Safety data obtained from randomized clinical trials designed to evaluate the efficacy of rheumatoid arthritis (RA) drugs can be misleading for several reasons. Often, the studies are short term (6 months or less), and are highly selective of the subjects included (usually subjects with very active disease and with few medical comorbidities). In addition, background DMARDs are usually restricted to methotrexate.
Tumor necrosis factor alpha (TNF-a) is a highly inflammatory cytokine with an important role in coordinating the inflammatory response seen in the axial skeleton of patients with ankylosing spondylitis (AS). Two biologic inhibitors of this cytokine, etanercept (Enbrel) and infliximab (Remicade), have been shown to be effective at reducing the subjective symptoms and reducing the systemic inflammatory response in AS in randomized clinical trials.
Celecoxib Effective at Reducing Recurrent Colonic Adenomatous Polyps, but May Increase Cardiovascular Risk
In addition to analgesic effects, animal studies have shown that inhibition of cyclooxygenase-2 (COX-2) is chemoprotective against colonic adenomas. In humans, the use of the COX-2 inhibitor celecoxib (Celebrex) has demonstrated anti-tumor activity in patients with familial adenomatous polyposis, a condition characterized by numerous colonic adenomas that often lead to frank colon cancer early in life.
Temporal Trends in the Maintenance of Bone Health among Chronic Glucocorticoid Users Improving, but Fall Short of Recommendations
The association of glucocorticoid use, low bone mineral density (BMD), and osteoporotic fracture is well established. However, the use of bone-protective measures for users of glucocorticoids has traditionally been sub-optimal. The 1996 American College of Rheumatology Guidelines recommend routine BMD testing and liberal use of anti-osteoporosis medications in chronic glucocorticoid users, yet the effectiveness of these recommendations in clinical practice have not been systematically evaluated.
The Food and Drug Administration (FDA) has approved automated delivery systems for both Humira® (adalimumab) and Enbrel® (etanercept). The Humira Pen and Enbrel SureClickTM will be available for patient use in the first week of August 2006. In both systems, the medication is in a prefilled pen-like device and the needle is not visible to [...]