Joint Pain Forum – News you can use!
drug beat my teenage arthritis
11th April 2007
UK Daily Mail
At 15 Kate
was bedridden and in crippling pain. Now she's about to walk down the
aisle. So why is the drug that rescued her denied to so many others?
At first doctors told Kate Oakes the
tightness in her joints was growing pains. It was October 1999 and she
had just returned to school after the summer for her GCSE year.
No one could have imagined within a few
weeks she would go from being an active 15-year-old who enjoyed
cross-country running and netball, to being bedridden, in almost
constant agony, unable even to hold a pen.
"It happened so suddenly," says Kate, from
Pelsall in the West Midlands. "One day I was fine, the next my elbows
were so painful I couldn't straighten my arms and they were stuck at
right angles. It felt as if all my joints were trapped in a burning hot
"Within a week my knees had swollen to
twice their normal size, and the pain was so intense I could barely
stand for a few seconds without bursting into tears. My fingers were so
stiff that my hands were permanently in fists."
After a month Kate's parents took her to
be examined by a rheumatologist. Blood tests confirmed Kate was
suffering from severe rheumatoid arthritis in every joint in her body.
The condition, in which the body's immune
system attacks the tissues that line the joints - known as the synovium
- causing inflammation and pain, typically begins in early adulthood or
middle age. However, it is increasingly seen in teenagers and children.
between 0.5 per cent and 1 per
cent of the population and is characterised by painful periods known as
flare-ups. If left untreated, the cartilage, ligaments and bones can be
Despite beginning drug treatment
immediately, over the following years Kate's condition became so severe
that she was often confined to a wheelchair.
So it is nothing short of remarkable that
today, aged 23, she is studying for a university degree and is planning
to walk down the aisle in June. Perhaps most importantly, she is
This turnaround is largely thanks to
anti-TNF therapy, a revolutionary family of drug treatments, introduced
in 2000, that has drastically changed the lives of rheumatoid arthritis
Anti-TNF treatments have proved effective
in the 10per cent of patients who fail to respond to standard
therapies, namely non-steroidal anti-inflammatory drugs such as aspirin
and ibuprofen, and disease modifying anti rheumatic drugs for more
severe cases, which work by suppressing the immune system.
The most common disease modifying
antirheumatic drug is methotrexate.
Anti-TNFs have been shown to reduce damage
of the disease and in some cases put the patient into remission.
Studies have found around threequarters of patients who do not respond
to disease modifying anti rheumatic drugs respond well to anti-TNF
The drugs work by 'switching off' a
chemical enzyme called tumour necrosis factor, which plays an important
role in causing inflammation and tissue damage in rheumatoid arthritis
Yet despite their undoubted effectiveness,
the National Institute for Health and Clinical Excellence recently made
recommendations to limit prescribing drastically - a move vehemently
opposed by doctors, charities and patient groups.
The treatment is available to patients who
have tried two or more disease modifying antirheumatic drugs, and found
them ineffective. NICE proposes to stop patients from switching between
anti-TNF drugs. If one doesn't work, they won't be allowed to try
This matters because around half of
patients switch before finding one that works. There are three
different anti-TNF drugs on the market at present: Enbrel (etanercept),
Humira (adalimumab) and Remicade (infliximab), delivered either by
injection or drip.
After diagnosis, Kate was started on
methotrexate and sulfasalazine. The treatment initially worked, but
over the next three years it lost effectiveness, and her symptoms
returned worse than ever.
Kate was the perfect candidate for
anti-TNF treatment, which she began in 2002. She tried two types before
finding a third, Humira, which worked. Kate sees a nurse for an
injectionof the drug once a fortnight, which has effectively halted the
progression of her disease.
She says: "Thanks to the anti-TNF I've
been able to get on with my life. Some days, I feel completely normal.
Other days there is pain, but I'm used to it and I have far fewer
Kate lives with her father Graham, 53, and
mother June, 50. Last year, she began an Open University course in
English, and in June she will marry her boyfriend Sean Dennis, 28.
"It makes me so angry to think that people
like me might be denied treatment that could change their lives," says
Consultant rheumatologist Professor David
Scott, at Norfolk & Norwich University Hospital, believes the
decision is primarily an economic one.
Anti-TNFs cost the NHS around £10,000 per
patient, per year. "This therapy has been one of the major advances in
treatment of arthritis in the past 60 years," he says.
"Rheumatoid arthritis patients who are
allowed to deteriorate will cost the NHS more in the long run."
Kate is looking forward to a full life
thanks to anti-TNF therapy. Only NICE can decide whether thousands of
others will be given the same chance.
Map | CONTACT