Small-scale trials of a new treatment for rheumatoid arthritis are giving encouraging results, announced a team from University College London at the annual meeting of the American College of Rheumatology this week. The announcement sparked intense media interest, prompting rheumatologists to warn that the treatment is only in its infancy and should not be considered a 'cure'.
The treatment involves the use of the drug rituximab, which attaches to a protein on the surface of B cells and suppresses their activity. The drug is effective at killing mutated B cells that attack the body's healthy tissues, damaging joints and causing the symptoms of arthritis. Once these lymphocytes have been cleared out, fresh B cells are produced to replace them. The chance of new B cells also being genetically mutated is very small, according to Professor Jonathan Edwards, who led the study.
Suppression of the immune system could be a drawback of the treatment but Professor Edwards and his team confirmed that killing these B cells did not lead to an increased risk of other diseases occurring. The drug was tested on 20 patients, who had suffered from arthritis for an average of 20 years. All of them had failed to respond to conventional medication. After 18 months, five of the patients were experiencing only residual pain, with their symptoms reduced by 70%. Only two of the original patients showed no benefit at all, and one patient appeared to have beaten the arthritis circle, and had no arthritis antibodies at all after two years.
Professor Edwards also believes that the therapy could prove beneficial for other autoimmune diseases. "If our explanation is right, autoimmune disease could be like bugs in a computer programme. The solution is to turn everything off and start up afresh."