Supplement: The Trials of Keeping Track

1 on the epidemiology of autoimmune diseases, perhaps the most detailed publication on the topic so far. That report shows that in the more common conditions, such as MS, the imbalance tilts so that affected patients are roughly two-thirds female. "In some diseases, however, the degree of disproportion is very extreme," Cooper says. For example, at least 85% of patients with thyroiditis, systemic sclerosis, systemic lupus erythematosus, and Sjögren disease are female. In data from the Cent

Stephen Pinock

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The struggle to track these diseases matches the pharmaceutical industry's failure to treat them. For example, drugs for rheumatoid arthritis evolved from injectable gold in the 1930s to biologics today, but treatment results remain mediocre. According to Anthony Manning, vice president and global head of inflammation, autoimmunity, and transplant research at Roche, only about one-third of patients with rheumatoid-arthritis get "significant benefit," even with today's best therapies.

Such lacklustre results probably arise from rheumatoid arthritis' heterogeneity, varying in mechanism between individuals and within the same individual over time. Many other autoimmune diseases include similar variability, which thwarts effective treatment. Still, some members of the pharmaceutical community feel optimistic about improving results in the very near future. "Five years ago, we didn't have the plethora of tools that we have today," says Andrew C. Chan, vice president of research immunology and antibody engineering at Genentech. "If you only have one or ...

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