A real breakthrough in RA treatment? Maybe!

June 19, 2009 at 5:28 pm | Posted in rheumatoid arthritis (RA) | 2 Comments
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Could the news that rituximab (MabThera) can provide dramatically improved results in patients with early rheumatoid arthritis be a real breakthrough at last? The thing I find most encouraging about the research, carried out by Prof. Paul-Peter Tak from the University of Amsterdam, is that it’s research based on a drug that’s already out there in the market, not something we’ll have to wait ten years for approval for.

Tak (which means thank-you in Norwegian, something many of us might want to say to him if this research is taken through into treatment) showed that treating patients early with rituximab and methotrexate in combination,  can virtually stop the disease in its tracks. The 755 patient trial of recently diagnosed patients, most of whom had suffered the disease for less than a year, showed that nearly 2.5 times as many patients on the treatment went in to remission, compared with those treated with methotrexate alone.

Of course, like all RA treatments (to date, anyway) it doesn’t work for everyone, and so far the investigation has only been on recently diagnosed patients, but it certainly sounds encouraging. At the moment in the UK rituximab is only prescribed after failure of anti-TNF therapy, but NICE might actually take this option seriously as the cost of rituximab is about a quarter of an anti-TNF so it makes economic as well as medical sense to try rituximab first.

Here’s hoping NICE do something sensible for once!

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  1. Nice will have to move fast if this piece of research is gold plated…is it? Is it great quality? Will have to go find out this week.

    But I have a consult on Weds when I had planned to ask for anti-tnf as MTX def has failed with me. Might cut to the chase and ask for Rituximab+MTX as i fit the criteria to get really helped. Will see if the consultant agrees in my case

  2. I have a consultant’s appointment on Wednesday too! As ever I’m actually doing pretty well the one time in six months that I get to see him … I have to say, at the moment at least, your department sounds a lot more clued up then mine … but then again it sounds like you’ve got it pretty hard, whereas I’ve got it relatively easy so they don’t take me too seriously! I’d love to know what the consultant says about your possible options – I rather think they aren’t even allowed to prescribe Rituximab + MTX according to NICE rules as yet, and if that’s the case I hope they get on and give you an anti-TNF pronto … All depends on your DAS28 (spelling?) score and all that though so if you feel rotten just make sure they know!!!


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