As for concerns over safety, all new drugs carry risks and the new biologics are no different. One of the most significant is an increased risk of infection, especially in those patients with latent tuberculosis (TB) (they're nonactive carriers). Because of this, all patients are tested for TB and, if necessary, treated before starting any of these medications. These four new drugs are just the start to a new trend for RA treatment. According to Dr. Edward Keystone, director of the Rebecca MacDonald Centre for Arthritis and Autoimmune at Mount Sinai Hospital in Toronto, about 145 new medications are in preclinical trials with another 80 already undergoing testing in human subjects. This explosion in new therapies is possible because researchers today have a better understanding of RA, so they're delivering improved ways and means of treating the disease.
One area of interest is developing new ways to remove or decrease the relatively high levels of TNF, IL-1 and other types of interleukin found in inflamed joints.
One drug close to being evaluated for release, for example, blocks the ability of targeted cells to communicate with one another. This signal interference stops the release of hormones that excite cells, which, in turn, release chemicals that destroy tissue.
As well, an existing drug may offer significant advantages in the treatment of RA. Rituxan has been used against lymphoma (cancer of the lymphatic system) in more than 400,000 patients worldwide. In the past year researchers have discovered that for about 70 per cent of RA patients, two injections given two weeks apart provide good relief for at least a year.
And finally, several types of selective small molecule inhibitors are being developed, which, if successful, may do away with injections and infusions altogether. In their place? A pill, to be taken at breakfast. To quote Keystone: "It's a great time to be a rheumatologist; it's an even better time to be a patient."




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