Daytona Beach News Journal

Research participation fuels treatment evolution.

Rheumatoid arthritis (RA) is a chronic progressive inflammatory arthritis and autoimmune disease. When inflammation occurs, chemical mediators are released from cells and joint tissues. This process can damage cartilage, bone and ligament and cause joint deformities and function impairment.

Until the last few years, strategic RA treatment ranged from NSAIDs (non-steroidal anti-inflammatory drugs) and corticosteroids for symptom control, to a more biologically modifying process by adding Methotrexate (MTX) or other disease-modifying anti-rheumatic drugs (DMARDs) for joint damage control and prevention. Unfortunately, despite their power, DMARD treatment was still unsatisfactory.

Currently, the most current secret weapons called biologic response modifiers BRCMs have been approved by the FDA for treatment of RA: etanercept (Enbrel), infliximab (Remicade), and more recently adalimumab (Humira). BRCMs have dramatically changed the way we treat rheumatoid arthritis and psoriatic arthritis because they have proven themselves to effectively block chemical mediators, rendering anti-tumor necrosing factor (TNF) molecules unavailable for use within the inflammatory process.

The fact that these drugs have this power, gives them the ability to prevent cartilage, bone and ligament damage. Like anti-missiles, BRCMs can lock in on a target and block the enemy’s offensive maneuvers.

Today, more than twenty BRCMs are being studied at different phases of research. Prior to marketing these new drugs to the public, the FDA (Food and Drug Administration) requires that prescription and over-the counter medications undergo several phases of regulated testing through clinical trials. From the FDA, to the pharmaceutical company, to the clinical investigator, to the research coordinator, and to the patient, everyone accepts a defined role and responsibility, with a common goal of helping discover the best treatment available.

Thanks to breakthroughs in genetic engineering, to a better understanding of the role of different chemical and countless patients who have volunteered to participate in clinical trials, mediators, state of the art medicine is continually evolving into the most current best treatment for patients with RA.

Even though there is currently no cure for RA, the latest emergence in the research pipeline of new drugs gives us good reason to be optimistic.