NHS patients with rheumatoid arthritis are to benefit from a breakthrough drug that eases the agonising pain in joints.
The condition affects 400,000 Britons – many of them young adults – who can be left wheelchair-bound due to the pain and energy-sapping exhaustion it causes.
Current treatments are able to soothe pain and dampen inflammation but they rarely get rid of symptoms altogether. Some also need to be injected straight into the bloodstream, which has to be carried out by a healthcare professional.
The new medicine, Rinvoq, is a once-daily tablet, making it an easier option. Clinical trials have also revealed that it is remarkably effective, with up to 40 per cent of users seeing their symptoms disappear. It also works in those most severely hit by the disease.
A new medicine called Rinvoq could see symptoms disappear in 40 per cent of the 400,000 patients in Britain who are affected by rheumatoid arthritis. It could also alleviate the symptoms of those with the most serious form of condition
Rheumatoid arthritis occurs when the immune system turns on the body and attacks cells that line the joints. Why this happens is not clear, but some evidence suggests even a minor infection can ‘trip’ the immune system into going haywire. It often hits patients in their teens or 20s, and there appears to be a genetic element, with the disease running in families. Women are also more likely to get it.
Despite Rinvoq’s £10,000-a-year price tag, it has been given the green light in England by the drug watchdog, the National Institute for Health and Care Excellence (NICE), and will be offered to patients who have not found relief from other treatments. Experts have hailed the ruling as a major breakthrough, and one of the first patients to benefit, who once relied on a walking stick, says that thanks to the pills he’s now ‘jumping out of bed’.
‘This is very welcome news,’ says Professor Chris Edwards, consultant rheumatologist at University Hospital Southampton NHS Foundation Trust. ‘Rinvoq is able to induce disease remission, even when the condition has not responded to previous treatments.’
Rinvoq, also known as upadacitinib, belongs to a new class of tablets known as JAK inhibitors, which are transforming treatments.
The drugs work by blocking the effects of enzymes known as janus kinase that help to activate the immune response when the body is under attack from invading organisms, such as viruses or bacteria. By blocking these enzymes, the drugs stop the immune system from destroying healthy joint tissue.
A new £10,000-a-year drug Rinvoq, pictured, could help some of the 400,000 people in Britain who suffer rheumatoid arthritis
Rinvoq’s approval by NICE follows similar rulings for two other JAK inhibitors, tofacitinib and baricitinib – also daily tablets.
JAK inhibitors are also being used to tackle other autoimmune disorders, such as Crohn’s disease and severe psoriasis, and are being trialled as a remedy for ankylosing spondylitis – a crippling spinal condition where the bones in the spine can fuse together.
Even baldness is a possible target, as studies have found the drugs help trigger new hair growth.
Prof Edwards says although there have been no studies directly comparing the effectiveness of the drugs there’s some suggestion Rinvoq may be particularly effective. ‘It acts on JAK pathways in a slightly different way,’ he says. ‘This could affect how well it works. But the best results are generally seen when JAK inhibitors are given alongside an old drug for rheumatoid arthritis, called methotrexate.
Methotrexate helps by suppressing the immune system to reduce joint damage, but using it can seriously damage the liver.
Clare Jacklin, of the National Rheumatoid Arthritis Society, says doctors need as many weapons as they can muster against the life-changing disease
Clare Jacklin, of the National Rheumatoid Arthritis Society, says doctors need as many weapons as they can muster against the life-changing disease.
She adds: ‘It’s a complex condition which requires different medications. This is good news.’
Neil Feather, 55, was one of the first patients to be treated with Rinvoq as part of a clinical trial at Leeds Teaching Hospitals NHS Trust. The father-of-one, an IT services manager from Wakefield, West Yorkshire, had noticed that his joints were getting stiff and sore about six years ago.
He says: ‘I would get out of bed and it would take 30 minutes before I could get moving – everything was stiff and painful. After sitting at a desk for a few hours, my legs would give way when I stood up. I had a walking stick to get around.’
Blood tests by his GP confirmed that Neil was in the early stages of rheumatoid arthritis – but he was in luck as the hospital was looking for patients to try Rinvoq.
Neil signed up. He adds: ‘I felt better within a couple of weeks, and I was jumping out of bed rather than struggling to get moving. After six months on the drug, I had no symptoms at all. The pain and swelling had disappeared.’