Creaky Bones Rheumatoid Arthritis is a condition characterised by the inflammation of the joints in places like the hands, wrists, knees and feet. Contrary to popular belief, the condition can also affect young adults. But there's good news as a new treatment that promises to significantly slow down progression of the disease is now available. A doctor tells us more.
Tocilizumab (Actemra) approved for the treatment of rheumatoid arthritis by US FDA
This is a new biological agent for treatment of autoimmune disease. The target of action is unique in that it suppresses interleukin 6 (IL-6). Existing medications target TNF (tumour necrosis factor) or the B cell.
All of these agents are in concept "magic bullets" as they work at very specific sites in the immune system. This reduces the chances of side effects.
Actemra is given as intravenous infusion once a month. Gleneagles Hospital, with A/Prof Leong as Principal Investigator, is one of the sites used in the international multicentre study. When approved by the local authorities, it will be another option for patients with rheumatoid arthritis.
Zoledronate (Aclasta) proven to help patients even after a hip fracture
Aclasta (Zoledronate) is a bisphosphonate. It is a medication that slows down bone loss. It is approved for the treatment of osteoporosis as it can prevent fractures from happening and is given as an intravenous infusion once a year.
The research shows that it can even help patients who have already suffered an osteoporotic hip fracture. It is the only drug available so far where research has been done on such patients. In these hip fracture patients, it was shown that compared to placebo, zoledronate was able to prevent further fractures and even reduce mortality.
Does alendronate (Fosamax) cause unusual fractures?
There have been case reports from Singapore and USA that unusual fractures can happen to patients taking Fosamax. However, these are only case reports. These fractures have been also seen in patients not taking Fosamax. Many of the Singapore patients did not have osteoporosis when they were started on Fosamax. This tells us that treatment should not be started too early in patients who do not have osteoporosis yet.
Fosamax studies show that there are no unexpected problems up to 10 years. There is evidence that after taking it for 5 years there is a further protection against fractures for another five years. Therefore Fosamax can be safely taken for 5 to 10 years based on current research.
Recently there have been false claims made against Fosamax such that patients and some family doctors are misled to think that they should not use Fosamax or that they should stop the medication after 3 years. This would be a pity as it is one of only a few medications that have been clearly shown to prevent hip fractures.
Monday to Saturday: 9 am to 12.30pm :: Monday to Friday: 2.30pm to 4.30pm :: Close on Sunday & PH
Leong Keng Hong Arthritis And Medical Clinic 6 Napier Road #04-18 Gleneagles Medical Centre Singapore 258499
Tel: (65) 6472 4337 Fax: (65) 6472 0691 Email: info@leongkenghong.com
