Approval for golimumab (which will by marketed under the trade name Simponi) was granted this week by the U.S. Food and Drug Administration. The drug received approval for the treatment of moderate to severe RA (in conjunction with methotrexate), active psoriatic arthritis (as monotherapy or with methotrexate), and active ankylosing spondylitis at a dose of […]
Cases of new onset psoriasis in patients receiving TNF inhibitors for the treatment of rheumatoid arthritis (RA) have been reported; however, case reports do not permit the calculation of drug-associated incidence rates. Here, Harrison et al (Ann Rheum Dis 2009; 68: 209) compare incident psoriasis in TNF inhibitor treated vs. untreated patients enrolled in the […]
RA patients who use methotrexate have been shown to have lower cardiovascular mortality compared to non-users; however, the mechanism underlying this protection is unclear. Here, Reiss et al (Arthritis Rheum 2008; 58(12): 3675) explore the atheroprotective effects of methotrexate in an experimental model of atherogenesis. Methods THP-1 monocytes/macrophages and human donor peripheral blood mononuclear cells […]
The efficacy of rituximab, a monoclonal antibody directed against CD20 positive B cells, has been demonstrated for the treatment of rheumatoid arthritis (RA) in a number of key studies. However, not all patients respond to therapy. Whether patients with initial non-response may benefit from follow-up treatments (i.e. initial treatment resistance) has not been investigated.
Antibodies against citrullinated proteins have emerged as powerful diagnostic and prognostic tools in RA that may contribute to the initiation phases of the disease. The enzymes that catalyze the citrullination process, known as peptidyl argenine deiminases (or PADs), may also be involved in the initiation and propagation steps of the RA disease process. Additionally, autoimmunity to these catalysts may identify a subset of RA patients with unique disease phenotypes.
Anti-B cell therapy with rituximab has been shown to be safe and beneficial for RA treatment. Rituximab is approved and marketed for the treatment of RA in patients who have failed other therapies. Ocrelizumab, a fully human monoclonal antibody against CD20, may have less immunogenicity and less complement activation than rituximab which, theoretically, may reduce […]
On July 29, 2008, the Arthritis Advisory Board of the FDA reviewed the new Biologics License Application for tocilizumab, which will be marketed under the trade name Actemra, as presented by the manufacturer, Hoffmann-La Roche. After reviewing the efficacy and safety data from multiple Phase III studies, the Board recommended the approval of the biologic […]
Type II collagen is abundant in the joint and is a major target of immune-mediated damage in RA. As suggested in studies of experimental animals, induction of immune tolerance at the level of the cartilage may be a way of reducing the signs and symptoms of RA and prevent joint destruction. However, whether oral administration of Type II collagen is an efficacious treatment for humans with established active RA has not been established.
Increasing the dose of infliximab and, in some cases, adalimumab can result in improved efficacy in RA patients with inadequate responses to initial dosing. However, whether increasing the dose of etanercept can also result in clinical improvement has not been studied.
Bone erosions in response to inflammation in RA are driven by osteoclasts which are in turn activated by RANKL (Receptor Activator for Nuclear Factor κ B Ligand) binding to its receptor RANK. Inhibition of RANKL has the potential to retard bone erosions in RA patients, thereby limiting progressive joint damage and destruction.