Breakthroughs in RA Treatment

By

Cindy Kuzma

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What RA Does to the Hands and Wrists

Inflammation from RA can make it difficult to use your hands.
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In the last decade, biologic response modifiers, or biologics, have changed what it means to have rheumatoid arthritis (RA). These medications block a specific step in the inflammation process, and can help even when other treatments have failed. Thanks to these drugs—such as abatacept (Orencia), adalimumab (Humira), and rituximab (Rituxan)—many patients have drastically reduced their symptoms. Some have even gone into remission entirely. In other words, they live their lives free from signs of the disease.

The good news doesn’t stop there. Scientists continue to study more new treatments. The goal: Develop drugs that reduce symptoms and have fewer side effects. Read on to learn more about the latest drug approvals and new therapies on the horizon.

New Oral Medications

When you have RA, something goes awry in the way your immune system cells communicate. Enzymes called kinases play a key role in the way cells send and receive messages. New drugs attempt to block kinases to turn off these improper signals. Some experts have called this approach the next milestone in RA therapy.

The FDA approved the first of these drugs, tofacitinib (Xeljanz), in 2012. It’s known as a JAK-inhibitor because it blocks enzymes called Janus-associated kinases. Your doctor may prescribe Xeljanz if you have moderate to severe RA that hasn’t responded to other therapies. If so, you’ll likely take two 5-milligram pills per day.

Researchers are continuing to run clinical trials of SB1578, another JAK-inhibitor. And drugs that block another enzyme, spleen tyrosine kinase (SYK), have also shown promise in early research.

In some ways, these medications are similar to biologics. For instance, like biologics, they increase your risk for infections. But they work in a different way. In addition, you take them by mouth instead of injecting them.

Antibodies Fight Inflammation

When your body faces a foreign invader, your immune system produces proteins called antibodies to fight back. Infusions or injections of antibodies could also effectively treat RA. This approach reduces levels of cytokines, proteins responsible for inflammation.

Several drugs first developed to treat other diseases are now being tested against RA. Prime candidates include denosumab (Prolia), currently approved for osteoporosis, and ofatumumab (Arzerra), which treats leukemia.

Vitamin D to the Rescue

Blood tests on patients with RA frequently find low levels of vitamin D. Some doctors believe this deficiency may decrease how well RA treatment works.

Your skin absorbs vitamin D when exposed to sunlight. Fish and fortified milk also provide the nutrient. But in some cases, it’s best to take supplements. In fact, you might require an even higher dose of vitamin D than someone without RA to reach the same blood levels.

Early Detection Aids Treatment

Many medications work best when you begin taking them early in the course of RA. That way, you can prevent damage to your joints before it occurs. Besides searching for new treatments, scientists are also developing other ways to catch cases of RA before the first symptoms strike.

Soon, genetic testing and new blood or ultrasound tests could spot patients who would benefit from RA treatment before they first feel stiff or achy. In the meantime, if you develop joint pain but haven’t yet been diagnosed with RA, see your doctor as soon as possible.

Key Takeaways

  • When you have RA, something goes awry in the way your immune system cells communicate. Enzymes called kinases play a key role in the way cells send and receive messages. New oral drugs, such as tofacitinib (Xeljanz), attempt to block kinases to turn off these improper signals.

  • Infusions or injections of antibodies could also treat RA. Several drugs developed to treat other diseases could be options, such as denosumab (Prolia) and ofatumumab (Arzerra).

  • People with RA frequently have low levels of vitamin D, which may interfere with RA treatment. Sunlight, certain foods, and supplements can help.

Medical Reviewers: Williams, Robert, MD Last Review Date: May 15, 2013

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