Arthritis Arthritis Treatment

Rheumatoid Arthritis: TNF-Alpha Blockers

The most important recent advance in the treatment of rheumatoid arthritis (RA) has been the development of drugs called biologic response modifiers. They are a subset of the class of drugs known as disease modifying antirheumatic drugs or DMARDs. However, instead of affecting the entire immune system as the traditional DMARDs do, these sophisticated drugs zero in on a specific component of the immune system. As a result of this approach, they have been proven to work faster and without the side effects associated with other DMARDs. They have also been proven to be effective at stopping the progressive joint damage associated with rheumatoid arthritis.

Biologics are derived from living or synthetic organisms. Some of the biologics currently in use to treat rheumatoid arthritis target a specific component of the immune system called cytokines. These proteins play a pivotal role in the inflammatory process. Three of these drugs block a cytokine in the joints called tumor necrosis factor alpha (TNF-alpha), which is a known cause of inflammation, fever, pain, tenderness and swelling—all symptoms common to rheumatoid arthritis and other inflammatory conditions. By blocking TNF-alpha, the drugs help reduce inflammation and the resulting structural damage to the joints. This, in turn, improves patients’ quality of life by improving their mobility and function.

Specific Therapies
The following TNF-alpha blockers are approved for the treatment of rheumatoid arthritis. Enbrel® (entercept) is a synthetic, man-made protein that binds to TNF-alpha and acts like a sponge to remove the TNF-alpha molecules from the joints and blood. It has proven effective at preventing the progressive destruction of the joints in patients with rheumatoid arthritis. It is often prescribed when patients have not responded to other drugs. It is commonly given alone or in combination with methotrexate.

Enbrel is given by self-injection once or twice per week. Studies show it may cause irritation at the injection site. Other common side effects include headache, dizziness and nasal and throat irritation.

Because the drug weakens the immune system, patients with serious infections should not take Enbrel. In addition, research conducted since it was approved by the U.S. Food and Drug Administration in 1998 shows that in rare circumstances the medication has been associated with severe and sometimes fatal blood disorders or the worsening of existing blood disorders.

There have also been reports linking Enbrel to multiple sclerosis and optic neuritis or inflammation of the optical nerve. Reports of an increased risk of congestive heart failure have prompted doctors to use caution if patients have already been diagnosed with the condition.

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