Market and Competition RA

Rheumatoid Arthritis afflicts approximately 3.3 million people (US, EU and Japan), of which more than 75% are women. Peak onset of the disease is in between the ages of 20 and 40. RA is a chronic disease, in which various joints in the body are inflamed, leading to swelling, pain, stiffness and the possible loss of function.

The joint inflammation begins in the synovium and slowly destroys the cartilage, narrowing the joint and eventually damaging the bone. Normally the inflammatory process is controlled and self-limited, but in individuals with RA this process is kept going.

Exactly what causes RA has not been established but research has identified certain genes that play a role in the immune system that are associated with the tendency to develop the disease. Some evidence indicates that infectious agents, such as viruses and bacteria, may trigger RA in individuals who have an inherited predisposition to the disease.

Research is trying to identify which infectious agents may be responsible. Research is also being conducted in order to understand the basic mechanisms by which these agents might trigger the onset of RA.

Treatment of RA focuses on relieving pain, reducing inflammation, slowing or stopping joint damage, and improving the patients' well being and ability to function. A combination of treatments is almost always used. Commonly used types of medications include various therapeutic classes:

• DMARDs (Disease Modifying Anti-Rheumatic Drugs)
• Biological agents (also disease modifying)
• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) incl. Cox-2 inhibitors

NSAIDs are generally prescribed to relieve pain and swelling but they do not slow the disease process. First line of treatment when RA is confirmed is the use of DMARDs that generally take some time to be effective, up to several months. Most of them were originally developed to treat other diseases and have no common properties other than the ability to slow the progression of RA.

The most recently developed RA therapeutics, biological agents, are drugs that interfere with the autoimmune response in RA. These are drugs that are genetically engineered to target the immune factors known as cytokines, particularly tumor necrosis factor (TNF) and certain interleukins, which play a major role in the destructive RA process. Further biological agents targeting other functions have recently been approved.