Posted in February 26, 2010 ¬ 4:53 amh.admin1 Comment »
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Actemra, The New Rheumatoid Arthritis Drug... What Makes it so Special?
Biological response modifiers (BRMS) are drugs that target inflammatory pathways in rheumatoid arthritis (RA) and represent a relatively new approach to the treatment of RA.
Medications that block tumor necrosis factor alpha (TNF-a), a pro-inflammatory cytokine important in the pathogenesis of RA, were among the first to be developed and approved for the treatment of RA. Several anti-TNF-a medications including Enbrel, Humira, and Remicade are currently marketed for the treatment of RA.
Actemra (tocilizumab) differs from currently marketed biological response modifiers that block TNF-a, since it targets interleukin-6 (IL-6), a cytokine that is also over-produced in the joints of RA patients.
Il-6 is believed to contribute to inflammation, swelling and joint damage and possibly the anemia and platelet elevation counts seen in RA.
Actemra is a humanized anti-human IL-6 receptor monoclonal antibody that works by competitively blocking the binding of IL-6 to its receptor. In essence, it inhibits the deleterious effects of IL-6, which lead to inflammation and proliferation of inflammatory cells and the destructive organ potential in RA.
Multiple clinical trials have examined the efficacy and safety of Actemra.
The largest of these trials was the OPTION (TOcilizumab Pivotal Trial in Methotrexate Inadequate RespONders), a three-arm, randomized, double-blind, controlled study designed to compare the safety and efficacy of Actemra plus methotrexate with methotrexate plus placebo in RA patients who had an inadequate response to methotrexate alone.
Results from the OPTION trial demonstrated that rheumatoid arthritis (RA) patients not only achieved greater improvement of symptoms but also a higher quality-of-life with Actemra compared with methotrexate, a commonly used RA treatment.
In the OPTION trial, which was a three-arm, double-blind, controlled Phase III study, 623 patients were randomized to receive Actemra intravenously (either 4mg/kg or 8mg/kg) every four weeks plus methotrexate weekly or placebo infusions plus methotrexate weekly. The study was conducted in 73 trial sites in 17 countries outside the United States.
A rapid decrease in disease activity was seen as early as two weeks in a greater proportion of patients treated with Actemra plus methotrexate, with 27.5% achieving clinical remission by 24 weeks.
Additionally, results showed that 80% of patients in the Actemra plus methotrexate group responded with moderate to good improvements in RA symptoms, compared with 35% for those treated with placebo and methotrexate at 24 weeks.
The OPTION trial also assessed physical function and quality-of-life at baseline and every four weeks thereafter. Patients receiving Actemra achieved significantly greater improvement in areas of fatigue and mental function at 24 weeks, and achieved normal levels of hemoglobin (red blood cell count)and C-reactive protein (CRP), a marker of inflammation due to RA, compared with patients receiving placebo plus methotrexate. In addition, platelets, blood cells that often increase in number during the inflammation that accompanies RA, seemed to drop as well.
According to Dr. Nathan Wei, "The advantage of Actemra is that it offers treating rheumatologists another weapon in our arsenal for treating rheumatoid arthritis. Nowadays, it is my expectation that when I see a patient with rheumatoid arthritis, I can count on getting them into remission. It may be only a short time into the future that we will be able to cure this disease."
Roche, the manufacturer of Actemra in the United States, announced that the Arthritis Advisory Committee of the U.S. Food and Drug Administration (FDA) by a near unanimous (10-1) vote recommended approval of Actemra (tocilizumab), a novel interleukin-6 (IL-6) receptor-inhibiting monoclonal antibody, for reducing the signs and symptoms in adults with moderate to severe rheumatoid arthritis (RA).
Ok, here's the thing, I have a 17 yr old exmoor type pony, so shes around 13hh she has quite bad arthritis in one knee and shoulder!!
We usually give her "one" of the following, along with oils and devils relief (devils claw): MSM, cortaflex or Glucosamine.
This summer we bought all 3! I'm just wondering if its safe to give her all 3 together? or at least 2 of them...
we have:-100% MSM
- Cortaflex
- Glucosamine 10,000 plus MSM
So i'm thinking the glucosamine already has MSM in it..? and i don't want to over do it! I would obviously be cutting the recommended amount 2 take in each by 3rd if i was 2 give her 2 or all 3 of them but i don't know if I should just stick to the usual and give her one at a time!?
Please help, i know i probably am not making alota sense....?
Thanks
seems like you have tried everything.....my sisters horse is 28...she has a bit of arthritis too..... along with cortaflex she gives her danylon....you have to get it from vets......but it keeps her sound enough to ride lightly.....
Good spinning reel for 9 foot surf rod?
I'm normally a conventional reel type of guy but lately finding myself hurting too much at the end of the day. Arthritis is creeping in me bones. I want to buy a 9 foot surf rod ( spinning, M/Hvy ) but need help with a reel. I'm checking out the Tica reels but heard too many complaints about the bail closing prematurely during a hard cast. I need some help here, which reels are good with huge line capacity. Model #'s would be a plus. I normally wouldn't ask this but I'm more conventional rather than spinning so I may not be up to par and this is why I ask. Thanks guys. ~Chimp Dancer
~By the way, I'm not looking for the high priced stuff. My daughter's school is milking away that fun so please, moderately priced but decent.
~I want to thank every one for answering and giving me some insight on the larger spinning reels out on the market.~chimp.
Nice answer Shop! (Thumbs up)
Penn Spin-fishers are good/great reels and hold-up well under extreme conditions. I managed a major tackle store in the early-mid 90's and (to be honest) I was very proud to sell "certain" Penn equipment.
The problem with the "New" Penn outfits?
About 98' they began trying to compete with Shimano/Daiwa, (they needed reels that had instant anti-reverse, ETC). They started "farming out" misc parts of their new line of reels to China. Thats when Penn started to go down-hill.
HOWEVER, (in my opinion), if you stay with the "old style" Penn (Metal body Spinfisher) reels you should be alright. (Shop, don't you think an 850 is a bit much? An 850 is a VERY heavy reel generally used for offshore fish! Using a braided-line and downsizing the reel will greatly affect the WEIGHT of the outfit! In my opinion, try a 650 SSM and some braided line if you go the Penn route.......)
CD, your in Fla aren't you?
If I were you I'd look at the Daiwa Black Gold series too. Neither the Penn SSM OR the Black Golds have all the newest "bells & whistles", (instant anti-reverse, 14 ball bearings, ETC) and they've changed very little in 40 years; they just last FOREVER.
BG's are built like tanks and can be easily fixed at your local reel shop. I have one from the late 80's that still works perfectly and it's caught tons of fish!
I'd rig up with a BG15 or BG20 (depending upon what type of line you intend to use; Braid or Mono).
Black Golds are $79.99 at Bass Pro Shops. You should go and read the reviews regarding them. A Penn 650 SSM is $119.
The reason I'm partial to the BG's (over the Penn) is because of "wobble". A Penn Spinfisher "wobbles" like a top when you retrieve it. Whereas, the BG's are "smoother" on the retrieve.
Either way- Penn SSM or Daiwa Black Gold would be 2 good inexpensive reel choices that will last a LONG time.
Hope this helps ya bro?
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one will be a bit better or charge a bit more either will do it