Arthritis: Reports from 2003 Arthritis Meeting (cont.)

Researchers from the United Kingdom reported that patients whose rheumatoid arthritis is not controlled with Remicade can respond successfully to Enbrel.

Dr. Shiel's Perspective: Well, this is very interesting. Since both Remicade and Enbrel block TNF as a key method of action, one might expect that switching from one drug to the other might not be effective. Wrong. The researchers point out that the reason for the benefit from switching might be related to the fact that they do differ slightly in their targets (Remicade binds to both a soluble form of TNF-alpha and to TNF-alpha bound to membranes of cells, while Enbrel binds to soluble TNF-alpha and to another chemical messenger lymphotoxin-alpha). Big words! They simply mean that if one fails on one TNF-blocking drug, it is rational to try another.

Remicade was reported as safe and effective in psoriasis and ankylosing spondylitis.

Dr. Shiel's Perspective: Actually, rheumatologist have been using the drug for these patients for some time because of other preliminary positive reports in these conditions. It is good to have the support of this further long-term follow-up research.

Remicade was effective in treating sarcoidosis of the lungs and its accompanying toxic levels of calcium.

Dr. Shiel's Perspective: Other reports of Remicade treatment of sarcoidosis are supported by this report. Remicade seems to have beneficial effects in many diseases that feature microscopic areas of tissue inflammation called granulomas. These diseases include Crohn's disease, Wegener's granulomatosis, and sarcoidosis.

Remicade was also reported to be effective in juvenile ankylosing spondylitis.

Dr. Shiel's Perspective: Welcome news for this painful form of arthritis in children.

Enbrel (etanercept)