Brighter outlook for people with rheumatoid arthritis
There is “much to look forward to” for the 2% of the Australian population living with rheumatoid arthritis (RA), according to the authors of a narrative review published in the Medical Journal of Australia.
The cause of RA remains unknown, but many genes have been implicated. Identifying the genes allows specialists to predict a patient’s response to treatment. Treatment that is currently costing the Australian healthcare system approximately $600 million a year.
The authors, led by Professor Graeme Jones from the Menzies Institute for Medical Research at the University of Tasmania, wrote, “There are now eight approved biological disease-modifying antirheumatic drugs (bDMARDs), two biosimilars and one targeted synthetic DMARD in Australia with a number of new products and biosimilars in the pipeline.”
They continued, “There is still an unmet need in RA, with most patients achieving at least a major clinical improvement, but with many still not achieving remission status.
“A number of novel agents are in development, including Australian discoveries such as mavrilimumab (a granulocyte-macrophage colony-stimulating factor antagonist) and novel ways of preventing RA using a vaccine-like approach, which induces dendritic cell tolerance in patients who are CCP (cyclic citrullinated peptide) positive. Thus, there is much to look forward to for patients with RA,” they wrote.
The authors also confirmed that there is evidence of a “window of opportunity” early in the progress of the disease that can be crucial to prognosis.
“There is now evidence for a window of opportunity in the first 6 months of the disease, where therapies are more effective and have a long term effect on the disease, regardless of subsequent therapy,” they wrote.
“This means that RA should be diagnosed and treated with DMARD therapy as quickly as possible to maximise this benefit. Indeed, most rheumatologists in Australia have triage systems in place to see patients with RA quickly.”
Other RA concerns discussed in the narrative review were toxicity concerns, the use of biosimilars versus bio-originators, switching and tapering.
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