Drug May Slow Rheumatoid Arthritis

Thursday, November 30th 2000, 12:00 am

By: News On 6

BOSTON (AP) â€” A drug used to relieve the symptoms of advanced rheumatoid arthritis also appears to slow or stop the progression of the disease when given in its early stages, a study concludes.

The latest work shows that the drug, called Enbrel, works better than the standard treatment in these patients and carries fewer side effects

A study directed by Dr. Joan M. Bathon of Johns Hopkins University tested the medicine on 632 people who had suffered from rheumatoid arthritis for less than three years.

The progression of the disease stopped completely in 72 percent of the patients getting twice-weekly injections of the drug for one year. By comparison, 60 percent fared this well when taking methotrexate pills, the older standard medicine.

Those getting methotrexate were twice as likely to experience side effects bad enough to make them stop taking the drug.

Enbrel works by blocking a natural substance called tumor necrosis factor, which triggers much of the joint inflammation in the disease. Victims of rheumatoid arthritis suffer destruction of bone and cartilage in their joints. It is caused by a misguided attack of the body's immune defenses on its own tissue.

Rheumatoid arthritis afflicts more than 2 million Americans and is different from the common form of arthritis that results from the wear-and-tear of aging.

The study was published in Thursday's New England Journal of Medicine. Another report in the journal confirmed the effectiveness of the drug Remicade, which also works by blocking tumor necrosis factor, in patients who had the disease for an average of about 10 years.

Joint function improved in about half of patients getting both Remicade and methotrexate, suggesting that the treatment repaired some of the damage. The study was directed by Dr. Peter E. Lipsky of the University of Texas Southwestern Medical Center at Dallas.

Enbrel is made by Immunex and Remicade by Centocor. The makers financed both studies.

In a journal editorial, Dr. John H. Kippel of the Arthritis Foundation said all patients with rheumatoid arthritis should take one of these drugs as soon as possible, and there is no clear medical reason to choose one over the other.

The main drawback is cost â€” $10,000 to $12,000 a year. Kippel noted that Medicare pays for Remicade since it requires intravenous infusion. But it does not cover Enbrel because it's given by self-injection.