New approach to treating rheumatoid arthritis shows promise

People with early stages of rheumatoid arthritis seem to have fewer symptoms and less rapid progression of joint damage when they are treated with drugs that block the protein that promotes inflammation, known as tumour necrosis factor.

Two new studies show that two tumour necrosis factor inhibitors, infliximab and etanercept, seem to do as good or better a job of treating rheumatoid arthritis than methotrexate, which is the current standard of care (New England Journal of Medicine 2000;343:1586-93, 1594-1602).

In the first study, directed by Dr Joan M Bathon of Johns Hopkins University, Baltimore, Maryland, 632 patients with early rheumatoid arthritis received subcutaneous etanercept (10 mg or 25 mg) twice weekly or oral methotrexate (mean 19 mg weekly) for 12 months.

Clinical response was defined as the percentage improvement in disease activity according to the criteria of the American College of Rheumatology. Bone erosion and narrowing of joint spaces were measured radiographically and scored using …