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Professor VonVollenhoven discusses factors which distinguish individual responses by patients with rheumatoid arthritis to various anti-TNF agents. He describes observations of radiologic and clinical progression of illness in subgroups of patients and provides an overview of considerations in choosing one pharmacologic agent over another. Professor VonVollenhoven also discusses recent research on the role of biologic markers for RA.
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Contemporary research shows that the early diagnosis and treatment of RA can offer patients the possibility of achieving remission. The goal for any patient with early RA should be to achieve remission. If a patient does not already have joint damage, the goal should be a normal acute-phase response and no swollen joints as soon as possible.
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Professor Smolen discusses the evidence supporting the ability of TNF-alpha agents to result in substantial and sustained improvement in symptoms of psoriatic arthritis. Agents including infliximab and etanercept result in not only clinical improvement but also slow the radiographic progression of joint disease and damage. Further, the combination therapy of a TNF-alpha agent and methotrexate results in highly significant improvement in arthritic symptoms and signs.
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Professor Sir Ravinder Maini's groundbreaking work on the characterization of TNF-alpha began in the mid-1980's with his collaboration with Professor Mark Feldman. In his study of intercellular messenger molecules, Professor Sir Maini utilized two new technologies -- protein sequencing and cDNA protein coding -- to investigate half a dozen cytokines that appeared to mediate the pathogenesis of connective tissue diseases. One of them, TNF-alpha, proved to play a pivotal role in the cascading interaction of cytokines. When antibody against TNF-alpha was produced, a new field of biologic therapy in the management of rheumatic diseases was born. In this interview, Professor Sir Maini describes the scientific discovery that earned him the title "Father of Translational Research." Listen to him describe this historic exploration in his own words. The podcast also features: Inflammation is Hallmark of Coronary Disease in RA
