New Treatments for Arthritis Hold Promise

Although no cure is in sight for the painful, debilitating disease rheumatoid arthritis, new treatments promise to do a better job of relieving symptoms of sufferers.

An estimated 2.1 million Americans--including more than twice as many women as men--are affected by this mysterious disease of unknown origin. Despite decades of research, scientists do not know why the disorder makes the body turn on itself, attacking bone and cartilage.

Whatever the cause of rheumatoid arthritis, though, the result is an inflammation of the joints that can cause stiffness, fluid accumulation, fatigue and weight loss in addition to pain. In the absence of a means to prevent the disease or cure it, the emphasis has been on treatments to alleviate symptoms.

Now, several new approaches to dealing with the disorder hold out hope of further relief for those afflicted, researchers said during a recent meeting of the American College of Rheumatology.

One of the more promising developments is a new class of drugs called 5-lipoxygenase inhibitors, which act on cells that cause inflammation, said Dr. Michael Weinblatt of Brigham and Women’s Hospital in Boston.

In a recent study, a brand of the drug made by Abbott Laboratories of Abbott Park, Ill.--called Zileuton--was effective in blocking the action of cells called leukotrienes, which are known to cause pain and inflammation in joints and other tissue, Weinblatt said.

The drug effectively diminished symptoms in 12 arthritis patients who received it. “It’s very preliminary,” Weinblatt said, “but it’s exciting.”

Another so-called “pathway” of inflammation in rheumatoid arthritis is through the effects on tissue of an enzyme called cyclooxygenose, he said. Doctors typically have tried to suppress the enzyme with aspirin, ibuprofen, steroids and gold salts, but Weinblatt said they are not entirely effective.

In the study, he said Zileuton appeared to work against the enzyme, with patients showing “a trend toward improvement” of symptoms. But he added that “further studies regarding the effectiveness are needed and in progress.”

Weinblatt noted that 12 patients in the study who received a dummy substitute for comparison also displayed improvements, although to a lesser extent. The finding supports other research pointing to a psychological element in the disease.

Several studies found that a sufferer’s level of education appeared to have a correlation to the severity of his or her pain. Patients with higher levels of education appeared to have better coping abilities, more optimism, less sense of helplessness and more support from peers than those with less education, researchers said.

“These findings suggest that formal education and psychological influences are a determining factor in the status of (the disease),” said Dr. Theodore Pincus of Vanderbilt University in Nashville, Tenn.

Researchers from the University of Texas Southwestern, meanwhile, reported another promising treatment that uses an arthritis sufferer’s own antibodies to suppress painful inflammation.

In laboratory tests performed so far only on rabbits, scientists used a technique to curb arthritis symptoms that already has proved useful in treating lung inflammation.

Dr. Hugo Jasin said the antibodies interfere with the ability of problem cells to attach themselves to walls of tissue in a manner that triggers the swelling and inflammation process.

However, he said more animal researcher need to be done and it could be two years or more before the treatment is tried on humans.