'Smart' drugs arthritis hope

Three cutting-edge "smart" drugs have ushered in a new era of treatment for sufferers of rheumatoid arthritis.

Each consists of molecules that target different parts of the immune system.

Two drugs, MabThera and Orencia, are licensed in the UK, although the latter was only launched this month. The third, tocilizumab, is still undergoing trials.

Researchers who analysed trial data on the drugs said all three slowed progression of the disease and reduced its symptoms.

All achieved the best results when used in combination with the standard treatment methotrexate.

The scientists, led by Professor Josef Smolen, from the Medical University of Vienna in Austria, wrote in an online edition of The Lancet medical journal: "The emerging agents show that a new era has started in the treatment of rheumatoid arthritis."

Rheumatoid arthritis (RA) is a painful and sometimes crippling auto-immune disease which affects an estimated 400,000 people in the UK, 4,000 of them seriously.

It occurs when the immune system attacks the joints, causing swelling and damage of cartilage and bone.

Traditional treatments for RA include non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoid steroids, and disease-modifying antirheumatic drugs (DMARDs). Methotrexate, the most widely used DMARD, is a cornerstone of most treatment regimens.

All these treatments have limited effectiveness, and even responses to newer biological agents such as tumour necrosis factor (TNF) inhibitors may be restricted, said the researchers. Further advances and more treatment choices were therefore needed.

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