The biologic drug bortezomib (Velcade), a proteasome inhibitor used to treat multiple myeloma, may represent a promising treatment for rheumatoid arthritis (RA), says a new study.
In this study, bortezomib displayed favorable effects in an animal model of inflammatory arthritis that mimics RA, in reducing disease severity and inflammation, and promoting bone healing. Full findings of this study are published in the November issue of
Arthritis & Rheumatism, a journal of the American College of Rheumatology (ACR).
RA is a chronic, systemic, autoimmune disease characterized by inflammation and joint destruction. The newer biologics, such as the tumor necrosis factor (TNF) inhibitors and monoclonal antibodies, have increased the therapeutic options for patients with RA. However, studies have shown that more than 50% of patients treated with a TNF inhibitor do not meet the ACR 50 improvement criteria—a standard set of measures developed by the college to determine efficacy of drugs in clinical trials.
"The definitive role of biologic agents in treating this difficult-to-cure population has yet to be defined in prospective trials comparing the available therapeutic options," explained study leader Evangelia Yannaki, M.D., of George Papanicolaou Hospital in Thessaloniki, Greece. "Given the lack of options for poor responders and the increased risk of infections and malignancies with available biologic agents for RA, there is a great need for novel therapies that are safe and effective."
The research team explored bortezomib as an optimal treatment for RA because the drug targets multiple pathways. In RA, the most important proinflammatory mediators are regulated by the transcription factor NF-KB—proteins that control genes involved in inflammation and the immune response to infection. Where bortezomib inhibits NF-KB, researchers speculate that the drug may improve autoimmune conditions, such as RA, which are characterized by chronic inflammation.