By: Sarah Yim, M.D.
May is Arthritis Awareness Month, an opportunity to reflect on progress that’s been made in developing new drugs for those who suffer from this often debilitating condition.
Arthritis has many forms and faces. Two common forms are osteoarthritis (OA), which results from wear and tear on the body’s joints, and rheumatoid arthritis (RA), in which inflammation and damage of the joints results from a person’s body developing a reaction to itself, known as an autoimmune reaction. Combined, all forms of arthritis affect 50 million adults and 300,000 children in the United States.
For many years, mainstay drug therapies for treating patients with arthritis have included drugs known as non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, and corticosteroids, such as prednisone. Although these traditional treatments are still used to treat symptoms of pain and inflammation, we’ve seen encouraging progress in the development of newer treatments that target the underlying abnormalities, particularly for rheumatoid arthritis.
Over the past 60 years, 18 drugs or biologics, other than NSAIDs or corticosteroids, have been approved for rheumatoid arthritis (RA), with the majority being approved in the last 16 years. The more recent products are intended to target specific molecules in the immune system and help prevent the actual damage associated with RA, as opposed to treating symptoms alone. These advances have come about in large part due to a combination of research scientists gaining a stronger understanding of the processes driving RA and advances in the technologies involved in creating new potential therapies.
Patients with other forms of arthritis are also benefitting from these advances, too. For instance, many of the products approved for RA have also been approved for psoriatic arthritis and juvenile arthritis; but beyond this, additional products that have not been approved for RA have been approved for both of these conditions.
However, in the midst of these promising developments, Arthritis Awareness Month also serves as a reminder that much work remains to be done. Challenges remain for advancing the development of new therapies for the many other forms of arthritis. Osteoarthritis (OA) is the most common form of arthritis, affecting about 27 million adults; but the drugs approved for OA have so far been limited to the treatment of symptoms rather than joint damage itself. Because OA involves mechanical factors and typically develops slowly over time, it is not yet clear whether there are parts of the joint damage process that could serve as a target for a local or systemic drug treatment and be effective in modifying the usual progression of OA. But the sheer number of patients who could benefit from such a treatment makes this an area worth investigating.
Great strides have been made in the treatment of arthritis, but great challenges remain. We at FDA remain committed to working with the patient, academic and industry communities to bring about innovative solutions to those challenges.
Sarah Yim, M.D., is Supervisory Associate Director in FDA’s Division of Pulmonary, Allergy, and Rheumatology Products in the Center for Drug Evaluation and Research