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New pill better targets rheumatoid arthritis

It’s the first oral therapy approved for RA in more than 15 years.

Rheumatoid arthritis (RA) is much more common in women than men, and there is currently no cure or means of preventing the disease. However, in November 2012, the FDA approved a potent new treatment for people who have not had success with methotrexate (Rheumatrex), the standard initial therapy for RA symptoms. The new drug is tofacitinib (Xeljanz).

RA is an autoimmune disease: the body’s immune system mistakenly attacks healthy tissue in the joints, leading to the production of inflammatory molecules called cytokines. The joints become warm, red, and tender. Methotrexate, taken orally, is the first line of defense. Doctors also prescribe biologic therapies (Enbrel, Humira) that quiet certain inflammatory cytokines. These are injectable treatments.

The new drug targets another type of inflammatory molecule than do the biologics. And it’s not an injection; it’s a pill you take twice a day.

Dr. Michael Weinblatt, the John R. and Eileen K. Riedman Professor of Medicine at Harvard Medical School, who was a consultant to the manufacturer on the development of tofacitinib, says the new drug has a short-term safety profile similar to the biologic therapies, with a slightly higher rate of shingles as a complication. But so far there are few data on its long-term use. And it comes with a premium yearly price tag, in the $20,000 range, which is similar to the biologics. “In patients who have not received biologics,” says Dr. Weinblatt, “response rates are 60% to 70%, which is very good and comparable to the biologics.”

Posted by: Dr.Health

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