May 1, 2002 — People who suffer from a relatively rare, but potentially disabling form of spine arthritis known as ankylosing spondylitis may find relief from a popular drug currently used to treat rheumatoid arthritis. A new study shows the drug Enbrel improves symptoms such as morning stiffness and back pain and improves the quality of life for many patients.
Until recently, there have been limited treatment options for the approximately one in 1,000 persons who have ankylosing spondylitis. There is no cure for the disease and none of the currently used medications have been shown to actually slow progression of the disease.
Patients typically use a combination of anti-inflammatory drugs, physical therapy, and exercise to treat the symptoms of the disease, which include joint pain and inflammation, reduced mobility, back pain, and fatigue.
But a growing number of studies now show that these patients may also benefit from treatments originally designed to treat rheumatoid arthritis, which also causes joint pain and inflammation.
In the study, published in the May 2 issue of TheNew England Journal of Medicine, 80% of patients treated with Enbrel reported improvement in their symptoms.
“The marked reduction in stiffness, pain, and functional limitations with [Enbrel] therapy is particularly promising, since these are the primary problems reported by patients with ankylosing spondylitis and are among the leading causes of disability,” writes lead researcher Jennifer D. Gorman, MD.
Gorman’s team from the University of California at San Francisco compared the effects of twice-weekly injections of the drug and placebo over a period of four months in a group of 40 patients. They found the improvements in the Enbrel group were rapid and did not diminish over time. The drug was also well tolerated by the patients, who reported few negative side effects.
In an editorial that accompanies the study, Jean-Michel Dayer, MD, of the Geneva University School of Medicine in Switzerland, and Stephen Krane, MD, of Massachusetts General Hospital, argue that more research is needed to understand how diseases like ankylosing spondylitis affect the body.
They say although it’s clear that some patients benefit from some current rheumatoid arthritis drugs, it’s not known exactly how the drugs work in these patients. Further study is required, the editorialists say, to identify who would most likely benefit from these new tools and who may be at risk of potentially serious side effects.
Another study released earlier this year found that the drug Remicade, which works similarly to Enbrel and is also used to treat rheumatoid arthritis, was effective at treating a group of inflammatory diseases that affect the spine and joints, including ankylosing spondylitis.
Both Remicade and Enbrel inhibit an inflammatory chemical in the body called TNF. Increased amounts of TNF have been seen in patients with ankylosing spondylitis. But because the drugs work by suppressing the immune system, serious infections and even deaths have been seen with both. In addition, a recent report linked Remicade to worsening heart failure.
Still, these drugs are a welcomed addition for people with ankylosing spondylitis. Currently, no drugs have been shown to slow the disease and further research may just show that these drugs — or others — are able to do so.