Britain

May 31, 2004

Arthritis sufferers helped by blood cleaning machine
By Sam Lister, Health Correspondent
 
A GROUNDBREAKING treatment for rheumatoid arthritis, which removes a
patient’s blood, cleans it of inflammatory agents and then pumps it back
into the body, is to be introduced in Britain.
Sufferers of the crippling joint condition, which affects more than half
a million people in Britain, could benefit from the treatment, which
experts claim can trigger long-term remission from the disease.



The process, which does not require any drugs, works in a similar way to
a kidney dialysis machine, removing blood from the body for purification
and then returning it. Known as apheresis, it is normally used for
inflammatory bowel disorders, such as Crohn’s disease and ulcerative
colitis.

The treatment, which has already been tested on arthritis sufferers in
Japan, Germany and the United States, is to be introduced in four
private clinics in Britain from next month. Patients will also be able
to apply for the therapy through bursary schemes, and it is being
considered for provision on the NHS for sufferers who do not respond to
mainstream drug treatments.

The Adacolumn, a 1ft-high device developed by Otsuka, a Japanese firm,
works by selectively removing white blood cells while leaving red cells
and other blood components largely unaffected. A tube carries blood from
a patient’s arm to the filter, which is linked to the apheresis machine
controlling the purification process.

Rheumatoid arthritis, an auto-immune disease, is often triggered by an
infection. Antibodies that normally protect against disease turn against
the body, damaging joints to the extent that many patients with the
disease need joint replacement surgery. Conventional treatment relies on
powerful painkillers and anti-inflammatory drugs, including steroids, to
alleviate symptoms. There is also a range of disease-modifying
treatments, including chemotherapy drugs, to keep the disease at bay.

Taher Mahmud, a consultant rheumatologist and director of the Arthritis
Centre, where the Adacolumn is to be used, said that the technique
represented a big step forward in therapies for the disease.

“Rheumatoid arthritis is very common and fantastically destructive,
causing an enormous amount of damage to a patient’s quality of life,” he
said. “This treatment has been shown to reduce down tenderness and
swelling within two weeks. Because you are reducing the inflammation,
patients tend to go into remission and have been shown to stay like that
for a year. There is no reason why it shouldn’t fundamentally change the
course of the disease.”

Rheumatoid arthritis often starts in a sufferer’s feet, creeping up into
the wrists and hands. The shooting pain becomes so intense that, after
five years, more than 40 per cent of all patients are forced to give up
work — with many left so immobile that they cannot get out of bed, walk
down stairs or even wear shoes.

Those with the advanced form of the disease — of which there are five
million worldwide — sometimes even have to get their joints surgically
fused because the limbs become so mangled. About 12,000 new cases are
diagnosed in Britain every year.

A similar scheme trialled in America found a remarkable success rate for
arthritis sufferers who had failed to respond to all other treatments,
with more than a third showing a marked recovery.