Future treatments

Scientists throughout the world are studying many promising areas of new treatment approaches for rheumatoid arthritis. These areas include treatments that block the action of the special inflammation factors, such as tumor necrosis factor (TNFalpha) and interleukin-1 (IL-1), as described above. Also, biologic medications that block interleukin-6 (IL-6) have been shown by researchers to be of benefit in treating rheumatoid arthritis. Many other drugs are being developed that act against certain critical white blood cells involved in rheumatoid inflammation. Also, new NSAIDs with mechanisms of action that are different from current drugs are on the horizon.

Better methods of more accurately defining which patients are more likely to develop more aggressive disease are becoming available. Recent antibody research has found that the presence of citrulline antibodies in the blood (see above, in diagnosis) has been associated with a greater tendency toward more destructive forms of rheumatoid arthritis.

Studies involving various types of the connective tissue collagen are in progress and show encouraging signs of reducing rheumatoid disease activity. Finally, genetic research and engineering is likely to bring forth many new avenues for earlier diagnosis and accurate treatment in the near future. Gene profiling, also known as gene array analysis, is being identified as a helpful method of defining which people will respond to which medications. Studies are under way that are using gene array analysis to determine which patients will be at more risk for more aggressive disease. This is all occurring because of improvements in technology. We are at the threshold of tremendous improvements in the way rheumatoid arthritis is managed.
Rheumatoid Arthritis At A Glance

* Rheumatoid arthritis is an autoimmune disease that can cause chronic inflammation of the joints and other areas of the body.
* Rheumatoid arthritis can affect people of all ages.
* The cause of rheumatoid arthritis is not known.
* Rheumatoid arthritis is a chronic disease, characterized by periods of disease flares and remissions.
* In rheumatoid arthritis, multiple joints are usually, but not always, affected in a symmetrical pattern.
* Chronic inflammation of rheumatoid arthritis can cause permanent joint destruction and deformity.
* Damage to joints can occur early and does not correlate with the severity of symptoms.
* The "rheumatoid factor" is an antibody that can be found in the blood of 80% of patients with rheumatoid arthritis.
* There is no known cure for rheumatoid arthritis.
* The treatment of rheumatoid arthritis optimally involves a combination of patient education, rest and exercise, joint protection, medications, and occasionally surgery.
* Early treatment of rheumatoid arthritis results in better outcomes.

For further information about rheumatoid arthritis, please visit the following site:

The Arthritis Foundation (http://www.arthritis.org)
P.O. Box 19000
Atlanta, Georgia 30326
(or contact your local chapter)

For additional information, please contact:

National Arthritis and Musculoskeletal and Skin Diseases Clearinghouse
Box AMS
Bethesda, Maryland 20892
301-495-4484

References: Clinical Primer of Rheumatology, Lippincott Williams & Wilkens, edited by William Koopman, et al., 2003.

Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.