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| Rheumatoid Arthritis Therapy |
Increased understanding of the immunobiology of rheumatoid arthritis (RA) has revealed a number of new targets for the development of therapeutic agents. The resulting biologic agents offer new hope to RA patients for the safe and effective long-term control of their chronic inflammatory disease. This page is your guide to the most recent and comprehensive material on biologic therapies for RA, including reviews of the immunopathology of the disease, the latest clinical findings and safety evaluations, and selected expert accounts of practical considerations in biologic therapy by experienced users of these agents. A more exhaustive list of publications, meeting reports, and CME activities related to biologic therapy can be found on other pages of this Web site.
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Immunopathology of Rheumatoid Arthritis
The Immunopathology of Rheumatoid Arthritis and the Development of Biologic Agents
B-Cell Therapies
Rituximab
Costimulation Therapies
Abatacept
Abatacept for rheumatoid arthritis refractory to tumor necrosis factor alpha inhibition [published correction appears in N Engl J Med. 2005;353:2311].
Genovese MC, Becker JC, Schiff M, et al.
N Engl J Med. 2005;353:1114-1123.
Costimulatory blockade in patients with rheumatoid arthritis: a pilot, dose-finding, double-blind, placebo-controlled clinical trial evaluating CTLA-4Ig and LEA29Y eighty-five days after the first infusion.
Moreland LW, Alten R, Van den Bosch F, et al.
Arthritis Rheum. 2002;46:1470-1479.
Treatment of rheumatoid arthritis by selective inhibition of T-cell activation with fusion protein CTLA4Ig.
Kremer JM, Westhovens R, Leon M, et al.
N Engl J Med. 2003;349:1907-1915.
Treatment of rheumatoid arthritis with the selective costimulation modulator abatacept: twelve-month results of a phase iib, double-blind, randomized, placebo-controlled trial [published correction appears in Arthritis Rheum. 2005;52:3321].
Kremer JM, Dougados M, Emery P.
Arthritis and Rheumatism. 2263-2271
IL-1 Therapies
Anakinra
A multicentre, double blind, randomised, placebo controlled trial of anakinra (Kineret), a recombinant interleukin 1 receptor antagonist, in patients with rheumatoid arthritis treated with background methotrexate.
Cohen SB, Moreland LW, Cush JJ, et al, and the 990145 Study Group.
Ann Rheum Dis. 2004;63:1062-1068.
Anakinra, a recombinant human interleukin-1 receptor antagonist (r-metHuIL-1ra), in patients with rheumatoid arthritis: a large, international, multicenter, placebo-controlled trial.
Fleischmann RM, Schechtman J, Bennett R, et al.
Arthritis Rheum. 2003;48:927-934.
TNF Therapies
Adalimumab
The PREMIER study: a multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment.
Breedveld FC, Weisman MH, Kavanaugh AF, et al.
Arthritis Rheum. 2006;54:26-37.
Efficacy and safety of adalimumab as monotherapy in patients with rheumatoid arthritis for whom previous disease modifying antirheumatic drug treatment has failed.
van de Putte LB, Atkins C, Malaise M, et al.
Ann Rheum Dis. 2004;63:508-516.
Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomized, placebo-controlled, 52-week trial.
Keystone EC, Kavanaugh AF, Sharp JT, et al.
Arthritis Rheum. 2004;50:1400-1411.
Adalimumab, a fully human anti tumor necrosis factor-alpha monoclonal antibody, and concomitant standard antirheumatic therapy for the treatment of rheumatoid arthritis: results of STAR (Safety Trial of Adalimumab in Rheumatoid Arthritis).
Furst DE, Schiff MH, Fleischmann RM, et al.
J Rheumatol. 2003;30:2563-2571.
Adalimumab, a fully human anti-tumor necrosis factor alpha monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial [published correction appears in Arthritis Rheum.2003;48:855].
Weinblatt ME, Keystone EC, Furst DE, et al.
Arthritis Rheum. 2003;48:35-45.
Etanercept
Etanercept added to background methotrexate therapy in patients with rheumatoid arthritis: continued observations.
Kremer JM, Weinblatt ME, Bankhurst AD, et al.
Arthritis Rheum. 2003;48:1493-1499.
Etanercept therapy in rheumatoid arthritis: a randomized, controlled trial.
Moreland LW, Schiff MH, Baumgartner SW, et al.
Ann Intern Med. 1999;130:478-486.
A trial of etanercept, a recombinant tumor necrosis factor receptor:Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate.
Weinblatt ME, Kremer JM, Bankhurst AD, et al.
N Engl J Med. 1999;340:253-259.
Infliximab
Predictors of joint damage in patients with early rheumatoid arthritis treated with high-dose methotrexate with or without concomitant infliximab: results from the ASPIRE trial.
Smolen JS, Van Der Heijde DM, St Clair EW, et al, and the Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset (ASPIRE) Study Group.
Arthritis Rheum. 2006;54:702-710.
Evidence of radiographic benefit of treatment with infliximab plus methotrexate in rheumatoid arthritis patients who had no clinical improvement: a detailed subanalysis of data from the anti-tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy study.
Smolen JS, Han C, Bala M, et al, and the ATTRACT Study Group.
Arthritis Rheum. 2005;52:1020-1030.
Sustained improvement over two years in physical function, structural damage, and signs and symptoms among patients with rheumatoid arthritis treated with infliximab and methotrexate.
Maini RN, Breedveld FC, Kalden JR, et al, for the Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group.
Arthritis Rheum. 2004;50:1051-1065.
Infliximab and methotrexate in the treatment of rheumatoid arthritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group.
Lipsky PE, van der Heijde DM, St Clair EW, et al; Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group.
N Engl J Med. 2000;343:1594-1602.
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