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The sustained benefits of very early treatment of rheumatoid arthritis with anti-TNF-alpha therapy

A major cause of pain and disability, rheumatoid arthritis (RA) is also potentially the most treatable form of chronic arthritis. Researchers, doctors, and patients agree that a group of drugs called disease-modifying antirheumatic drugs (DMARDs) can effectively reduce joint pain and stiffness. Yet, even when prescribed early and aggressively, DMARDs alone do not guarantee the desired outcome: the rapid and prolonged suppression of inflammation needed to induce remission.

Fortunately, there is new hope for treating RA early and experiencing long-lasting gains. Biologic agents that target tumor necrosis factor (TNF)-alpha a protein known for provoking inflammation have been successfully used to curtail the activity of rheumatoid arthritis among other chronic inflammatory conditions. Recently, a team of researchers in the United Kingdom set out to test the effectiveness of anti-TNF-alpha therapy on a small sample of patients with very early, poor-prognosis, previously untreated RA. The promising results and practical treatment implications of their pilot study are featured in the January 2005 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis).

Based at Leeds General Infirmary, the research team recruited twenty patients with a diagnosis of RA meeting the American College of Rheumatology's criteria. On average, the patients had complained of disease symptoms for six months. None had ever been prescribed DMARDs or steroids. At the study's onset, the patients were randomly divided into two treatment groups. One group received a standard dosage of a TNF-alpha inhibitor, infliximab (also known by the commercial name Remicade), while the other group received the a placebo. Patients in both groups also began a course of escalating DMARD therapy with methotrexate
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Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
7-Jan-2005


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