-Caveat Lector- >From Int'l Herald Tribune Paris, Tuesday, December 29, 1998 'New Era' of Treatments For Arthritis Is Dawning ------------------------------------------------------------------------ By Justin Gillis Washington Post Service ------------------------------------------------------------------------ WASHINGTON - A new generation of arthritis treatments emerging from U.S. research laboratories holds out hope for millions who suffer from one of humankind's oldest and most exasperating afflictions. The treatments, some of which are already on the market, are particularly important to 2.1 million Americans, including 71,000 children, who have a form of the disease called rheumatoid arthritis. The disease can destroy joints and cause lifelong pain, but treatments are having such striking effects that some people with this disease have stopped using wheelchairs or walkers and resumed active lives. Alyce Kelso, 63, used to work 10 or 12 hours a day as a bus driver. But then her immune system went haywire and began attacking the joints in her body. As her rheumatoid arthritis worsened, she had to stop working, and eventually she needed a wheelchair or walker to get around her home in Rochester, New York. She feared that she would waste away in a rocking chair. ''I was just in pain every day of my life,'' she said. Desperate, she enrolled in a study testing one of the first drugs for rheumatoid arthritis produced by the budding U.S. biotechnology industry. Last year she started injecting herself twice a week with the compound Enbrel. The results were electrifying. In weeks her swollen joints shrank, most of her symptoms cleared up and the pain dissipated. She canceled two surgeries to alleviate problems in her elbow and toes. The wheelchair and the walker fell by the wayside. Rheumatologists - doctors who specialize in treating arthritis - are watching in amazement as children who once used wheelchairs are instead running and jumping like other children. These doctors are pinching themselves as adult patients show up to report that, for the first time in years, the pain of rheumatoid arthritis is gone. ''This is the beginning of an entirely new era in the treatment of arthritis,'' said Dr. Daniel Lovell, a pediatric rheumatologist at Children's Hospital Medical Center of Cincinnati and director of a national network testing arthritis treatments in children. ''I'm very optimistic that within the near future we'll have the ability to design treatment approaches that will work very effectively for large numbers of our patients.'' Many doctors remain somewhat cautious, unsure of the long-term effects of drugs like Enbrel. But these days, a rising sense of hope pervades their professional discussions. ''It's too soon to be saying things like, 'By golly, we're going to cure rheumatoid arthritis,''' said Dr. Richard Brasington, clinical director of rheumatology at the Washington University School of Medicine in St. Louis. ''But there's tremendous excitement and optimism.'' New treatments such as Enbrel are designed to take advantage of detailed knowledge of the immune system gained in recent years. The goal is to selectively tone down components of the system that seem to be overactive. The same strategy is working against the debilitating bowel ailment Crohn's disease, and it may prove useful in diseases as diverse as congestive heart failure and the nerve ailment multiple sclerosis. Arthritis is a broad name for a group of more than 100 diseases that cause pain, tenderness and limited movement in - or permanent damage to - the joints. The most important types are osteoarthritis, the ''wear and tear'' form of the disease that people tend to get in their older years, and rheumatoid arthritis, which can occur at any age. Both involve activation of the immune system, but rheumatoid arthritis is a classic ''autoimmune'' disease - an ailment in which the body aggressively attacks its own tissues. In the case of osteoarthritis, research is proceeding on how to interrupt the underlying disease, with some promising strategies just beginning to reach human trials. More immediately, to combat the symptoms, scientists have created anti-inflammatory drugs that seem to promise pain relief without the serious side effects, such as bleeding ulcers, sometimes caused by aspirin, Advil and similar compounds. ~~~~~~~~~~~~ A<>E<>R The only real voyage of discovery consists not in seeking new landscapes but in having new eyes. -Marcel Proust DECLARATION & DISCLAIMER ========== CTRL is a discussion and informational exchange list. 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