Rheumatoid arthritis New approaches to therapy

Personalized medicine as the main trend in rheumatoid arthritis
The treatment options for rheumatoid arthritis have improved significantly in recent years. The most important trend here is currently the so-called personalized medicine. Nevertheless, the therapy is quite difficult in some patients. They may, however, be helped in the near future with a new drug.

Precision medicine or personalized medicine is also the most important and current trend in the treatment of rheumatoid arthritis, report the experts Prof. Josef Smolen and Daniel Aletaha from the MedUni Vienna together with Prof. Iain McInnes from the University of Glasgow in a contribution to the renowned Specialist magazine "The Lancet". The "personalized medicine for rheumatism today means that for each patient can be determined more precisely than hitherto, which therapy is the best and fastest, and which is rather not suitable," said the corresponding press release of MedUni Vienna.

Thanks to personalized medicine, rheumatoid arthritis offers excellent treatment options. (Image: psdesign1 / fotolia.com)

Without therapy, the joints are destroyed
The chronic autoimmune disease in the form of rheumatoid arthritis predominantly affects women (about two-thirds of those affected) and is most often diagnosed in patients between the ages of 40 and 70, the experts report. About one percent of the world's population is affected by the disease. This is characterized by "inflammation in the joints. Swelling, overheating and a functional restriction, "said the MedUni Vienna. Without proper therapy, the disease will lead to increased destruction of the joints and joint-proximate bone, resulting in malpositions, deformations and increasing permanent disability. However, rheumatoid arthritis is relatively easy to treat in most patients today.

Abandonment of currently used biologic injections
In recent years, the focus in therapy has increasingly shifted towards personalized medicine, which, according to the experts, has enabled significantly better treatment outcomes. The central findings of the expert review also confirm that "at the MedUni Vienna, we know very well both clinically and scientifically how rheumatoid arthritis works, how to quickly diagnose, evaluate and optimally treat the disease," emphasizes the rheumatologist Prof. Smolen. With the possibilities of precision medicine, the therapy of the future will also see a departure from the currently widely used biologics by means of injection. Instead, oral drug therapies, but tailor-made for the inhibition of certain molecules within a cell, would be provided.

New active ingredient already tested
MedUni Vienna also reports that Prof. Smolen and colleagues did not complete a clinical Phase 3 study until April 2016, in which significant treatment success with the active substance baricitinib was achieved. Baricitinib is an "orally administered inhibitor (inhibitor) of Janus kinase 1 and 2," explain the scientists. According to the researchers, with his help, significant improvements can be achieved in patients with rheumatoid arthritis ... "With baricitinib, we have a new active ingredient in the hand, which acts even when currently in-use drugs are not sufficient," said Prof. Smolen.

Baricitinib already available in 2017?
In the near future, according to the experts with baricitinib, a new drug may be available as a basis for the treatment of rheumatoid arthritis. The decision on the approval should fall in the coming weeks. "A realistic use is in clinical practice from 2017," estimates Prof. Smolen. But even with the new drug is always precise to estimate for which patients this therapy and for which the biologics are better, so the conclusion of the expert. (Fp)