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Research Round Up

There have been lots of news stories about new treatments for arthritis this week so I thought I’d try and summarise some of the research here.

Apremilast, I haven’t heard of it, but apparently it has been tried on 204 people with psoriatic arthritis and the results were reported at the American College of Rheumatology.

http://www.arc.org.uk/news/article/19419802

You can read the abstract here:

http://acr.confex.com/acr/2009/webprogram/Paper11462.html

If you read the abstract, you will be pleased to note “there were no deaths” !

This also lead me to a link in Nature Drug Discovery, this graph interested me, it is the number of people with mild, moderate and severe psoriasis and the treatments they receive.

http://www.nature.com/nrd/journal/v8/n10/full/nrd2996.html

You can download the pdf here:

http://www.nature.com/nrd/journal/v8/n10/pdf/nrd2996.pdf

Psoriasis market

This is a summary table I’ve drawn up using the information in the article

How does it work? Marketing Name Scientific Name Company that makes the drug Get it by…
Inhibits TNF alpha Humira adalimumab Abbott
Enbrel etanercept Amgen/Wyeth/Takeda
Remicade infliximab Centocor Ortho Biotech/Schering-Plough IV infusion
Simponi golimumab Centecor Ortho Biotech
Target T cells Raptiva (Xanelim) efalizumab Genentech/Roche/Merck-Serono
Amevive alefacept Astellas/Biogen
IL-12/ IL23 Inhibitor Stelera ustekinumab Centecor Ortho Biotech
PDE4 and other interleukins apremilast Celgene Tablet

Withdrawn

There are certainly lots of new drugs out there. But and it’s a big but, they all target general pathways that your cells use to signal (communicate) with each other and long term, no one knows what these drugs are going to do to you.

TNF was discovered because it could kill tumour cells, therefore, it’s possible that if you inhibit TNF you increase your risk of cancer.  So far, after 6 years of follow up, people taking TNF inhibitors are NOT at an increased risk of cancer.

However, cancer takes YEARS to develop and until we have data looking at 20-30 years we’re not going to know if these drugs do increase your cancer risk.  For example, being obese increases your risk of cancer.  About 40 % of cancers could be prevented if people maintained a healthy lifestyle. If you are obese in your 20’s and 30’s you are not going to get cancer (due to obesity). If however you are in your 60’s or 70’s you ARE more likely to develop epithelial cancer because you are obese.  I think the same will be true for the TNF inhibitors.  They won’t give you cancer straight away, but over a lifetime they probably will increase your risk.  Whether the risk of developing cancer is worth being able to live your life in minimal pain and with much greater mobility for 20 years is a decision people who need the TNF inhibitors have to make.

The National Psoriasis Foundation in the US, have a good list of new drugs for psoriasis, whether these will be apporved by NICE/SIGN for use in the UK is a different matter entirely…

http://www.psoriasis.org/NetCommunity/Page.aspx?pid=664

There was also some new research out this week describing how fish oils could help arthritis:

http://www.arc.org.uk//news/pressreleases/18445.asp

http://www.wellcome.ac.uk/News/2009/News/WTX057226.htm

http://www.sciencedaily.com/releases/2009/10/091028142227.htm

The science bit….

http://www.nature.com/nature/journal/v461/n7268/full/nature08541.html

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