Combination therapy with the new biologic drug adalimumab and methotrexate has been found to be about five times more effective for people with long-standing rheumatoid arthritis when compared to the usual management with methotrexate alone. It has been found to decrease pain and swelling in patients who fail to respond to standard treatment.
At the end of the 6-month trial, 43 percent of all subjects on adalimumab plus methotrexate had achieved a 50-percent improvement in symptoms, compared with 9 percent of all subjects receiving placebo plus methotrexate. In addition, adalimumab injections slowed progression of joint damage as revealed by joint X-rays.
Rheumatoid arthritis is an autoimmune disease, which develops when certain cells of the immune system malfunction and attack healthy joints. The cause of rheumatoid arthritis is unknown. The primary focus of the inflammation is in the synovium, the lining tissue of the joint. Inflammatory chemicals released by the immune cells cause swelling and damage to cartilage and bone.
Adalimumab works by preventing a protein called tumor necrosis factor (TNF) from signaling the release of joint-damaging substances. Adalimumab is approved for the treatment of moderate to severe rheumatoid arthritis in adults who do not respond to other treatments.
Addressing future research priorities, long-term efficacy and safety studies are needed before this therapy can be put into clinical practice.