There are an estimated 277 new experimental agents now in development for the treatment of RA. Among the most promising DMARDs are monoclonal antibodies, JAK2 and JAK3 inhibitors, and SYK inhibitors.
JAK3 is an enzyme important for production of white blood cells. Inhibiting this enzyme is a strategy aimed at regulating inflammation and has already been used successfully in the treatment of RA. A number of JAK 2 and JAK3 agents are in Phase II clinical trials and one, called tasocitinib, is now in Phase III studies.
SYK inhibitors interfere with RA progression by blocking a different target, spleen tyrosine kinase. A promising SYK inhibitor called fostamatinibdisodium is in Phase II trials.
Another promising therapy in development is a humanized monoclonal antibody called denosumab; it has shown rapid onset of action in clinical trials and researchers believe it has potential to decrease structural damage to joints.
On the horizon, there is hope for vaccines and stem cell therapies that might even provide a cure for RA.
Researchers have been working to develop an arthritis vaccine. One strategy is to modify cells taken from a sample of the patient’s white blood cells. Researchers are targeting osteoarthritis using a promising stem cell therapy; numerous medical and veterinary centers (UC Davis, Tufts, University of Pennsylvania) are successfully using stem cells to treat arthritis in horses and dogs.