As per the biggest study of its kind, rituximab that is used to treat rheumatoid arthritis (RA) is safe and effective at the same time. The results of this study were presented for the first time at the Annual European Congress of Rheumatology, EULAR 2005, in Vienna.

It was remarked by lead author, Professor Paul Emery from the University of Leeds in the UK, of the DANCER Study (Double blind placebo controlled dose ranging study) that rituximab is very much effective and better option than a placebo.

From News-Medical.Net:

Professor Paul Emery from the University of Leeds in the UK led the DANCER study (Double blind placebo controlled dose ranging study), designed to confirm the efficacy of rituximab for the treatment of patients with active RA who have failed to improve on one or more disease modifying anti-rheumatic drugs (DMARDs). Rituximab targets a specific type of immune cell and helps to control inflammation and pain.

The DANCER study involved 465 men and women who had had arthritis for about 10 years. It examined the relative efficacy of two different dose levels of rituximab, as well as the role of anti-inflammatory drugs, glucocorticoids (steroids), in the treatment programme.

Professor Emery said that findings of this study clearly suggest that rituximab is safe and well-tolerated for patients with rheumatoid arthritis.

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According to a published study in an edition of the Journal of Biological Chemistry, researchers have been successful in discovering how rheumatoid arthritis (RA) destroys bone. These new findings have been able to guide attempts to design new drugs for reversing RA-related bone loss and have the ability to address more common forms of osteoporosis.

It is believed that rheumatoid arthritis affects two million Americans and results in serious health risks such as pain and deformity in joints, swelling, and thinning of bone.

From News-Medical.Net:

While the new drugs are effective for many patients, others experience infections and even lymphoma in a few cases. The new drugs are based on bioengineered versions of proteins made by human immune cells called antibodies, and are very expensive to make. Thus, the field has been searching for smaller, simpler chemicals that would be effective, but with lower costs and fewer side effects.

“The significance of our study is that it identifies SMURF1 as the signaling partner through which TNF does damage in RA-related bone loss,” said Lianping Xing, Ph.D., assistant professor of Pathology and Laboratory Medicine at the University of Rochester Medical Center. “That has enabled researchers to begin designing small molecule drugs to shut down the action of Smurf 1 and its relatives. Furthermore, since mice engineered to have less Smurf1 expression develop thicker bones, future drugs that shut down Smurf1 may be also useful against more common forms of osteoporosis simply by changing the dose. Of course, this is early-stage work with many obstacles ahead, but it is exciting nonetheless.”

It was revealed during the study that while traditional RA drugs like steroids and NSAIDs are effective for controlling symptoms, a newer class of drugs (e.g. Humira, Remicade and Enbrel) is effective for reversing the RA process by shutting down TNF alpha activity.

Along with Xing, the study was led by Ruolin Guo, Motozo Yamashita, Laura Yanoso, Lan Zhao, Qian Zhang, Quan Zhou, Di Chen, David G. Reynolds, Hani Awad, Edward Schwarz, Ying Zhang and Brendan Boyce within the Department of Pathology and Laboratory Medicineat University of Rochester.

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According to Dr. Deborah Symmons, MD and Dr. Susan Verstappen, MD, chief investigators from the University of Manchester in Manchester, United Kingdom, the earlier a patient receives steroid injections, the better results would be achieved for his or her rheumatoid condition.

A recently published study in Arthritis Today discussed the results of steroid injections given during the onset of rheumatoid arthritis. The study showed that steroid injections given during the first signs of rheumatoid arthritis might help prevent the progression of the disease in one of ten people for at least a year.

Rheumatoid arthritis is an autoimmune disease, which means the body’s own immune system does not recognize the joints and will therefore attack it. The effects could lead to joint deformity and later on, disability. This disease affects more than 1.3 million people in the United States.

The study was conducted by the Steroids in Very Early Arthritis (STIVEA) team. It involved patients with polyarthritis, any type of arthritis involving more than 5 joints. The group was divided into two, the first given steroids shots while the second group was given placebo injections.

Results showed almost half of the patients who received steroids shots did not acquire RA and 20% were free of RA for a year.

From Little Chicago Review:

According to a recent article published in the May/June issue of Arthritis Today, a new study suggests that a three week course of steroid injections given at the first signs of rheumatoid arthritis (RA) may prevent one in ten people from progressing to RA for at least one year.

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In a study conducted by medical team headed by Dr. Eva Baecklund of Uppsala University Hospital in Sweden, anew aspect of treatment was found. Patients with severe rheumatoid arthritis have an increased risk of getting sick with lymphoma. Lymphoma is a type of cancer which originates in lymphocytes of the immune system. They often originate in lymph nodes, often presenting as a node enlargement (tumor).

The study invloved patients with lymphoma associated with rheumatoid-arthritis. They were compared with patients in the control group, those with rheumatoid arthritis but without lymphoma.

Various information were collected, such as the type of lymphoma, type of steroids used, duration of steroid usage and inflammatory load, from both treatment and control groups.

The risk of rheumatoid arthritis- associated lymphomas was significantly reduced in individuals treated with steroids for over two years. Those who received steroid treatment for less than two years for their rheumatoid arthritis yielded no such reduced risk. The most significant protective steroidal effect was observed in the large B-call lymphoma, the type of lymphoma most commonly associated with rheumatoid arthritis.

The researchers concluded that two years or more of oral steroid treatment decreases the risk of rheumatoid arthritis- associated lymphoma, however, these beneficial effects were not observed if the steroids were taken for less than two years. These effects were not affected by length of RA at onset of steroidal treatment.

According to Dr. Eva Baecklund:

“The pros and cons of corticosteroid treatment in rheumatoid arthritis have been a subject of much debate and long term steroid treatment is often limited as a result of concerns about various side effects. What our data show is a new aspect of steroid treatment. Patients with severe rheumatoid arthritis are at increased risk for malignant lymphomas (cancer in the immune system), but long term steroid treatment may decrease this risk.”

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Rheumatoid arthritis (RA) is a chronic disease in which the body’s immune system attacks and destroys healthy joint tissue. The hands and feet are frequently affected, and as the disease progresses it can cause pain, swelling, deformity and disability.

A review revealed that this disease can be treated with low doses of steroids which inhibit joint damage when used during the early phase of RA. The steroids studied in the review are known as glucocorticoids and include the well-known anti-inflammatory prednisone. This medication is often prescribed in the first few months after diagnosis to relieve the discomfort of RA until slower-acting drugs begin protecting the joints.

From Bio-Medicine:

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The systematic review is based on 15 studies including 1,414 patients. In most of the studies, patients received low dose s of glucocorticoid pills along with so-called disease-modifying drugs for one to two years. Periodic X-rays revealed the extent of joint erosion and other signs of damage.

Because of the known health risks associated with intensive steroid use, concern persists regarding long-term use at any level. The authors cite a 2006 systematic review covering the adverse effects of low-dose glucocorticoids, which concluded that “few of the commonly held beliefs about their incidence, prevalence and impact are supported by clear scientific evidence.”

All studies except one showed reduced progression of joint damage in patients taking glucocorticoids.

The most immediate concern of low dose of steroids in RA is the reduced bone mineral density. However, recent clinical trials have proven that this side effect can now be readily treated.

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As per a new review of evidence, low doses of steroids can help in restraining joint damage if used in the initial stages of rheumatoid arthritis. The review, led by John Kirwan of Liverpool Women’s Hospital in England, recommends a combination of pills with standard medication in the first 2 years after diagnosis.

Rheumatoid arthritis is a chronic ailment in which the immune system of the body destroys healthy joint tissues. Hands and feet are affected by this on a frequent basis and the disease is known to cause deformity, swelling, and disability in a patient.

From Bio-Medical.org:

The steroids studied in the review are known as glucocorticoids and include the well-known anti-inflammatory prednisone. This medication is often prescribed in the first few months after diagnosis to relieve the discomfort of RA until slower-acting drugs begin protecting the joints.

Until now, concerns about side effects caused most rheumatologists to “put people on the lowest possible dose of steroids and get them off it as soon as possible,” said Scott Zashin, M.D., of the University of Texas Southwestern Medical Center. “Now, we have to give steroids a little more respect.”

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Scott Zashin, M.D., of the University of Texas Southwestern Medical Center, remarked that the usage of steroids can be made for a period longer than what was being followed till now.

Even in the most conservative of estimates, there was evidence that glucocorticoids along with standard therapy can significantly minimize the rate of erosion progression in rheumatoid arthritis. It was also remarked that early & aggressive treatment for rheumatoid arthritis can help in the prevention of acute joint damage and disability for a majority of patients.

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There had been significant development in the life of the people suffering from the rheumatoid arthritis as the steroids were used with the standard treatment According to the sources, low doses of steroids can inhibit joint damage, if used in the early stage of rheumatoid arthritis.

Rheumatoid arthritis is a chronic disease in which the body’s immune system attacks and destroys healthy joint tissue. The hands and feet are generally affected, and as the disease progresses it can cause pain, swelling, deformity and disability.

The steroids used in the treatment are called as glucocorticoids and it also includes the well-known anti-inflammatory prednisone. This medication is generally suggested in the first few months after diagnosis to relieve the discomfort of RA until slower-acting drugs begin protecting the joints.

From BIO-MEDICINE:

Low doses of steroids can inhibit joint damage when used in the early phase of rheumatoid arthritis, according to a new review of evidence.

The steroids studied in the review are known as glucocorticoids and include the well-known anti-inflammatory prednisone. This medication is often prescribed in the first few months after diagnosis to relieve the discomfort of RA until slower-acting drugs begin protecting the joints.

Quality evidence supports medication of combining the pills with standard medications in the first two years after diagnosis. Sources say that the research was conducted by the scientists which had 15 studies including 1,414 patients. In most of the cases, patients were given low doses of glucocorticoid pills along with disease-modifying drugs for one to two years.

Periodic X-rays showed the extent of joint erosion and other signs of damage a bit less than what it was before staring with the treatment.

On the basis of the report by the sources it can be conclude that if people are put on the lowest possible dose of steroids it can get them off it as soon as possible. Glucocorticoid pills are really effective in treatment of the rheumatoid arthritis.

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