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Rheumatoid arthritis
The observed immunological effects have encouraged researchers to test the effects of Avemar not only on immune response to tumours, but in other immunological models as well. The experimental induction of 'adjuvant' arthritis in rats is one of the most commonly used models to test human rheumatoid arthritis. Taking into account the fact that, as compared with non-steroid anti-inflammatory drugs (NSAID) and steroids, Avemar has no side effects, Avemar provides a promising alternative in the treatment of rheumatoid arthritis. This possibility is supported by preliminary and on-going clinical studies. The efficacy of a dose of 2.5 g/kg of Avemar administered twice daily to rats suffering from 'adjuvant' arthritis (the equivalent of human rheumatoid arthritis) closely resembled that of indomethacin and dexamethason, as evaluated through plethysmography and the histopathological examination of joints. Avemar influenced both the primary and secondary immune responses. In another study, dexamethason and diclofenac treatment was supplemented with the appropriate anti-inflammatory dose of Avemar. Avemar + diclofenac had a synergistic effect, while that of Avemar + dexamethasone was antagonistic.
Conclusions: The anti-inflammatory effect of Avemar is similar to that of NSAIDs, but different from that of corticosteroids.
The effect of Avemar on the relative gene expression of COX-1 and COX-2 (cyclooxigenase) enzymes was also examined. The same dose of Avemar decreased COX-1/COX-2 activity at the same level. Selective inhibition of COX-2 is an important criterion in the development of new NSAIDs and, while this effect did not prove to be selective with Avemar, its other known beneficial effects strongly suggest that it can produce a similar degree of anti-inflammatory effect with fewer side effects than NSAIDs. However, the mechanism is still not completely known. Preliminary clinical investigations are in progress at the National Institute of Rheumatology and Physiotherapy (Országos Reumatológiai és Fizioterápiás Intézet) in Budapest under the direction of G. Bálint and his colleagues. 15 patients suffering from rheumatoid arthritis are involved. The preliminary results confirm expectations. Further clinical studies with the participation of centres in other countries are also in progress.
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