EULAR Congress: European researchers present the newest therapies in the fight against rheumatic diseases
Increased heart attack risks in RA patients despite changes in disease management A study showed that, despite changes in the management of rheumatoid arthritis in the last 20 years, there is no significant impact on co-morbidity related to cardiovascular diseases, in particular, related to myocardial infarction (heart attack). Patients with rheumatoid arthritis (RA) have a shortened lifespan when compared to people with same gender and similar age and recent studies suggest that this is largely due to increased mortality from premature cardiovascular disease, in particular myocardial infarction. “The management of the disease has changed significantly over the decades and this study gives excellent measurement into whether this has had an improvement on cardiovascular events experienced by RA patients”, said Dr. Bergström. “It shows that further action is necessary in order to reduce additional mortality in RA”. TNF inhibitors reduces the risk of serious cardiovascular events in rheumatoid arthritis patients A new study showed encouraging data that treatment with TNF inhibitor reduces the risk of Myocardial Infarction (MI) and Cerebrovascular Accidents (CVA) in rheumatoid arthritis (RA) patients, when compared to patients treated with traditional DMARDs. Recent studies suggest that the excess of deaths in rheumatoid arthritis patients is largely due to increased mortality from premature cardiovascular disease. Dr. Dixon comments, “It is already known that TNF inhibitors reduce the risk of cardiovascular events in RA patients, including less serious events. But this study has suggested that they specifically reduce the risk of myocardial infarction and cerebrovascular accidents, which are two of the most serious cardiovascular events, which often lead to death”. He added, “This study shows encouraging results for people with RA which could potentially reduce the mortality amongst these patients.” Increased risk of serious infections with TNF inhibitor treatment According to a new study treatment with TNF inhibitors might increase the risk of common serious infections. As recognized by the investigators of the study, it is already established that TNF inhibitors increases the risk for intracellular infections such as TB and although several studies from clinical practice have shown an increased risk of serious infections, clinical trials have been unable to demonstrate this. “The reason for this drug-related increase in risk of infections is not yet clear, but one theory is that the drugs might interfere with the body's normal defenses against infections as well as against cancerous cells”, Dr. Askling said. “However, the TNF inhibitors drugs have showed great effectiveness for many patients and is an excellent example that raises the discussion of whether the benefits the drugs outweighs the risks associated with them”, Dr. Askling added. Tocilizumab offers new hope for children with arthritis A new study has confirmed significant improvements after treatment with tocilizumab amongst children with systemic juvenile idiopathic arthritis. Juvenile idiopathic arthritis is a relatively rare disease, affecting 30 to 150 children per 100,000 per year in Europe, and is one of the most severe types as it affects the whole body and most of the joints. “this study confirms that tocilizumab is one of the most promising therapies to treat children with sJIA who have not benefited from conventional therapies”, said professor Yokota. Identification of role for proteins in children’s muscle disease could open up new treatment options A study showed for the first time that a protein – heat shock protein 60 - triggers a response by T-cells in children with juvenile dermatomyositis (JDM). “We have shown for the first time that heat shock protein 60 plays an active part in the control of the inflammatory process in JDM. Thus, therapy aimed at the expansion of T-cells with regulatory capacities reacting to heat shock protein 60 could contribute to disease remission in patients with JDM. This conclusions opens up new perspectives for the understanding and approach for antigens in immunotherapy”, said Mrs. Elst, pediatric immunologist at the University Medical Centre Utrecht. Tocilizumab in monotherapy significantly improves signs and symptoms of active rheumatoid arthritis in patients with an inadequate response to methotrexate. A study, investigating the safety and efficacy of tocilizumab monotherapy in patients with active rheumatoid arthritis with an inadequate response to methotrexate showed that patients’ response rate was statistically significantly higher in the tocilizumab group than in the methotrexate group. “In this double blind study tocilizumab in monotherapy for 24 weeks significantly improved signs and symptoms and was well tolerated in patients who had active rheumatoid arthritis despite receiving methotrexate”, explained N. Nishimoto, study’s lead and professor at the Laboratory of Immune Regulation, Graduate School of Frontier Biosciences, Osaka University, Suita-City. “These data support the use of tocilizumab in the treatment of rheumatoid arthritis patients with inadequate response to methotrexate.” he concluded. Methotrexate shown to delay and prevent rheumatoid arthritis progression Patients diagnosed with ‘undifferentiated rheumatoid’ arthritis could actually have their disease outlook changed significantly if treatment is given at the right time. “One of the most interesting findings from the study was that the patients who benefited the most were the ones showing a positive anti-CCP test, which would in general terms show that a patient has a very high likelihood to develop a full-blown Rheumatoid Arthritis. However, this study indicates that the progression to a full-blown disease amongst these patients could be influenced”, noted Mrs. Van Dongen. About rheumatic diseases Rheumatic conditions are the most prevalent group of diseases in Europe, affecting an estimated 100 million people, or roughly one third of the European population. The impact on individual health and quality of life of those suffering from rheumatic diseases is substantial and societal costs and the pressure on health and social care systems are staggering. Rheumatic diseases are today the second most common reason for consulting a doctor. The annual Congress of Rheumatology, organised by the European League Against Rheumatism (EULAR) is an opportunity for professionals of the highest level to debate the societal impact, causes and current as well as future treatment of rheumatic diseases. By far the largest event in the field, this year’s Congress of Rheumatology attracted an audience of more than 10,000 international specialists. The next Congress will be held in Barcelona, Spain, 13-16 June 2007. For extended information for each of the studies please visit the website of EULAR and the EULAR congress at http://www.eular.org/eular2006(se abrirá en una nueva ventana)
Países
Austria, Belgium, Czechia, Germany, Denmark, Estonia, Greece, Spain, Finland, France, Hungary, Ireland, Italy, Lithuania, Luxembourg, Latvia, Malta, Netherlands, Poland, Portugal, Sweden, Slovenia, Slovakia, United Kingdom