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UK Researcher Targeting Arthritis

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PHILADELPHIA (AP) — An experimental new rheumatoid arthritis treatment that targets renegade white blood cells shows promise in early testing, allowing some victims to resume normal lives and stop taking other medicines, researchers said Monday.

The research, though preliminary, has had major benefits for the first five subjects treated after 18 months and has helped a second group of five people six months after treatment, said Dr. Jonathan Edwards of University College in London.

``It's early days yet, but we've gotten very good responses from the patients. We need to do a lot more work before this would be any sort of routine treatment,'' said Edwards, a professor of connective tissue medicine.

He will deliver a presentation on the treatment, which uses a biotechnology drug targeted at the immune system, on Wednesday at a meeting of the American College of Rheumatology in Philadelphia.

Dr. John Klippel, medical director of the Arthritis Foundation in Washington, who is also among the 7,000 people attending the convention, said Edwards' research stood out because the patients improved so markedly.

``The degree of improvement and the duration of the response is much, much greater than we are accustomed to seeing,'' Klippel said.

The 20 subjects treated so far ranged in age from 40 to 70 and had had arthritis for an average of 22 years.

Edwards said the first five patients treated had 70 percent improvement after 18 months, though two have required further treatment during that time. Two of the 20 treated so far have shown no improvement.

``All of the first five subjects returned to leading a more or less normal life, one going to the gym and one taking up gardening for the first time in years,'' Edwards said. He said they stopped taking their arthritis medications.

He said three subjects have had relapses during the study, but retreatment has produced results as good as or better than the first treatment. Even if treatment had to be repeated on average once a year, he said, it still would be worthwhile.

``We are talking about a therapy that might be available in five to seven years,'' Klippel said.

Edwards said he based the treatment on recent research indicating that B lymphocytes, which are antibody-forming white blood cells, create abnormal antibodies that not only cause rheumatoid arthritis symptoms but keep the disease going through a vicious cycle.

Edwards theorized that if the B lymphocytes were removed, normal cells making normal antibodies would return after a few months, in effect ``rebooting'' the immune system.

The B lymphocytes were removed using a new drug, Mabthera, also called rituximab, developed by Hoffman la Roche, in conjunction with prednisoline, a steroid, and cyclophosphyamide, also called cytoxan. The treatment required two short hospital stays for intravenous infusions of the drugs.

Edwards said he has begun a larger, controlled study that will last two years, involving 160 rheumatoid patients in Europe, Australia and Canada.

Edwards said Hoffman la Roche contributed 30 percent of the cost of the drugs for the study, with no other major contributors. ``We scraped together the rest,'' he said.





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