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Rheumatoid arthritis drugs in development
From MayoClinic.com
Special to CNN.com

Researchers are working hard to better understand what triggers the symptoms of rheumatoid arthritis and what can be done to relieve these symptoms. Despite developments, there's still no cure.

But don't let that get you down. Researchers are discovering new ways to treat arthritis. And promising developments in rheumatoid arthritis treatment may soon allow your arthritis to be treated earlier, more effectively and with fewer side effects. Research is focusing on several areas:

Biological response modifiers

Biological treatments target the parts of your body's immune system that might trigger joint damage and inflammation. TNF-alpha inhibitors are one type of biological treatment approved for rheumatoid arthritis. Other biological response modifiers being investigated include:

  • Tacrolimus (Prograf). Tacrolimus is an immunosuppressant that blocks the action of T cells — certain white blood cells that play a role in activating other cells in your immune system. Tacrolimus is already approved for people who've had liver or kidney transplants to keep their bodies from attacking their new organs. Researchers hope tacrolimus can help people with rheumatoid arthritis by stopping T cells from causing inflammation.
  • Interleukin-6 blockers. Interleukin-6 (IL-6) is a protein that's overproduced in the joints of people with rheumatoid arthritis, where it's believed to be responsible for joint damage and swelling. IL-6 may also be a cause of fever and excess blood platelets (thrombocytosis) in people with rheumatoid arthritis. Researchers hope that blocking IL-6 can reduce the damage it does. Early research has shown promise.
  • Costimulation blockers. T cells, which play a part in activating your immune system, require two signals to turn them on, and researchers hope blocking one of those signals will render the T cells inactive. Researchers have done some preliminary trials of drugs in this category, both alone and along with methotrexate (Rheumatrex). The Food and Drug Administration approved one costimulation blocker — abatacept (Orencia) — for use in people with moderate to severe rheumatoid arthritis who haven't been helped by other drugs.

Antibiotics

Researchers continue to explore the possibility that some form of infection may trigger the onset of rheumatoid arthritis. If an infectious agent can be found, taking an antibiotic might prevent the disease. Antibiotics might also help stop the progression of the disease or relieve symptoms once rheumatoid arthritis has developed. Results from clinical trials using antibiotics have been mixed.

Gene therapy

Specific genes in your body might direct cells to manufacture substances that help reduce inflammation or protect your joints. The goal of gene therapy is to increase the production of these protective substances. It might mean supplying your body with a healthy gene to replace a defective one. Or it might involve blocking the action of a harmful gene. Though researchers have identified some helpful genes, they have yet to figure out the best method for delivering the genes' protective benefits. Very small studies performed in people have shown some promise, but gene therapy is still many years from being used for arthritis treatment.

New drug development: Research, approval processes take years

It takes several years for drugs to move from a new idea, through research and development and, eventually, to approval. Some drugs that seemed promising in small studies won't pan out in larger clinical trials and may never receive approval. Though new developments may provide hope for the future, know that nothing is certain. Talk to your doctor as new drugs come on the market. Together you can decide what's best for you.

  • Thalidomide: Research advances in cancer and other conditions
  • Arthritis pain relief: Creams and gels for aching joints
  • Cortisone shots: Relieve joint pain at the source
  • TNF-alpha inhibitors: Treatment for inflammatory diseases
  • Rheumatoid arthritis treatment: Can antibiotics reduce symptoms?
  • Abatacept: A new drug for rheumatoid arthritis treatment
  • Are COX-2 drugs safe for you? An interview with a Mayo Clinic specialist
  • Bextra withdrawn from market
  • March 02, 2006

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