Last weekend was the annual American College of Rheumatology Conference, and though I was not in attendance, I learned that some intriguing information was revealed.
Much news, information, and research was shared, but there were a few key elements that could mean good things for those with rheumatoid arthritis.
Though the information has been “out there” for awhile, it was further elaborated upon this last weekend.
So let’s learn more about these potential advances in RA research.
If you have Rheumatoid Arthritis or a similar rheumatic condition, you have probably heard about Anti-TNFs (also called TNF-blockers) and also treatments that affect the B-cells.
A newer class of biologics that work differently than the existing ones are called JAK Inhibitors, and they are at present being further looked into. According to the ACR and MedPage Today, “JAK has attracted increasing attention as a drug target in rheumatoid arthritis because it’s central to the inflammatory response — mediating the release of tumor necrosis factor and other cytokines — and because, as a kinase enzyme, it should be amenable to blockade by an oral, small-molecule drug.” The emergence of the JAK kinase as the new hot target in rheumatoid arthritis has been further cemented “with positive phase II data on an oral drug that may compete with the field’s current leader.” Tony James from The Rheumatology Update agrees. “The novel oral JAK inhibitor tofacitinib significantly improves the signs and symptoms of RA in patients unresponsive to other TNF inhibitors, a phase III study shows.”
Other promising news included a vaccine designed to re-educate the immune system. According to a press release issued from the ACR Conference this past Saturday, “A vaccine designed to re-educate the immune system has been shown to be safe and feasible in the treatment of rheumatoid arthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Chicago. ‘RA is caused by an aberrant response that can be triggered by disease-specific antigens, or proteins,’ says lead investigator Ranjeny Thomas, MBBS MD; professor of rheumatology at The University of Queensland Diamantina Institute. ‘Current treatments attempt to reduce the joint destruction associated with this disease by targeting the inflammation that is a consequence of this immune response. However, non-specific suppression of inflammation may increase infection, and drugs may be toxic to vital organs.’
Dr. Thomas’ team recently completed a study looking at the feasibility and safety of using a vaccine, called Rheumavax®, to reduce the way a person’s immune system reacts towards the disease antigens thought to cause RA.
‘Approximately 70 to 80 percent of RA patients make antibodies towards RA-specific antigens called citrullinated peptides, which are identifiable with a blood test,’ explains Dr. Thomas. ‘While antigen-specific immune tolerance is a major goal for RA prevention and treatment, early trials failed to show a response, and the strategy was abandoned when biologic therapy was spectacularly successful. We reasoned the problem might be solved if the dendritic cells that normally educate the immune system towards these antigens were modified with a drug that would promote immune tolerance.’ And, with that thought in mind, Dr. Thomas’ team designed Rheumavax using drug-modified dendritic cells (generated from a person’s own blood) and citrullinated peptide antigens, to suppress specific RA immune reactivity (or restore immune tolerance) – leaving broader immunity towards infections intact.” You can read more, here.
For the estimated 1.3 million Americans with Rheumatoid Arthrtitis, both of these advances could be great news. Imagine if it were as simple as a vaccine.
Fingers (awkwardly, painfully) crossed!
Stay Well and Have a Great Weekend,