Arthritis Drugs & New Medications-2001 Meeting (cont.)

Remicade was found to be effective in much higher than the recommended doses.

Dr. Shiel's Perspective: This is similar to findings in patients with rheumatoid arthritis. That is, many times we must increase the doses above the starting doses to obtain the best results.

Remicade was also reported as effective in treating psoriasis and psoriatic arthritis in patients who had previously failed methotrexate or Enbrel.

Dr. Shiel's Perspective: This is consistent with recent reports of the effectiveness of Remicade in treating rheumatoid arthritis.

Remicade was shown to be extremely beneficial in the treatment of plaque-type psoriasis.

Dr. Shiel's Perspective: This was a fine study of 33 patients that documents not only the clinical benefit of Remicade alone in the treatment of this common form of psoriasis, but also its rapid onset of response of the inflamed skin to the drug.

Remicade was reported in this meeting as being effective for treating juvenile rheumatoid arthritis, thereby resulting in a significant and prompt reduction in disease activity and improved quality of life. Another paper presented data demonstrating that doses of Remicade that are higher than currently recommended doses could be effective and necessary in juvenile rheumatoid arthritis.

Dr. Shiel's Perspective: This does not surprise me, since it is the same situation for adults with rheumatoid arthritis who are being treated in my practice.

Remicade was reported as a successful treatment for a child with dermatomyositis, a severe disease with inflamed muscles.

Dr. Shiel's Perspective: This was only a single case report, but it was an impressive one. The patient, an 18 year old boy, had had dermatomyositis since age 11 years. He was becoming more and more seriously ill despite powerful treatments with cyclophosphamide (Cytoxan), methotrexate, intravenous immunoglobulin, plasmapheresis, and steroids. He was unable to move out of bed. After starting Remicade intravenous infusions, he gradually became stronger, his muscle enzyme tests normalized after being elevated in the thousands, and he eventually walked again. Remicade's action in blocking TNF-alpha is probably the reason he improved. Dermatomyositis has been associated with elevated levels of TNF-alpha in the blood.