Arthritis Treatments Based on Biological Mechanisms

Arthritis Treatments Based on Biological Mechanisms

The synthesis of chemicals is required to produce conventional medications. Three of the four biologics that are currently licensed help reduce inflammation and structural damage to the joints by blocking a substance known as tumor necrosis factor (TNF). TNF is a protein that is involved in the immune system's reactions. Patients with rheumatoid arthritis and certain other types of arthritis have synovial fluid that contains elevated amounts of TNF.

Etanercept, the active ingredient in Enbrel, was the first biologic to win FDA approval for treating patients with moderately severe to severely advanced rheumatoid arthritis. In the beginning, it was administered through injection twice per week; however, there is currently a preparation that is only administered once per week. It has been demonstrated that taking Enbrel can reduce joint pain and stiffness in the morning, as well as improve joint swelling and soreness. In the year 2000, the list of approved uses for the medicine was broadened to include postponing the onset of structural deterioration. Psoriatic arthritis and ankylosing spondylitis are two more common types of arthritis that have now been approved for treatment with Enbrel in addition to RA.

Remicade (infliximab) and Humira (adalimumab) are the two other TNF-blocking medications that have been licensed to treat RA. Humira was the drug that offered Shirley the long-awaited relief that she experienced during a clinical trial in 2002. In tests that lasted for at least two years, it was shown that blocking TNF activity with any of the three different drugs improved physical function.

"While all three inhibit the action of TNF, they do so in somewhat different ways," says Jeffrey N. Siegel, M.D., team head for the FDA's Division of Therapeutic Biological Internal Medicine Products. "While all three inhibit the action of TNF," he continues, "they do it in somewhat different ways. Remicade and Humira are examples of monoclonal antibodies, which are proteins manufactured in a laboratory that are analogous to those produced by a person's immune system. These antibodies attach to TNF and remove it from the body before it can trigger the immunological reaction that is responsible for rheumatoid arthritis.

Enbrel, on the other hand, is classified as a soluble cytokine receptor. This indicates that its structure is analogous to that of protein molecules that are found attached to the surface of cells and that bind TNF. Enbrel engages in competitive interactions with these receptors in order to prevent them from binding TNF. As a result, it prevents these receptors from initiating the immunological response that is responsible for rheumatoid arthritis (RA), psoriatic arthritis, and ankylosing spondylitis (AS).

Siegel stresses the importance of exercising extreme caution before putting these substances into treatment. He claims that all TNF blockers are linked to an increased risk of infection.

It has been demonstrated in clinical trials that the biologic treatment Kineret (anakinra), which has also been licensed by the FDA for people with RA, can relieve symptoms such as pain and swelling and reduce the progression of structural deterioration in patients.

Instruments for the Treatment of Arthritis

Hyalgan and Synvisc are two preparations that replicate hyaluronic acid, a naturally occurring material in the body that functions as a lubricant for the knee joint. These two medical device items are termed Hyalgan and Synvisc. In order to help give temporary pain relief and flexible joint movement, the products, which have been approved by the FDA for the treatment of osteoarthritis (OA) of the knee, are injected directly into the joint of the knee.

Transcutaneous electrical nerve stimulation (TENS), which has been shown to be useful in changing pain perception, is another device that is utilized in the treatment of arthritis. TENS works to prevent the transmission of pain signals to the brain by applying gentle electric pulses to nerve endings that are located just beneath the surface of the skin in the affected area.

People who suffer from severe cases of rheumatoid arthritis may benefit from having their blood passed through a device known as the Prosorba Column, which is designed to remove potentially dangerous antibodies.

Both heat and cold are effective in treating the pain and inflammation that are associated with arthritis. Patients and their doctors can decide which treatment option is most effective for them.

Shirley reports that her husband's current level of pain is only approximately ten percent of what it used to be because he is receiving the appropriate treatment. "It's hard to believe all the things I can do now," he recalls, "looking back on those days. My mobility and strength have both returned to normal. And now that everything is back to normal, Shirley is able to mow the grass, prepare meals, mend things around the house, and even engage in his favorite hobby, which is watching birds.

"Rheumatoid arthritis is now an illness for which newer treatments offer the real likelihood of patients being able to pursue a lifestyle without the limitations imposed by joint pain and deformity," adds Birbara. "Newer treatments offer the real likelihood that patients will be able to pursue a lifestyle without the limitations imposed by joint pain and deformity."

The Importance of Physical Activity and Diet

Arthritis specialists believe that non-pharmaceutical therapies, such as regular exercise, a healthy diet, and other lifestyle changes, have the potential to help prevent arthritis, lessen arthritis-related pain, and keep people moving. These goals are emphasized in a 10-year effort titled Healthy People 2010, which began in 2010. Healthy People 2010 is a comprehensive, national program for the promotion of health and the prevention of disease that was designed by the Department of Health and Human Services. The program comprises 467 goals for improving the health of the country in regards to disorders such as cancer, sexually transmitted infections, and arthritis.

According to the Arthritis Foundation and the American College of Rheumatology, research conducted in 2004 indicated that the combination of exercise and nutrition can considerably enhance physical function and reduce knee pain in adults older than 60 who are overweight or obese. This finding was supported by the findings of the same research. The findings of the research were presented in the May 2002 issue of Arthritis & Rheumatism. In a similar vein, the discomfort and incapacity that are associated with any kind of arthritis can be lessened with early diagnosis and effective management, which may include self-management, physical and occupational therapy, joint replacement surgery, weight control, and physical activity.

Research conducted by the Centers for Disease Control and Prevention (CDC) suggests that engaging in physical exercise can reduce joint discomfort, enhance function as well as a person's attitude and perspective, and delay the onset of impairment. People with various types of arthritis can have less pain and exhaustion when they exercise, which makes it easier for them to continue working, engaging in day-to-day activities, and maintaining their independence. 

Exercises that increase range of motion, strength, and endurance, such as moving a joint as far as it will go, using muscles without moving joints, and aerobic exercises, respectively, are beneficial in reducing fatigue, strengthening muscles and bones, increasing flexibility and stamina, and improving an overall sense of well-being. Examples of these types of exercises include moving a joint as far as it will go, using muscles without moving joints, and aerobic exercises.

People who are overweight have a greater chance of developing osteoarthritis (OA), so it is critical that they maintain a healthy weight throughout their lives, but especially as they get older. The likelihood of developing osteoarthritis of the knee and possibly of the hip is raised when extra weight is carried about. This is particularly crucial for women to keep in mind. An additional prevalent type of arthritis known as gout, which is caused by an excess of uric acid in the blood, is also more likely to develop in men who are overweight. Both the chance of having arthritis and the rate at which the disease progresses can be reduced by maintaining a healthy weight and avoiding damage to the joints.

Some individuals assert that they were able to recover after undergoing treatment with medicinal plants, oils, chemicals, specialized diets, radiation, or other therapies. However, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) asserts that there is no credible data to support the claim that such treatments may effectively cure arthritis. In addition, some of these experimental treatments may result in severe adverse consequences for the patient. Patients should see their primary care physicians before beginning treatment with any modality that has not been advised or prescribed by their health care team.

Arthritis in Young People

In the United States, there are about 300,000 children under the age of 16 who are affected by a form of juvenile arthritis or another rheumatic condition. Juvenile rheumatoid arthritis is the most typical presentation seen in young people. It is still not known what causes the majority of types of juvenile arthritis. There is no evidence that foods, pollutants, allergens, or vitamin deficiencies play a role in the development of juvenile arthritis, nor is there any indication that the condition is communicable. According to the most recent findings in this line of research, a hereditary susceptibility to juvenile arthritis may exist. 

In other words, the combination of genes that a child receives from their parents has the potential to contribute to the development of arthritis when paired with additional factors whose precise nature is not known. Inflammation is the primary cause of most of the symptoms that are associated with juvenile arthritis. This inflammation is caused by imbalances in the immune system. Even if the precise cause or causes of juvenile arthritis are unknown, there are a variety of effective medications that can help children and the adults who care for them manage the condition. The majority of children diagnosed with arthritis are expected to have normal lives, according to the opinions of many experts.

The Times to Come

The burden of arthritis on the lives of all Americans is currently being reduced thanks to the collaborative efforts of a large number of organizations, both public and private, who are working together to carry out a plan that will direct the use of the nation's resources in order to improve the quality of life for people who are afflicted with arthritis. It is known as the "National Arthritis Action Plan: A Public Health Strategy," and it serves as a guide for lowering pain, activity limits, and impairment among those who suffer from arthritis, as well as a plan for preventing specific types of arthritis.

When it comes to the reliability of upcoming treatments for arthritis, history has shown us that the necessary studies on a medicine's safety and efficacy that must be carried out before the Food and Drug Administration (FDA) can give its blessing to the drug do not always reveal the entire extent of some of the hazards that may be posed by it. When assessing the potential dangers and benefits of various pharmaceuticals for particular patients, the FDA reminds medical professionals that they should take into account any new information that becomes available for a given drug.