By 2030 the Centers for Disease Control and Prevention (CDC) predicts that over 67 million Americans will suffer from arthritis. With so many people currently suffering from arthritis and millions more who will be affected in the future, treatment innovation and progress is critical.
Is The Central Nervous System The Key to Better RA Treatment?
In recent years over 100 new drugs have been created to treat rheumatoid arthritis (RA). However, a new study indicates that it may not be the type of drug, but how the drug is given, that may make the most difference for some arthritis sufferers.
In a study conducted at the University of California San Diego School of Medicine, drugs were more efficient in treating arthritic rats when administered directly into the central nervous system (CNS).
Study leader Gary Firestein and his colleagues concentrated primarily on the protein, p38, which other research has shown is triggered in the CNS in response to peripheral pain. They wondered if the protein might also be involved in the interaction between inflammation in the joints and the CNS.
Firestein and his team induced inflammation in the joints of rats. They discovered that p38 was activated, however, the reaction also depended on another protein called TNFα, an inflammation regulator in the body. They decided to inhibit either p38 or the TNFα by administering drugs directly into the rats' spinal cord. As a result, these rats had significantly less inflammation, joint destruction and arthritis compared to rats that received the same treatment without an active drug.
The study also showed that this type of treatment required lower doses of drugs to be effective, compared to drugs given systemically (below the skin). It gives people suffering with arthritis hope of greater efficiency from their drug treatment, fewer side effects, and possibly, lower drug costs.
Tissue Engineering For Cartilage Replacement
New research may offer more permanent or longer-lasting results than hyaluronic injections. Researchers are hoping to find a way to reliably stimulate cartilage replacement. And some progress has been made on this goal.
In a study at Rice University in Houston, Texas, bioengineers discovered that intense pressure stimulates cartilage cells to grow new tissue with almost all the properties of natural cartilage. The type of pressure required is similar to what you'd experience half a mile below the ocean's surface.
The process does not require stem cell use, which will please critics of this medical approach. It also helps people with arthritis avoid any possible side effects of injections.
Good News for Kids with Juvenile Arthritis
For some children arthritis drugs are either ineffective or cause significant side effects, making drug options very limited. Previously, only etanercept (Enbrel) was approved for treating JIA. Last year the Food and Drug Administration approved two new drugs to treat juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis. JIA is the most common form of arthritis in children.
Adalumumab (Humira) was given the green light for treating symptoms of moderate to severe JIA in children four years and older. Abatacept (Orencia) was approved for patients six years and older. Both drugs are classified as biologics, and recent studies showed them to be safe and effective for treating children.
In a study reported in the Lancet (and funded by Bristol-Myers Squibb), 60 children between the ages of six and 17 with JIA were given 10 mg of abatacept intravenously and 62 were given a placebo. Twenty per cent of the abatacept group experienced flares compared to 53 per cent in the placebo group. Abatacept works by acting on the T cells, which help to cause inflammation.
In another study reported in the New England Journal of Medicine, adalimumab was shown to be effective in treating children with JIA, especially when combined with methotrexate (a disease-modifiying antirheumatic drug or DMARD).
