HEALTH: New Arthritis Treatment

[Guest guest]

NEW ARTHRITIS TREATMENT 'DRAMATIC'

The estimated 1 million people in the United States with the

painful, debilitating autoimmune disease psoriatic arthritis have new

hope -- and some say a new miracle -- in an old drug used to treat

rheumatoid arthritis.

 

Etanercept, sold in the United States as Enbrel, was already approved

by the Food and Drug Administration for treatment of rheumatoid

arthritis, and this week, the FDA extended its approval to psoriatic

arthritis.

 

For my mother, it came too late but for others it could be a

salvation. I visited my mother daily at the nursing home during her

last four years of life. At the end of each visit, after I read to her

from her devotional material, Mom would take my hand and ask me to say

the Lord's Prayer. I never quite got used to this moment; praying with

her didn't bother me but her hands did.

 

I never quite got used to what had happened to Mom's hands as a

result of her psoriatic arthritis, which simultaneously inflames

joints and ulcerates skin. Gnarled, red and encrusted with scaly skin, I

admired her for ever attempting to hold hands, since even that gesture was

painful.

Back in the mid-90s there was then no FDA-approved treatment for

psoriatic arthritis, so she had me apply a variety of lotions to her hands,

hoping they would help. Nothing helped. But that scenario now has changed.

" (Enbrel) It is the first drug specifically approved ever for psoriatic

arthritis, " Dr. Mark Lebwohl, chairman of the department of dermatology at

Mount Sinai Medical Center in New York, told United Press International. " It

was surprising even to me and other experts in the field that a recent

survey showed that as many as a million Americans have psoriatic arthritis.

Enbrel is a dramatic treatment for the condition. It will also allow

clinicians to spare patients other

damaging treatments, particularly methotrexate which can, over time, cause

severe liver damage. With Enbrel, there is no threat to the major organs of

the body. "

 

Lebwohl said the drug is nothing short of a miracle for some of his

patients.

" One of my patients used the word 'miracle' to describe its effect. He was

literally on crutches, and a day after starting on Enbrel he was walking

without them and without pain. This story has repeated itself multiple

times. So to say it's effects have often been dramatic is not an

overstatement. "

 

Psoriatic arthritis often shows symptoms of both arthritis and psoriasis.

Almost all affected patients have psoriasis, characterized by thick,

inflamed skin covered by silver-gray scales. About 20 percent to 30 percent

with psoriasis also have arthritis, which is characterized by pain and

swelling in one or more joints. It usually first appears in men and women

between the ages of 30 and 50. The

psoriatic component of the disease often precedes arthritis by several

months or even years. " From our perspective, it is a major step forward. "

Molly Marshall president and chief executive officer of the National

Psoriasis

Foundation, told UPI. " There hadn't been a drug specifically approved for

psoriatic arthritis. This drug not only appears to be effective but has

fewer side-effects that what has been used. " We have also heard directly from

patients about their dramatic improvements as they started on Enbrel. So we

are excited about this breakthrough. There is really no hype to this at all.

It is truly a new beginning for doctors and patients in the treatment of

this disabling, painful condition, " she said.

 

" The psoriasis started when I was 15, " Joe Carlin of Cary, N.C., told UPI.

" And in my mid-20s the arthritis began. I couldn't get up and walk to the

shower in the morning. I had to roll out of bed, crawl to the bathroom and

get the hot water going over my body, which helped some. " It took three

years for his psoriatic arthritis to be diagnosed. " I never stopped working,

but I never stopped suffering, " Carlin said. Carlin tried alternative

therapies, but nothing helped. " After 20 years of this, I wondered if I

could go on, " he said. In 2000, Carlin consulted with a physician at Duke

University in Durham, N.C. The doctor explained to him he had something that

might help, but which was FDA-approved only for rheumatoid arthritis.

 

Using a physician's prerogative to prescribe any FDA-approved drug

" off-label " for another use, he prescribed Enbrel for Carlin. " I literally

went to bed one night with all of my pain and got up out of bed the next day

with none of it, " Carlin said. " Eventually the psoriasis also diminished

from covering 85 percent of my body to about 5 percent now. That happens

with some patients. I'm one of the lucky ones. "

 

" I have new life now, " Helen Redmond of Chicago, told UPI. " I started on

Enbrel in 2000 when I could barely zip a zipper or open a door. Now I have

so much energy and strength. Last year, I actually climbed a mountain in

Utah. "

" I don't feel like I have arthritis anymore, " Redmond added. " I just pray

that it works for the rest of my life. "

(By BRUCE SYLVESTER, UPI Science News)

Copyright 2002 by United Press International.

All rights reserved.

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