Rheumatoid arthritis

In a 24-week trial comparing methotrexate and chicken type II collagen (CCII) for patients with rheumatoid arthritis, both treatments were effective in ameliorating symptoms and improving functional outcomes. Response rates were significantly higher in the methotrexate group than the CCII group, but the incidence of adverse events was significantly lower in patients treated with CCII than in those receiving methotrexate.

Zhang LL et al. (2008) A randomized, double-blind, multicenter, controlled clinical trial of chicken type II collagen in patients with rheumatoid arthritis. Arthritis Rheum 59: 905–910

A retrospective analysis of 256 patients who received anti-tumor necrosis factor therapy revealed that the 28-joint Disease Activity Score (DAS28) from the first pre-assessment was more predictive of response at 6 months than was baseline DAS28. If the pre-assessment DAS28 was taken as the baseline, 31.8% of those classified as responders at the 6-month assessment would be reclassified as nonresponders, and 9.4% of responders would be reclassified as nonresponders.

Smith N et al. (2008) The importance of the baseline Disease Activity Score 28 in determining responders and non-responders to anti-TNF in UK clinical practice. Rheumatology (Oxford) [doi:10.1093/rheumatology/ken233]

Blockade of the chemokine receptor CCR2, whose ligand is abundantly expressed in the synovium of patients with rheumatoid arthritis, has shown potential as a therapy for the disease in in vitro studies and animal models. A phase IIa clinical trial of a human CCR2 blocking antibody in 32 patients, however, has shown that the treatment did not produce any clinical improvement.

Vergunst CE et al. (2008) Modulation of CCR2 in rheumatoid arthritis: a double-blind, randomized, placebo-controlled clinical trial. Arthritis Rheum 58: 1931–1939

Systemic lupus erythematosus

Indirect immunofluorescence with HEp-2000 cells, an advanced substrate used for the detection of antinuclear antibodies, has a high sensitivity (81%) for detecting anti-Ro/SSA antibodies in the sera of patients with connective tissue diseases. This substrate could be a useful alternative to conventional HEp-2 cells in first-level screening for patients with systemic lupus erythematosus or photosensitivity.

Cozzani E et al. (2008) Indirect immunofluorescence on HEp-2000 substrate is a sensitive method for detecting anti-Ro/SSA antibodies in patients with lupus erythematosus and/or photosensitivity. J Rheumatol 35: 1320–1322

Inflammation

Treatment with the human monoclonal antibody ACZ885 has been tested in patients with rheumatoid arthritis in a proof-of-concept study, after it was shown to effectively neutralize the bioactivity of interkeuin-1β in mice. After 4 weeks, disease activity was significantly lower in patients treated with 10 mg/kg ACZ885 (n = 20) than in those who received placebo (n = 15), and the treatment was well-tolerated.

Alten R et al. (2008) The human anti-IL-1β monoclonal antibody ACZ885 is effective in joint inflammation models in mice and in a proof-of-concept study in patients with rheumatoid arthritis. Arthritis Res Ther 10: R67

Despite conflicting reports of the efficacy of interferon (IFN)-α therapy for familial Mediterranean fever, an open-label study of 10 patients with severe, colchicine-resistant disease has shown that early intervention with IFN-α might attenuate symptoms. Compared with untreated attacks, the duration and severity of attacks was significantly reduced (P <0.001) following patient self-controlled administration of subcutaneous IFN-α at attack onset.

Tweezer-Zaks N et al. (2008) Interferon-α as a treatment modality for colchicine-resistant familial Mediterranean fever. J Rheumatol 35: 1362–1365