Arthritis Breakthrough Gets A Cautious Welcome

      LONDON - Experts reacted cautiously Sunday to news that a team of British scientists may have developed a cure for the crippling disease rheumatoid arthritis and possibly other ``auto-immune'' diseases.

      Scientists from University College London (UCL) were announcing Monday, at an international conference, that they have had success in small-scale trials to treat people suffering from the painful disease, which affects 750,000 people in Britain.

      The treatment consists of drugs that destroy the body''s own ``B-cells,'' part of the immune system which defends the body against disease. Sometimes these B-cells attack the body''s own tissue, leading to rheumatoid arthritis.

      But, commenting on the reports, Dr. Anthony Clarke, medical director at the Royal National Hospital for Rheumatoid Diseases, said details on the treatment were ``sketchy'' and it was too early to hail it as a wonder cure. He said: ``Eighteen patients have shown benefits but for any new drug you have to put it through a long, testing process to make sure early promise proves to be correct and to make sure it is safe.'' Such testing can take five to ten years from the first human successes.

      The UCL team''s work looked at the role of the B-cells, the white blood cells that defend the body against viruses and bacteria by making antibodies that attack the hostile microbes. B-cells often accidentally make antibodies that attack healthy tissue; some of those errant antibodies then also trigger the production of copies of themselves. In that case, rheumatoid arthritis can follow, as the collagen which normally allows the joints to move smoothly becomes shredded and rough.

      The rheumatoid form is only one version of arthritis; the disease generally appears in old age as the collagen becomes worn naturally and is not replaced. The UCL team''s treatment will have no effect on that.

      The new treatment uses drugs that seek out and destroy B-cells. The body responds to the destruction of all its B-cells by making fresh ones. The chances are small that these new B-cells will make the same mistake as their predecessors and trigger a return of rheumatoid arthritis.

      Of 20 patients who underwent 18 months of treatment, five now have only some residual pain from the damage already done.

      Professor Edwards said: ``They have returned to leading a more or less normal life. So far, of the total of 20 patients only two have had no benefit at all.'' The patients have had rheumatoid arthritis for an average of 20 years, he added. The B-cell-based therapy might also offer hope to patients with other auto-immune diseases, such as Crohn''s disease, lupus and even multiple sclerosis, as it suggests ways of stopping the destructive cycle in which the immune system turns on the body''s own tissues.

      The team is announcing the results of its research at the annual scientific meeting of the American College of Rheumatology in Philadelphia. The findings will be also published in the leading journal Rheumatology.

      Richard Glutch, spokesman for voluntary group Arthritis Care, has told the Government that it will have to allocate substantial resources to pay for any drugs that emerge from the new treatment.

c.2000 The Independent, London