They are both considered orphan diseases because they each affect fewer than 200,000 people in the U.S.
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Sunday April 17, 2011
Researchers at Brigham and Women's Hospital have reported that the key to arthritis relief may eventually come in the form of an injectable gel. The injectable gel would allow for the targeted release of medicine at an affected joint. The medicine would be dispensed on demand in response to enzymes associated with a flare of arthritis symptoms. Why is this of such great interest compared to what's currently available to treat arthritis? Most current medications are taken orally and take time to work. Not only that, oral medications and even newer biologic injectable drugs can result in systemic side effects and toxicity. Something that could target the affected joint and bypass unwanted systemic effects would be a bold step forward in arthritis treatment.
Imagine! A gel that is injected into an arthritic joint, containing encapsulated agents which are released in the presence of enzymes associated with inflammation. It would be unlike anything else. The injectable gel has not yet been tested on humans -- only on mice. But researchers are optimistic and have applied for a patent on their work.
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