Anti-inflammatory drugs that minimize infection risk appear possible

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Rheumatoid arthritis drugs and anti-inflammatory medicines including Pfizer ($PFE) and Amgen's Enbrel and Johnson & Johnson's ($JNJRemicade are profoundly effective at doing their job, but they carry an enormous risk of infection. Now scientists at the University of Utah believe they've identified a way to make a drug that is equally effective as these and other treatments but minimizes the chance of infection.

The NIH-funded research, published Nov. 11 online in the journal Nature, focused on a discovery involving cytokines. The body releases them when facing infection, which helps kick the immune system into action but also causes inflammation. Drug treatments designed to address this in diseases such as rheumatoid arthritis block the cytokines, which helps beat back inflammation but also suppresses the immune system.

But the scientific team discovered in a mouse study that drugmakers could potentially make drugs that leave the immune system alone. That's because cytokines appear to use one cellular pathway to turn on the immune system and kill bugs, and a second one that affects inflammation of tissues and organs. And this, the researchers argue, makes the possibility of selectively blocking inflammation much greater without adversely affecting a patient's immune system.

Lead researcher Dean Y. Li, director of the University of Utah Molecular Medicine program, said the discovery could help develop far more targeted arthritis drugs. But knowledge of a separate cytokine pathway could also aid drugmakers in their quest to develop better drugs to treat other anti-inflammatory conditions including fibrosis, lupus and systemic sclerosis.

It's a tantalizing prospect. But this is early-stage research and the discovery needs much more preclinical research to ensure that safe and durable drugs can be developed and tested in human trials. Researchers themselves are mulling screening of new chemical compounds to advance their discovery, either on their own or through possible pharmaceutical company collaboration.

- read the release
- get the Nature abstract

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