Home Community Chat Transcripts-8/6/2001

Thomas Lee, PhD author of the new book: Conquering Rheumatoid Arthritis : The Latest Breakthroughs and Treatments joins us. Dr. Lee, who has rheumatoid arthritis, will talk about the latest treatments and what the future holds.

InsightHostKJ> OK....our guest tonight is Dr. Thomas Lee, author of Conquering Rheumatoid Arthritis : The Latest Breakthroughs and Treatments will join us. Dr. Lee, who has rheumatoid arthritis, will talk about the latest treatments and what the future holds. 

InsightHostKJ> Remember, we will be using the guest speaker protocol. Please hold all conversation and type a ? if you have a question. You may ask your question when I call on you. Please do not type your question into the room until you are called on. 

InsightHostKJ> Thanks for joining us Prof Lee 

ProfLee> Happy to be here. 

InsightHostKJ> Can you tell us a bit about yourself? 

ProfLee> I am a professor of biotechnology and microbiology at St. Anselm college in 'beautiful' Manchester, NH. My wife Eileen (an oncology nurse) and I have six children, one of whom-Julie-who does research in immunologuy at Genetics Institute in Cambridges, MA- 

InsightHostKJ> Wow 

InsightHostKJ> And why did you become interested in RA? 

Guest35> I was diagnosed six years ago with RA.

InsightHostKJ> lucky you! 

Guest35> I decided that a book was needed on new developments and new promises for treatment. 

InsightHostKJ> does our future look bright? 

Guest35> Yes. Although it may take a while. However, there are good meds now, but better ones on the way. 

InsightHostKJ> Less side effects? 

InsightHostKJ> or just more effective? 

Guest35> Hope so. In book, I cover about 25 new treatments now under development as well as current treatments. 

Guest35> more effective as well 

InsightHostKJ> The question we all wanna ask....Is a cure possible? 

Guest35> I would like to say yes but I am of the opinion that at this point we can hope for better control not total cure. 

InsightHostKJ> i'll take that 

Guest35> me too 

InsightHostKJ> how much research went into Conquering Rheumatoid Arthritis : The Latest Breakthroughs and Treatments ?

Guest35> about a year and a half of research and about a year of writing while still researching 

InsightHostKJ> Wow, a lot of work, thank you! We appreciate it! 

InsightHostKJ> I learned a lot from reading it 

Guest35> I hope it helps. My intention is to help people become more informed partners with their rheumatologists. 

InsightHostKJ> Which we all should become! 

InsightHostKJ> of the most recent drugs to hit the market, which do u consider to be the biggest breakthrough? 

Guest35> Probably Enbrel and Remicade. 

InsightHostKJ> why? 

Guest35> Because they appear to slow down the destructive process as opposed to just limiting pain 

InsightHostKJ> Which will be the next new drug to hit the market? 

Guest35> Perhaps Anakinra (Kineret). It blocks an inflammatory chemical, IL-1. 

InsightHostKJ> We will be having a chat with a doc from the Anakinra trials in Sept...looks very promising to me 

Guest35> Yes. And also D2E7, an antibody against TNF. 

InsightHostKJ> is D2E7 similar to enbrel and remicade? 

Guest35> In a way yes. They all go after TNF. 

Guest15> ? Are monoclonal antibodies the wave of the future in RA and other autoimmune diseases? 

Guest35> They certainly are part of it. Most monoclonals are now directed towards cancer but RA is becoming a favorite target.

InsightHostKJ> guest 15 please do not ask a ? until you have been called on 

InsightHostKJ> before we open the floor to questions, I have to ask you the same question we ask all people \with RA that come in here 

InsightHostKJ> what meds do you take and how are you doing with them? 

Guest35> I started out with prednisone and Plaquenil and Naprosyn. Now I am down to just Plaquenil and Celebrex. 

InsightHostKJ> great! ok then....please type a ? if you have a question and wait to be called on 

InsightHostKJ> how does anikinra differ from the TNF drugs? 

Guest35> It is a TNF drug and basically uses a human gene to make it. 

InsightHostKJ> how does that effect RA? 

Guest35> It blocks TNF which is a major chemical causing inflammation in the joints. Recent trials look good. 

InsightHostKJ> What about the controversial stem cell research....hope for RA? 

Guest35> absolutely. I have a chapter on that. Two ways - one replacing damaged tissue and stem cell transplants. 

InsightHostKJ> how can we replace damaged tissue? 

Guest35> If we get stem cells to grow into new cartilage they can repair joints. 

InsightHostKJ> how can we do that? 

Guest35> If I knew exactly, I'd be heading for the Nobel prize but researchers will learn the correct stimulus and do it. 

InsightHostKJ> LOL...have stem cell transplants been done for RA? 

Guest35> Yes. At least forty in various countries with good results BUT a tough and dangerous procedure. 

InsightHostKJ> only for the worst cases then? 

Guest35> Yes. It is done when nothing else helps. 

Rose> what, if anything, is happening with BMT (bone marrow transplantation)? 

Guest35> BMT is basically the same as stem cell transplants. As I said lots have been tried but it is a drastic procedure. 

InsightHostKJ> are they working to make it easier? 

Guest35> Yes. but it does involve wiping out a person's marrow and replacing it so that will always be dangerous. 

kjcatty> A few months ago there was mention of using fat cells- undifferentiated 

kjcatty> Any more news on that? 

Guest35> Fat cells are a good source of stem cells so there is hope there of a convienent source. 

kjcatty> would be good news for some of us on pred 

InsightHostKJ> thats interesting 

Melanie> A big component of RA (at least for me) is the fatigue. Any areas of research that would address this in particular, in addition to controlling the RA? 

Guest35> I am not aware of any specific anti-fatigue breakthroughs. I can tell you thats my biggest problem too. 

Melanie> thanks, Dr. Lee 

InsightHostKJ> The gene hunt....what role will that play in treating RA? 

Guest35> First of all, genes do play a role. When we identify them, we can try to control their functions. 

InsightHostKJ> how close are we to identifying them? 

Guest35> Thats impossible to say. But I suspect within five or so years. Afterall, it will be very profitable. 

InsightHostKJ> thats for sure! 

kjcatty> How about studies with twins- any success with them? 

Guest35> There is some genetic connection but if one twin has RA the other has only about 14%% chance of also RA. 

kjcatty> Thanks, my own experience 

InsightHostKJ> what about auto immnue diseases in general..if one has one...will the other? 

Guest35> I'm afraid too general to answer. There are a hundred or so autoimmune diseases. 

InsightHostKJ> last year there was hoopla about blocking the B cells. they even mentioned cure, but now we hear nothing....what happened? 

Guest35> In my book, I discuss this and give as I do many times a website to follow this. It is still in clinical trials with 160 people. 

InsightHostKJ> promising? 

Guest35> Well, its a tough treatment because the immune system has to be suppressed. Almost like BMT. But we'll see. 

InsightHostKJ> What about a vaccine? 

Guest35> There are at least 3 vaccines now under study of various types. could be promising. 

InsightHostKJ> and they will prevent RA? or how do they work? I am not clear on that 

Guest35> Not for prevention but they fight against the process. So again not like tetanus etc. but if effective, thats okay. 

InsightHostKJ> anything that works is okay with me! 

InsightHostKJ> what other things are in the pipeline? 

Guest35> Me too. You know even if RA is not cured if we stop the pain and fatigue hey I'll take that. 

InsightHostKJ> got that right! 

Guest35> Well, lots. For ex., there are new uses for marijuana, thalidomide for blockage of other inflammatory chemicals etc. 

InsightHostKJ> marijuana? for more than pain control? 

Guest35> Well, it helps the joints - pardon the expression. It is for pain relief like ibuprofen. Less stomach effects. 

InsightHostKJ> think they'll ever make it legal for us? 

Guest35> Artifical forms are being developed based on mj so probably okay. 

InsightHostKJ> thaliomide....what does it do? 

Guest35> It can block blood vessel growth in bad joints and fight TNF as well. 

Melanie> We all know of the side effects of thalidomide. No question exactly, but that really scares me. 

InsightHostKJ> yeah, but for those of us who have no chance at becoming pregnant... 

Melanie> well, true . . .. 

Guest35> I understand. New forms are being made. For ex. some block COX2 as well so they will be safe. 

kitty> well i have Jra and i want to be normal like other kids but i can't do things that i want to do 

Guest35> Well, JRA sure is tough. There is last month a new med okayed for JRA - gammaglobulin. 

kitty> I want to take Remicade but my doctor won't let me what else can i take 

Guest35> There are other choices but it is a decision to make with your physician. Just make sure she explains why. 

jo> does all the new research you rea doing apply where I live as well In australia? 

Guest35> sure does. 

InsightHostKJ> Dr Lee, is there anything else you'd like to share with us before we close? 

InsightHostKJ> You can find his book: Conquering Rheumatoid Arthritis : The Latest Breakthroughs and Treatments at Amazon.com. I highly recommend it 

Guest35> I want to thank you all for participating and I wish you all the very best for your RA.Lets be optimistic! 

Betty> Thank you, Dr. Lee 

Guest35> You're very welcome. 

Melanie> I wish you lots of energy and no pain, Dr. Lee. Thanks for being here. 

jo> thank you Dr Lee 

InsightHostKJ> Than you Dr Lee! 

InsightHostRon> Thank you Dr. Lee, for a very informative chat 

kaekae> Thank you Dr. Lee! 

Guest35> Peace.