Musculoskeletal Health and Arthritis

New hope for patients with debilitating arthritis

Millions of children and adults living with rheumatoid arthritis (RA) rely on anti-rheumatic drugs to treat their condition - but these drugs are unable to help 25 per cent of people with arthritis. Hope for treating these patients does exist, however, thanks to new drugs called biologics.  

"Biologics were first used with RA patients who didn't respond to standard medications,” says Dr. Arthur Bookman, TWH rheumatologist. “Now, we are also prescribing biologics for patients with other types of arthritis associated with severe inflammation, such as psoriatic arthritis (PsA) and ankylosing spondylitis (AS).” PsA is a condition marked by joint inflammation and a scaly rash on the skin. AS is a type of arthritis that affects the spine and spinal joints.

At TWH's Psoriatic Arthritis Clinic, Dr. Dafna Gladman, rheumatologist and head of the Psoriatic Arthritis Program, has followed the prognosis of 800 patients, the largest studied group of PsA patients in the world. “Through our investigations, we've seen that the biologic infliximab can be effective in treating skin and joint symptoms for severe cases of PsA,” says Dr. Gladman. “We're also discovering through the ongoing clinical research that if biologics are given to patients early enough, the disease progression of PsA and AS can be stopped.”

	What are biologics?
Also known as “biological response modifiers,” biologics are genetically engineered protein molecules. They target and soak up molecules such as TNF-alpha cytokines--molecules linked to painful joint inflammation that characterizes several types of arthritis.

Prior to the development of biologics, there were few effective therapies available for treating AS. But Dr. Robert Inman, TWH rheumatologist and Director of UHN's Arthritis Centre of Excellence, reports that one biologic called etanercept is particularly effective. “We found that after six months, etanercept results in reduced pain and improved mobility for people suffering from AS,” says Dr. Inman, who published his findings as part of an international research study.  

More good news about biologics: side effects are generally limited to conditions such headaches and a mild skin reaction at the site of injection. However, researchers point out that the drugs may increase a patient's susceptibility to infections, and an assessment is required to determine eligibility for treatment.

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