Your Arthritis dot org

By
Jenny Hope

Last updated at 10:29 AM on 22nd February 2012

A drug that could ease the agony of thousands of rheumatoid arthritis sufferers has been given the go-ahead for many more NHS patients in England and Wales.

RoActemra, which is the first innovation in the field for ten years, is being recommended for patients who have failed on standard treatments.

It is the first time RoActemra has been approved for NHS patients in England and Wales with moderate to severe rheumatoid arthritis who are at an early stage in the disease.

Hope: The NHS given go-ahead to prescribe RoActemra which eases the agony of rheumatoid arthritis

The drug has been available for early use in Scotland for two years.

At present in England and Wales it is used by only 1,200 patients at later stages of the disease. The decision by the Government’s rationing body, the National Institute for Health and Clinical Excellence (Nice), means up to 40,000 more patients will be eligible.

The £9,000 annual cost of RoActemra, also known as tocilizumab, is the same as other advanced ‘biologic’ drugs already being used, but a discount scheme has been agreed with manufacturers Roche.

Trial data shows almost half of patients on RoActemra are in remission – with virtually no symptoms – after a year compared with 8 per cent on a commonly used drug called methotrexate.

The rate of remission is almost six times higher than on methotrexate alone.

Trial data shows almost half of patients on RoActemra are in remission ¿ with virtually no symptoms

The new drug is a laboratory-manufactured antibody that blocks the activity of interleukin 6 (IL-6), an important immune system signalling molecule  that underpins many inflammatory processes.

Because RoActemra works in a completely different way to existing drugs it is likely to be effective in some patients where the other drugs don’t work or have stopped working.

John Isaacs, professor of clinical rheumatology at Newcastle University, says it vital sufferers have options

John Isaacs, professor of clinical rheumatology at Newcastle University, said: ‘Rheumatoid arthritis is an unrelenting disease and it is vital that patients have options available to them when they are no longer responding to, or can no longer tolerate, their current treatment.’

The disease occurs when the body’s immune system attacks the joints causing pain and swelling, most commonly in the hands, wrists and feet.

NHS figures suggest it affects 400,000 people in England and Wales, striking three times more women than men. It is most common between the ages of 40 and 70. Half of victims are unable to work through disability within ten years.

Professor Isaacs said it was vital to treat people as early as possible with the most effective drugs. He added: ‘We have evidence that if you can stop the disease early, you can change the way it progresses for the rest of the patient’s life.

‘This is particularly important when it strikes at a young age – women can be affected in their 40s and 50s but it can start in the 20s and younger.’

Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, said: ‘We are delighted with Nice’s decision, as there are so many patients with rheumatoid arthritis in need of tighter disease management.

‘This decision is most welcome as it is vital that patients have effective options available as soon as one treatment approach fails.’

Professor Carole Longson, director of the health technology evaluation centre at Nice, said: ‘Rheumatoid arthritis can have a huge impact on quality of life and for many it’s a disabling condition, so we’re pleased to recommend tocilizumab at an additional stage in treating the condition.’

The drug was also approved in December for children with  systemic juvenile arthritis, a severe inflammatory disease that can affect those as young as 18 months.

Around 2,500 children in Britain are living with the disease, which can persist into adulthood and cause significant disability.

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Article source: http://www.dailymail.co.uk/health/article-2104499/NHS-given-ahead-prescribe-new-drug-eases-agony-rheumatoid-arthritis.html?ITO=1490

By
Dina Behrman

Last updated at 9:45 PM on 18th February 2012

Laura Wright was just 15 when she won the BBC Radio 2 Chorister of the Year competition in 2005. For the soprano, now 21, the moment marked what she hoped would be the end of the ill-health that had threatened to rob her of both her singing ambitions – and her mobility.

When she was nine, Laura was told she might never walk again after contracting septic arthritis. ‘It was quite sudden,’ recalls the singer, who ran in the London Marathon last year and whose solo debut The Last Rose was No 1 in the classical charts for five weeks last year.

‘We were on holiday and I went for a jog with my dad and afterwards my right knee started to hurt. It got more and more painful, so my mum and dad took me to hospital.

Laura Wright has said that going through the health scare has made her more determined than ever

‘I was examined and scanned and they did all sorts of blood tests but could find nothing wrong, so I was sent home and told it would probably get better.’

However, the pain got worse. Within a month, Laura was confined to a wheelchair. She was admitted to hospital, where she remained for six months as doctors tried everything they could to get her back on her feet.

‘It turned out I had an infection in my knee,’ she says. ‘My leg felt much more comfortable bent rather than straight, but the doctors straightened it out and put it in a cast.

‘That’s when the infection began to spread through my entire body and I got very ill. At that point they were able to diagnose me with septic arthritis.’

Septic arthritis is an infection in a joint. Many different types of bacteria can cause it, but one called staphylococcus aureus is the most common culprit.

Bacteria can get to a joint via the bloodstream, from an infection in another part of the body, via an injury to the joint itself, or during surgery. Those suffering other types of arthritis are at higher risk, as are those with a compromised immune system – such as patients on chemotherapy or the elderly.

The knee is the site of infection in more than half of septic arthritis cases, and the hip is affected in about one in five cases. If the infection is treated promptly, there is a good chance of complete cure with no long-term problems. But if there is a delay in treatment, the infection can quickly destroy the joint, leading to long-term pain and disability.

Laura during her chorister days

In some cases, the infection becomes severe and leads to  potentially fatal blood poisoning – septicaemia.

Laura says: ‘I was in too much pain to walk and I was so weak I couldn’t eat anything. I was so young that they struggled to get fluids into my veins, and in the end they had to put the tubes in my neck. So then I was bedbound for quite some time. I had to have a nurse take me to the toilet and I had to have someone dress me. I couldn’t do anything myself.

‘Things got so bad that the doctors were worried I would never walk again. In fact, at one point they told my parents, “You should spend as much time with Laura as you can.”

After she was diagnosed, doctors tried different methods to treat her, including performing several operations to drain the fluid from her knee and prescribing various antibiotics to kill off the infection.

Eventually she recovered enough to leave hospital, but the road to recovery was a slow one.

‘When I went back to school I was in a wheelchair and then on crutches, hobbling around like a 90-year-old – it was utterly frustrating,’ she says. ‘But I know I was very lucky.

‘And I know that going through all that has definitely given me every ounce of determination and drive to embrace every opportunity I get.’

As soon as she was off the crutches, Laura threw herself into sport and was soon playing hockey for East of England. She also represented her county in netball. ‘I was super-keen because I had this opportunity I might not have had,’ she explains.

Today her right leg is weaker than her left, and it sometimes aches, but Laura isn’t letting it hold her back. ‘It’s a small price to pay so to me it doesn’t matter,’ she says.

These days she eats healthily and is conscious of managing stress levels. She goes to the gym four or five times a week and recently completed the Actimel Pedal to Paris, cycling an impressive 300 miles in aid of the Royal British Legion.

Consultant orthopaedic surgeon Elliot Sorene says: ‘The condition eats away at the cartilage and destroys the joint. In a child of that age, it could cause deformity or even lead to limb replacement, so Laura is lucky.

‘Such a condition may well lead to problems with arthritis in the future – she will probably have suffered some cartilage loss so the fact that she’s super-fit will help prevent this.’

Laura says: ‘Going through my health difficulties when I was younger was something that motivated me to do the bike ride. One of organisers told me the other day they were planning a trek across the Pyrenees – maybe that’ll be my next challenge.’

lLaura Wright’s The Last Rose is available on Decca Records

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Article source: http://www.dailymail.co.uk/health/article-2103125/Voice-angel-knees-pensioner-Soprano-Laura-Wright-speaks-battle-beat-septic-arthritis.html?ITO=1490

By
Fiona Macrae Science Correspondent

Last updated at 12:01 AM on 17th February 2012

Scientists have invented an electronic chip that could put an end to painful daily injections for osteoporosis sufferers.

The device, slipped under the skin, releases daily doses of the bone-building drug teriparatide.

In trials on elderly women, it worked just as well as regular injections of the medicine. 

Size comparison: The MicroCHIPS wireless drug-delivery device, right, which is placed in the body, is pictured next to a conventional computer memory stick

Crucially, many said the device – the first of its kind – was so comfortable that they often forgot it was there.

The chip can be adapted to dispense
other medicines and it is hoped it will be popular with those who
dislike injecting themselves, or find it difficult to do so due to
arthritis. It could also ensure better treatment. 

Although drugs such as teriparatide –
also known as Forsteo – work well, the lack of any outward sign that
they are improving health means that up to three-quarters of
osteoporosis patients stop taking them.

With the condition affecting 3million
Britons, the innovation could have a dramatic impact on quality of life,
the American Association for the Advancement of Science’s annual
conference in Vancouver, Canada, heard.

The device’s co-inventor, Robert
Langer, one of the world’s top scientists, said: ‘Patients are freed
from the daily reminder, or burden, of disease, by eliminating the need
for regular injections.’  

The chip contains a series of tiny
wells, each packed with a daily dose of teriparatide. The drug is so
potent, that a day’s supply is no bigger than a pin head. The wells,
which are sealed with an ultra-fine layer of titanium and platinum, pop
open either on a programmed schedule or in response to a wireless
signal.

Clear potential: MicroCHIPS president Robert Farra says the wireless device is fully programmable and can deliver the right drugs dosage even if patients forget

This rapidly releases the drug into the bloodstream.

The chip is housed in a casing which
also contains a battery, as well as the electronics needed for a
wireless signal and the control of drug release. The whole device is
about two inches in height.

The chip, which is about five years
from the market, takes 30 minutes to insert into the abdomen, just below
the skin. The operation is done under local anaesthetic and patients
can walk home afterwards.

Results of a trial on eight women,
published in the journal Science Translational Medicine, show chips
loaded with 20 days’ supply of treatment worked well in all but one
case. Scientists from MicroCHIPS, the U.S. firm commercialising the
device, are working on a chip that carries and dispenses hundreds of
doses.

Other illnesses that could be treated in this way include diabetes, cancer, multiple sclerosis and heart disease.

The inclusion of wireless technology would allow doctors to remotely alter the amount of drug dispensed as necessary.

Professor Langer, whose other
achievements range from growing an ear on the back of a mouse to
creating a spray that keeps frizzy hair at bay, said: ‘You could
literally have a pharmacy on a chip.’

Julia Thomson, of the National
Osteoporosis Society, said that swapping daily jabs for an implant would
make it easier for patients to take their drug.

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Article source: http://www.dailymail.co.uk/health/article-2102210/Chip-end-daily-jabs-osteoporosis.html?ITO=1490

By
Hilary Freeman

Last updated at 10:08 PM on 4th February 2012

Tiffany Robertson says she can do everything, including morris dancing

Children suffering the agony of juvenile arthritis – which can leave many wheelchair-bound and result in permanent deformity – have been offered hope from a new drug therapy.

The National Institute for Health and Clinical Excellence, the body that provides prescribing guidelines, has approved RoActemra (tocilizumab) to treat systemic juvenile idiopathic arthritis (sJIA). Currently incurable, sJIA is the most severe type of juvenile arthritis and affects about 2,500 under-16s in the UK.

It is an extremely debilitating inflammatory condition causing extreme joint pain, a distinctive salmon-coloured skin rash and a constant high fever. It can also lead to problems with the spleen, liver and heart that can be life-threatening.

Dr Eileen Baildam, a paediatric rheumatologist at Alder Hey Children’s Hospital in Liverpool, says nobody knows the causes but it is thought to be an autoimmune condition, with a genetic component. ‘About a third of patients get better spontaneously, but two-thirds will continue to have serious flare-ups,’ she says.

One patient to have benefited already is 12-year-old Tiffany Robertson, who was five when she developed the condition. It left her in agony and bedridden for months. Her mother Kate, 34, from Southport, Merseyside, recalls: ‘The joints all over her body would swell up and stiffen and it could happen in one area or in several places at once: her hips, wrists, neck, ankles, fingers and toes.

RoActemra, previously used to treat adult
rheumatoid arthritis, works by blocking an immune system messenger
called IL-6, which causes fever and inflammation in joints and organs 

‘She couldn’t get herself to the bathroom and if I touched her, she would scream. At some points she needed a wheelchair. She was put on steroids, with terrible side effects. By the time she was seven, she was so bloated that she was wearing clothes for 11-year-olds. People stared at her, which made her very self-conscious. She missed so much school they put a bed for her in the classroom, so she could at least be around other children.’

Tiffany tried various medications but none worked for long. Until now, the commonly used treatments for sJIA were anti-inflammatory drugs – ibuprofen or corticosteroids and methotrexate – which often do not slow the progression of the disease.

RoActemra, previously used to treat adult rheumatoid arthritis, works by blocking an immune system messenger called IL-6, which causes fever and inflammation in joints and organs.

IL-6 is meant to protect the body against infection but malfunctions and attacks the body. The more damage that occurs, the more the immune system’s white cells produce IL-6 to fight the unknown invader.

The new drug will bring relief to nine in ten young patients

RoActemra was licensed for use following a five-year trial. Dr Baildam says the results were astounding. ‘After a year, two-thirds of patients had a 90 per cent improvement in their symptoms, which is extraordinary – three times as good as we had expected. For a lot of patients it switches off the condition. And it’s well tolerated with virtually no side effects. It gives thousands of children hope of restoring normality to day-to-day life.’

Eighteen months ago, just as she was about to start secondary school, Tiffany was allowed to try RoActemra, which is administered in hospital every two weeks by drip. ‘We were desperate,’ says Kate. ‘We didn’t want Tiffany to go on the trial because we were worried she would get a placebo and deteriorate even more, so she was prescribed the drug on compassionate grounds. After nine months we started to notice a difference and now you wouldn’t know she has sJIA.

‘She gets the odd niggle but she’s able to go to school every day and she even does morris dancing, travelling all over the North West. She’s a lot happier. The drug has made a huge difference to all our lives.’

Tiffany says: ‘I used to be very poorly, on and off, and miss school and going out with my friends, but now I can do everything I want to do, just like everybody else.

‘I am very thankful to my doctors and nurses for getting me the new medicine and looking after me.’

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Article source: http://www.dailymail.co.uk/health/article-2096448/Jab-ends-agony-childhood-arthritis-New-NHS-treatment-brings-relief-young-patients.html?ITO=1490