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| |  DG DISPATCH - AAPM: Cox 2 Drugs, Biologic Therapy Agents Usher New Era Of Arthritis Treatment By Lisette Hilton Special to DG News
MIAMI, FL -- February 18, 2001 -- Anti-inflammatory medications and biologic therapies offer good news in the treatment of arthritis, says a researchers speaking Friday (Feb. 16) at the 17th Annual Meeting of the American Academy of Pain Medicine, held here. About 43 million people in the United States suffer the pain, swelling and stiffness associated with more than 100 types of arthritis, according to the Arthritis Foundation. "I would say there have been more advances in the last two years then the last 25 years combined," said Edward V. Lally, MD, who presented "Evaluation and Treatment of Arthritis Pain". Dr. Lally, a rheumatologist and director of Division of Rheumatology at Roger Williams Medical Center, in Providence, Rhode Island, noted two broad categories of advances that have occurred in the last 24 months: anti-inflammatory medications and biologic therapy.
Anti-inflammatory Treatments The major developments in the anti-inflammatory area are the Cox 2 specific anti-inflammatory medications, including Celebrex (celecoxib) and Vioxx (rofecoxib). Mobic (meloxicam), an NSAID, also is a newly approved drug for the treatment of arthritis. "The advantage is not so much that they work better but they are much safer. In terms of GI (gastrointestinal) tract, they have a much lower incidence of causing ulcers and complications of ulcers, such as bleeding, perforation, obstruction etc.," he said. These medications offer a new option to people who previously could not take anti-inflammatories because of their risks for side effects, including patients with histories of ulcers and bleeding problems.
Biologic Therapy Biologic therapy addresses rheumatoid arthritis. The new drugs in this category are Arava (leflunomide), which is similar to the standard treatment methotrexate, and two other medications directed against the chemical called tumor necrosis factor (TNF). One of these is Enbrel (etanercept), which prevents t-cells that are important in stopping arthritis from proliferating, and Remicade (infliximab). Both, according to Dr. Lally, have been very successful in treating severe cases of rheumatoid arthritis. Another area of treatment that is controversial and undergoing clinical trials, according to Dr. Lally, is the use of injectable hyaluronic acid into the joints of osteoarthritis patients. The two products in that category are Hyalgan (sodium hyaluronate) and Synvisc (Hylan G-F 20). The theory is that these help to lubricate joints. "The clinical trials are still somewhat inconclusive about how effective it [hyaluronic acid] is," Dr. Lally said.
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