Recent Developments

The past two years have brought more new treatment options than any other time in RA history. We have more choices than ever before, from DMARDS to NSAIDS to blood filtering and many combinations, life is good for many with RA.

The avalanche of new treatments began in September of 1998 when the FDA approved the first new DMARD in ten years, Arava. Arava is indicated in adults for the treatment of active rheumatoid arthritis to reduce signs and symptoms and to retard structural damage as evidenced by x-ray erosions and joint space narrowing. This was the first time that a drug was indicated for retardation of structural damage in RA based on x-ray analysis.

Right behind Arava, Enbrel received FDA approval in November of 1998. This was an entirely new approach to treating RA. A biologic response modifier, Enbrel works by binding to a type of inflammatory antibody, the tumor necrosis factor. Given by injection twice weekly, Enbrel was welcomed with open arms by those who had failed traditional DMARDs.

Next came the first of two new NSAIDs, Celebrex was approved by the FDA in December of 1998. Searle and Pfizer’s version of the COX 2 inhibitor, Celebrex works to decrease inflammation and pain like traditional NSAIDs with less GI irritation. One study showed Celebrex to be as effective in relieving symptoms of as the NSAID diclofenac, and that the rate of gastrointestinal complaints was 33% higher in the diclofenac-treated group. Vioxx, Merck?s COX 2 inhibitor was approved in May of 1999.

1999 rolled around and the avalanche continued. The non-drug treatment, Prosorba Column, was granted FDA approval in March. A blood filtering device, the treatment offers great hope to those who failed or cannot tolerate the side effects of traditional DMARDs.

The last of the new treatments was granted FDA approval in November of 1999. Remicade, another biologic response modifier, is given by IV infusion in a doctor?s office or clinic setting. Similar to Enbrel it also works by disrupting the activity of the tumor necrosis factor, unlike Enbrel Remicade should be used with methotrexate.

Thus far, the year 2000 has been anticlimactic compared to the two previous years. No new RA treatments have been released yet this year and nothing new is rumored to be coming soon, though many are in the development stages. We can only hope that the next two years will be as good as the last two years.

For more information see:

Pharm Info Net – Vioxx
Rofecoxib (Vioxx)-Arthritis Insight

Pharm Info Net – Celebrex
Celecoxib (Celebrex)-Arthritis Insight

Pharm Info Net – Enbrel
Etanercept (Enbrel)-Arthritis Insight

Pharm Info Net – Remicade
Infliximab (Remicade)-Arthritis Insight

Pharm Info Net – Arava
Leflunomide (Arava)-Arthritis Insight

Fresenius Hemotechnology-Prosorba Column For Rheumatoid Arthritis
Prosorba Column-Arthritis Insight

References:
Pharm InfoNet – Enbrel (Etanercept) Recommended for Approval For Rheumatoid Arthritis
Pharm InfoNet – Arava? (Leflunomide) Approved For Adult Rheumatoid Arthritis
Pharm InfoNet – Remicade (infliximab) for the Treatment of Rheumatoid Arthritis
Pharm InfoNet – First COX-2 Inhibitor Approved for OA and RA
Med Watch News – FDA APPROVES VIOXX FOR OSTEOARTHRITIS, PAIN AND MENSTRUAL PAIN
Fresenius Hemotechnology – Prosorba Column For Rheumatoid Arthritis