John Hardin reflects on the 525-mile scenic bike ride he took with Tracie Seimon and her husband in October. They rode eight hours a day for eight straight days, from San Francisco to Los Angeles.
Not exactly what he pictured when Hardin met Seimon two years ago. She was 37 and turned to Hardin, a prominent New York rheumatologist, for help when others couldn't diagnose the cause behind a crippling pain that started in her feet, spread to other joints and was accompanied by swelling, fatigue and fever.
"When I see patients in that condition, I am concerned they might end up in a wheelchair," says Hardin, vice president of research for the Arthritis Foundation. "She was having trouble walking and needed assistance going upstairs. People don't need to suffer like that anymore."
After examining her health history and doing tests, he diagnosed rheumatoid arthritis and put her on an aggressive new drug therapy. It took several months to start working, but she's in remission from an inflammatory disease that afflicts 1.5 million in the USA and can cause loss of function. It is an autoimmune disease, in which the immune system mistakenly attacks tissues. It can also attack the heart and lungs.
"I am so grateful," says Seimon, who lives in Nyack, N.Y., with husband Anton Seimon and their two dogs. "The drugs made me a little nauseous at first, but my body has gotten used to them, and I seem to be tolerating them well now."
She's back doing fieldwork as a conservation researcher at the Bronx Zoo. She travels to remote locales (including Russia, Peru and Vietnam soon) seeking pathogens that kill wildlife. "I have to be strong to do my job," she says. "I am often working at high altitudes and flipping over big rocks looking for amphibians."
The drug regimen she's on includes Enbrel and Methotrexate, which both work on the immune system by blocking or reducing the proteins contributing to the disease process. Plaquenil was developed to treat malaria, Hardin says, but it is also effective in treating early RA.
People who begin treatment within two years of the disease's onset can expect to have low or moderate disease activity, rather than merely relief from symptoms, says Hardin. In a study of 682 people with RA, more than 75% of those treated with Enbrel and Methotrexate (by injection or infusions) had no progression of joint damage after three years.
More new therapies are in the pipeline. The Food and Drug Administration in November approved Tofacitinib, a new class of oral drugs for people with moderate to severe symptoms who haven't been helped by other therapies. Tofacitinib works by suppressing the immune system.
Seimon must protect herself from getting sick, since her immune system is depressed by the treatments. "I'm always washing my hands I'm careful about what I eat and make sure I get enough sleep," she says.
She had one flare-up when she experimented with tapering off the drugs before the October bike ride, but resuming the therapy eliminated the problem. She plans to take them for the long haul. The long-term effect of the drugs is unknown.
"But my choices weren't good ones," she says. "Looking at what the alternatives would be, I'd have no life and I wouldn't be doing my research that I love to do on frogs."
The following fields overflowed:
SIGNATURE = 2012-12-19-New-treatments-put-rheumatoid-arthritis-in-remission_ST_U.xml
To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com
Copyright 2012 USA TODAY, a division of Gannett Co. Inc.