Some people with Rheumatoid Arthritis being treated with Remicade may feel little improvement but they may still benefit from this therapy, which appears to protect against joint damage, according to European and US researchers.

Remicade, known generically as infliximab, is one of the new class of anti-arthritis drugs called TNF-blockers, because they target ‘tumor necrosis factor’ that is involved in the disease process.

Dr. Josef S. Smolen of the Medical University of Vienna explained that TNF blockers may inhibit the activity of bone-resorbing cells, which damage bones in the joint, “even if enough TNF-activity persists to drive the inflammatory response.”

Smolen and his colleagues examined data from a trial in which 428 Rheumatoid Arthritis patients were given either infliximab and another arthritis drug, methotrexate, or methotrexate and an inactive placebo.

After a year, patients in the infliximab group who did not show a 20 percent improvement in their disease still demonstrated mild but significant improvements in joint disease scores and the tender joint count.

Regardless of the clinical response, joint damage seen on x-rays progressed faster in the placebo patients than in the infliximab patients, the researchers report in the medical journal Arthritis and Rheumatism.

By a variety of measures, structural damage was significantly less in the subjects who did not improve clinically on Remicade and methotrexate, compared with that seen in patients on methotrexate and placebo.

“Thus, TNF- blockers may revert destructive to non-destructive arthritis.” Smolen concluded - even when pain and inflammation persist.

SOURCE: Arthritis and Rheumatism, April 2005.