New treatment for rheumatoid arthritis helps reach remission

The treatment has been included in the national health basket services for 2020 and will be available to patients in all the health funds

Pills medicine medication treatment (photo credit: Srdjan Zivulovic / Reuters)
Pills medicine medication treatment
(photo credit: Srdjan Zivulovic / Reuters)

Rheumatoid Arthritis is a chronic inflammatory disease that occurs when the immune system "attacks" the different bodily organs instead of attacking external invaders. It is a relatively common disease affecting people of all ages and significantly reducing their health and quality of life. The disease causes a great deal of suffering to those coping with it. It is accompanied by extreme pain, weakness and constant fatigue and often by depression as well. The swelling and sensitivity in the joints and their "rigidity" (particularly in the morning) make simple actions such as opening a bottle or tying one's shoes difficult or impossible. When the condition progresses, many patients can become bedridden and are sometimes even pushed out of the work force. According to the available information, the disease is connected to additional diseases and medical conditions such as cancerous tumors and accelerated arteriosclerosis and to a high prevalence of infections. When it is not treated on time, it can cause permanent damage such as irreversible joint deformation and loss of joint mobility, with the risk of permanent disability. Acute inflammation that is not treated is dangerous and has been connected to increased mortality. It has been estimated that some 21 million people around the world are living with the disease at varying degrees of severity, with about 70,000 of them in Israel.

In recent years there has been considerable progress in the treatment of this disease. Today, when the suitable treatment is provided on time, it can ,in most cases halt its progression. Therefore professional supervision by a rheumatologist and early diagnosis and treatment are extremely important. 

Rinvoq (generically known as Upadacitinib) is a new, advanced oral medication (one tablet daily) for rheumatoid arthritis, and its efficacy and safety have been studied on about 5,000 patients in medical centers around the world for several years, seven of them being in Israel (Ichilov, Bney Zion, Barzilay, Carmel, Rambam, Meir and Sheba). The results of these studies indicate a consistent high degree of efficacy and significant, noticeable clinical improvement in the symptoms of moderate to severe rheumatic arthritis among different patient populations including both new patients and patients in which former treatments have failed, with a safety profile similar to what is found in existing treatments. According to the reports of patients who have participated in these studies, the treatment has brought about quick improvement in their sensation of pain, physical performance, degree of fatigue, work capability and general quality of life, with the simplicity of its administration (taking one tablet daily as opposed to injections or intravenous therapy that are considered a customary treatment of the disease) considerably contributing to patient adherence and compliance.  

Information accumulated in studies that have compared this to the existing standard of care have shown that it permits more patients coping with rheumatoid arthritis to achieve Boolean remission, which means significant improvement in their daily performance and health condition (even as far as going back to normal performance similar to what it was prior to the outbreak of the disease), which can even be achieved by patients coping with a severe disease. 

Prof. Gleb Slobodin, a senior rheumatologist and the director of the rheumatology unit at the Bney Zion Medical Center who has been a party to these studies, says that "patients report quick improvement in their condition. We have witnessed quick response and a remission in the symptoms of the disease which is reflected by significant improvement in the daily performance and quality of life of the people coping with rheumatoid arthritis."  

One of the patients, an academic 45 year old woman living in Haifa, has participated in the study that was conducted at the Bney Zion Medical Center. She says: "The disease started about four years ago. I began having severe pains that greatly limited my every day activities. In my profession I regularly use a computer, and the strong pains in my hands were very disturbing, as were the pains in my legs experienced when walking. I visited my GP who sent me to a rheumatologist. I went through the entire routine series of tests. I have tried quite a broad spectrum of medications that are normally used to treat this disease, but not all of them were suitable for me. An expert rheumatologist at my HMO who also works at the Bney Zion Hospital referred me to their research team. I am not even supposed to know the dose of the medication assigned to me. But as part of my follow up, I report what I feel as a result of the treatment to the doctor, and I assume that according to this he is able to analyze the information. I can say wholeheartedly that this innovative medication has really saved me, because I was on the verge of desperation as the disease had caused my health to deteriorate although I was quite young."

Rinvoq was developed by the global bio-pharmaceutical company AbbVie, and has been approved by health authorities in Israel and overseas (the American FDA in August of 2019, the European EMA in December 2019, and the Israeli Health Ministry in April 2020). The treatment has been included in the health services package for 2020 and will be available to patients in all the Israeli health funds.