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Australian Prescriber Vol. 27 No. 2 2004

Rheumatoid arthritis

Severe rheumatoid arthritis sometimes needs treatment which alters the immune system. This reduces inflammation in the joints.

Genetic engineering is making new products to reduce inflammation. Adalimumab, etanercept and infliximab are three of these products.

These products do not make a big difference to a lot of patients, but more than 50% of people may have a slight improvement in their arthritis. These treatments may need to be taken with other medicines such as methotrexate.

Adalimumab, etanercept and infliximab need to be given by injection. Many people get skin reactions at the injection site.

As these treatments can affect the immune system, their long-term safety is unknown. There is a risk that they may make old infections such as tuberculosis (TB) flare up again.

Adalimumab, etanercept and infliximab are expensive and only have modest benefits. They will probably only be used in patients who have not improved with other treatments.