Severe arthritis under attack.

Arthritis, which strickes one in seven people in the United States, costs $14 billion each year, including $5 billion in health care and another $6 billion in lost income due to illness, estimates the Arlington, Va.-based Arthritis Foundation. Even more painful is the physical and emotional price paid by the patients -- particularly by the 7 million who suffer from rheumatoid arthritis, a potentially life-threatening form that can destroy joints and attack body organs. But medical researchers are searching for better treatments, and some recent results give hope for a cure.

Traditional treatments for rheumatoid arthritis include anti-inflammatory drugs and injection of gold salts. Because the disease is considered an autoimmune disorder, with a patient's own cells triggering tissue destruction, newer treatments like irradiation are aimed at the body's immune system. But these can be toxicc to the patient, causing harmful side effects. Searching for drugs that may be effective in nontoxic doses, U.S. researchers earlier this year developed treatment regimens using the anticancer agent methotrexate and an ingestible form of gold.

Now, unpublished data sugges two more methods to stop the disease and help identify its mysterious etiology.

By manipulating the immune system, scientists at the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases (NIADDK) in Bethesda, Md., hope to halt the erosion of joint tissue. After an NIADDK seminar last week, senior investigator Ronald L. Wilder said he is reluctant to label the immunosuppressive drug cyclosporin A (CSA) anything more than a "potentially promising approach" to treating rheumatoid arthritis, but he admitted his group is excited about research results with the drug at NIADDK'S Arthritis and Rheumatism Branch.

In this study, CSA was injected into laboratory rats previously treated with bacterial cell walls that somehow induce arthritis. The drug inhibited the later development of chronic arthritis in many of the animals, Wilder says. Although CSA already has federal approval for use in organ transplant patients to reduce transplant rejection (SN: 10/24/81, p. 263), its use for rheumatoid arthritis would have to wind through a maze of research and regulatory red tape before being clinically tested in humans.

Closer to a place on the pharmacy shell is a by-product of the generic engineering industry. Last week officials from Biogen Inc. in Cambridge, Mass., confirmed that results from early human trials using a type of interferon injected into rheumatoid arthritis patients "appear promising." Gamma interferon, produced by Biogen using recombinant DNA techniques (SN: 1/26/,/, p. 52), apparently ameliorates patient symptoms by stimulating some component of the immune system.

According to Biogen spokesperson Robert Gottlieb, in two studies recently completed, two-thirds of the 80 patients reported having less pain, swelling and joint tenderness after injection with the protein. Just as significant was the absence of serious side effects from the low doses of interferon given patients. Another study is beginning in Europe, but plans for large-scale testing of the interferon are awaiting consultation with the U.S. Food and Drug Administration.