New Arthritis Drugs for Rheumatoid Arthritis and Osteoarthritis.* Drug Category: Biological Response Modifiers biological response modifiers, n.pl substances such as phytochemicals and fibers that modulate mech-anisms related to the development of disease, such as hormonal changes, immune function, inflammatory activity, oxidative stress, and home-ostasis. for Rheumatoid Arthritis rheumatoid arthritis Chronic, progressive autoimmune disease causing connective-tissue inflammation, mostly in synovial joints. It can occur at any age, is more common in women, and has an unpredictable course. * Drug Category: Disease-Modifying Antirheumatic Drugs (DMARDs) for Rheumatoid Arthritis * Drug Category: Nonsteroidal Anti-Inflammatory Drugs Nonsteroidal Anti-Inflammatory Drugs Definition Nonsteroidal anti-inflammatory drugs are medicines that relieve pain, swelling, stiffness, and inflammation. (NSAIDs), Specifically Cyclo-Oxygenase-2 (COX-2) Inhibitors, for Rheumatoid Arthritis and Osteoarthritis osteoarthritis or osteoarthrosis or degenerative joint disease Most common joint disorder, afflicting over 80% of those who reach age 70. It does not involve excessive inflammation and may have no symptoms, especially at first. * Drug Category: Other Products * Additional Resources Arthritis treatments aim to relieve pain, reduce inflammation, and slow or stop joint damage to maintain or restore the patient's functional ability and quality of life. Arthritis therapies generally used today address the medical needs of many patients. However, these therapies are occasionally associated with harmful side effects Side effects Effects of a proposed project on other parts of the firm. ranging from mild to severe. Medical research continues to search for effective, fast-acting treatments with fewer side effects. New arthritis drugs designed to meet these treatment needs are presently available or awaiting approval by the U.S. Food and Drug Administration (FDA FDA abbr. Food and Drug Administration FDA, n.pr See Food and Drug Administration. FDA, n.pr the abbreviation for the Food and Drug Administration. ). The foundation for these new drugs was laid in basic biomedical research supported by the National Institutes of Health. Drug Category: Biological Response Modifiers for Rheumatoid Arthritis Description: One class of drugs in this category reduces inflammation in the joints by blocking the action of a substance called tumor necrosis factor tumor necrosis factor n. Abbr. TNF A protein that is produced in the presence of an endotoxin, especially by monocytes and macrophages, is able to attack and destroy tumor cells, and exacerbates chronic inflammatory diseases. (TNF TNF abbr. tumor necrosis factor TNF, n an abbreviation for tumor necrosis f ). TNF is a protein of the body's immune system immune system Cells, cell products, organs, and structures of the body involved in the detection and destruction of foreign invaders, such as bacteria, viruses, and cancer cells. Immunity is based on the system's ability to launch a defense against such invaders. that triggers inflammation during normal immune responses; however, when overproduced, TNF can lead to excessive inflammation such as that experienced by patients with rheumatoid arthritis. Medication (drug name): Enbrel[R] (etanercept) How taken: twice-weekly subcutaneous (under the skin) injections by the patient or health care provider Most common side effects: mild to moderate injection-site reactions injection-site reactions apart from those caused by infection at the site there is a characteristic reaction in dogs and cats which is a germinal center created by the strong antigenic stimulus provided by the injection. (itching, pain, swelling) Drug status: approved by the FDA; not recommended for patients with active infections; caution should be used in patients with a history of infections or those who develop new infections while taking Enbrel[R]; not recommended for pregnant women. For more information: Immunex Corporation 51 University Street Seattle, WA 98101 (800) 436-2735 World Wide Web Address: http://www.enbrelinfo.com/ Medication (drug name): Remicade[R] (infliximab) How taken: intravenous (in the vein) injections by the health care provider once every 8 weeks Most common side effects: mild infusion reactions Drug status: approved by the FDA for use in combination with methotrexate methotrexate, drug used in halting the growth of actively proliferating tissues. Introduced in the 1950s, it is used in the treatment of leukemia, psoriasis, and non-Hodgkin's lymphoma. ; not recommended for pregnant women For more information: Centocor 200 Great Valley Parkway Malvern, PA 19355 (800) 457-6399 World Wide Web Address: http://www.centocor.com/ Drug Category: Disease-Modifying Antirheumatic Drugs (DMARDs) for Rheumatoid Arthritis Description: These are the mainstay arthritis drugs that are known to relieve painful, swollen joints and to slow joint damage. Medication (drug name): Arava[R] (leflunomide) How taken: orally, once daily Most common side effects: diarrhea, hair loss, rash Drug status: approved by the FDA; not recommended for pregnant women For more information: Aventis P.O. Box 9627 Kansas City, MO 64134-0627 (816) 966-4000 World Wide Web Address: http://www.aventis.com/ Drug Category: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Specifically Cyclo-Oxygenase-2 (COX-2) Inhibitors, for Rheumatoid Arthritis and Osteoarthritis Description: COX-2 inhibitors Cox-2 Inhibitors Definition Cox-2 inhibitors are non-steroidal anti-inflammatory drugs (NSAIDs) which selectively inhibit cyclooxygenase-2. The cyclooxygenases are required for the creation of prostaglandins. , like traditional NSAIDs, block COX-2, an enzyme in the body known to stimulate an inflammatory response. Unlike traditional NSAIDs, however, they do not block the action of COX-1, an enzyme known to protect the stomach lining. Therefore, drags in this category reduce joint pain and inflammation with reduced risk of gastrointestinal ulceration and bleeding. Medication (drug name): Celebrex[R] (celecoxib) for rheumatoid arthritis and osteoarthritis How taken: orally once or twice daily, dosage determined by the physician Most common side effects: abdominal pain, nausea, indigestion, diarrhea Drug status: approved by the FDA For more information: G.D. Searle & Company 5200 Old Orchard Road Skokie, IL 60077 World Wide Web Address: http://www.searle.com/ Medication (drug name): Vioxx[R] (rofecoxib) for rheumatoid arthritis and osteoarthritis, as well as acute pain associated with primary dysmenorrhea primary dysmenorrhea n. Dysmenorrhea resulting from a functional disturbance and not to inflammation, growths, or anatomical factors. Also called essential dysmenorrhea. (painful menstruation) and postsurgical pain How taken: orally, once daily Most common side effects: abdominal pain, diarrhea, indigestion, insomnia, edema edema (ĭdē`mə), abnormal accumulation of fluid in the body tissues or in the body cavities causing swelling or distention of the affected parts. Drug status: approved by the FDA For more information: Merck & Co., Inc. One Merck Drive Whitehouse Station, NJ 08889-0100 World Wide Web Address: http://www.merck.com/product/usa/ Drug Category: Other Products Description: Hyaluronic acid hyaluronic acid: see mucopolysaccharide. Hyaluronic acid A polysaccharide which is an integral part of the gel-like substance of animal connective tissue; it supposedly serves as a lubricant and shock absorbent in the joints. viscosupplementation products for osteoarthritis. These products mimic a naturally occurring substance in the body called hyaluronic acid by providing lubrication lubrication, introduction of a substance between the contact surfaces of moving parts to reduce friction and to dissipate heat. A lubricant may be oil, grease, graphite, or any substance—gas, liquid, semisolid, or solid—that permits free action of to the knee joint, thus permitting flexible joint movement without pain. Medication (drug name): Hyalgan[R] (hyaluronan) How taken: a series of five injections per knee by a health care provider over 4 weeks Most common side effects: some pain and swelling at the injection site Drug status: approved by the FDA For more information: Sanofi~Synthelabo, Inc. 90 Park Avenue New York, NY 10016 (800) 446-6267 World Wide Web Address: http://www.hyalgan.com/ Medication (drug name): Synvisc[R] (hylan G-F20) How taken: a series of three injections per knee by a health care provider over a 15-day period Most common side effects: some pain and swelling at the injection site Drug status: approved by the FDA For more information: Biomatrix, Inc. 65 Railroad Avenue Ridgefield, NJ 07657 (800) 666-7248 World Wide Web Address: http://www.biomatrix.com/ Description: Blood filtering device for severe rheumatoid arthritis. This device is designed to remove harmful antibodies from the patient's immune system, thus lowering disease activity associated with severe rheumatoid arthritis. Device (device name): Prosorba Column[R] (apheresis apheresis (əfĕr`əsĭs), or hemapheresis (hē'məfĕr`əsĭs), any procedure in which blood is drawn from a donor or patient and a component (platelets, plasma, or white blood ) How used: The device consists of a catheter, tubing, and a column. The catheter and tubing are used to filter the patient's blood through the column (which is coated with protein A, a substance that attracts harmful antibodies), then reinfuse it into the patient's body. The procedure takes 2 hours and is performed weekly at a health care facility for 12 weeks. Most common side effects: flu-like symptoms (chills, fever, nausea, and joint/muscle pain) Drug status: approved by the FDA For more information: Cypress Bioscience 4350 Executive Drive, Suite 325 San Diego, CA 92121 (800) 635-4673 World Wide Web Address: http://www.cypressbio.com/ Additional Resources To find out more about these drugs and devices, including dosage, full range of side effects, and study results, check the following resources: * National Library of Medicine's (NLM's) Internet Grateful Med is a computer system that allows users to search through 15 of the NLM's databases for bibliographic references and abstracts on medical and scientific information pertaining to rheumatic diseases, including treatments. World Wide Web Address: http://www.nlm.nih.gov/ * U.S. Food and Drug Administration (FDA), Center for Evaluation and Research, provides information on drugs that have been approved, as well as those undergoing the approval process. World Wide Web Address: http://www.fda.gov/cder/ * The Arthritis Foundation offers The Drug Guide, a reprint from Arthritis Today. World Wide Web Address: http://www.arthritis.org/ * Local public university libraries have journals on rheumatic diseases and pharmaceutical (drug) therapies, as well as reference books such as the Physician's Desk Reference Physician's Desk Reference (PDR), n an informational, scientifically validated resource that provides information relating to indications, chemical formulations, actions and potential hazards associated with most medicinal remedies currently being used. , an annually updated guide that describes the use, effects, dosages, and administration of FDA-approved drugs, as well as warnings, side effects, and precautions. Many libraries also provide computers with public access to the Internet. NOTE: Brand names included in this document are provided as examples only, and their inclusion does not mean that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory. The National Institute of Arthritis and Musculoskeletal and Skin Diseases The National Institute of Arthritis and Musculoskeletal and Skin Diseases, or NIAMS, is an institute of the National Institutes of Health, an agency of the United States Department of Health and Human Services. Information Clearinghouse is a public service sponsored by the NIAMS NIAMS National Institute of Arthritis, Musculoskeletal and Skin Diseases (USA) that provides health information and information sources. The NIAMS, a component of the National Institutes of Health, leads and coordinates the Federal medical effort in arthritis, musculoskeletal musculoskeletal /mus·cu·lo·skel·e·tal/ (-skel´e-t'l) pertaining to or comprising the skeleton and muscles. mus·cu·lo·skel·e·tal adj. Relating to or involving the muscles and the skeleton. , bone, muscle, and skin diseases by conducting and supporting research projects, research training, clinical trials, and epidemiological studies, and by disseminating information on research initiatives and research results. March 2000 |
|
||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion