Reversing Rheumatoid Arthritis

New treatment reduces symptoms and may undo damage already done by rheumatoid arthritis

(RxWiki News) Treating the symptoms of rheumatoid arthritis is one thing, but researchers may have gone one step further with the discovery of a protein that could potentially reverse pre-existing damage.

Rheumatoid arthritis is notoriously hard to treat. However, researchers have developed a protein that can not only reduce inflammation, but also potentially rid people of the disease, as shown by positive results from tests on mice.

dailyRx Insight: Scientists think the protein progranuli may someday work better than current rheumatoid arthritis drugs -- and be cheaper.

The drugs that are currently used to treat rheumatoid arthritis inhibit tumor necrosis factor (TNF), a molecule that causes inflammation and is associated with a variety of other autoimmune diseases. Although anti-TNF drugs help many rheumatoid arthritis patients deal with their symptoms, there are alot of patients who do not respond to the drugs. Furthermore, anti-TNF drugs are expensive and may even increase the risk of cancer and make other autoimmune diseases worse.

In order to find a better alternative to current treatments, a team of researchers tested one treatment option on mice. The researchers found that a protein called progranulin, when bound to TNF receptors, reduced the inflammation associated with rheumatoid arthritis. In some cases, the course of the course of the disease was reversed.

If applied to humans, this new treatment could be much more beneficial than anti-TNF drugs. Not only does the new protein better target the sources of inflammation, but it also may cost much less than current treatments.

There are approximately 1.3 million rheumatoid arthritis sufferers in the United States, about 75 percent of whom are women. Rheumatoid arthritis damages the joints, most commonly in the hands, feet, and cervical spine. Inflammation can also affects other organs and systems in the body such as the skin, lungs (fibrosis), kidneys (amyloid protein deposits), and cardiovascular system (increased risk for heart attack and stroke, as well as fibrosis and pericarditis). A clinical diagnosis can be made on the basis of symptoms, physical exam, radiographs, x-rays and lab tests. There are many prescription medications used to treat rheumatoid arthritis such as hydroxychloroquine (Plaquenil®), chloroquine (Aralen®), leflunomide (Arava®), and methotrexate (Rheumatrex ®). Non-pharmacological treatment includes psychical therapy, orthoses, and nutritional therapy but these do not stop progression of joint destruction. Analgesia (painkillers) and anti-inflammatory drugs, including steroids, are used to suppress the symptoms, while disease-modifying antirheumatic drugs (DMARDs) are required to inhibit or halt the underlying immune process and prevent long-term damage. Recently the newer group of biologics, such as abatacept (Orencia®), adalimumab (Humira®), etanercept (Enbrel®), infliximab (Remicade®), and rituximab (Rituxan®) have increased treatment options.

The study is published in the journal Science. 

Review Date: 
March 14, 2011