When Lori Anne was diagnosed with RA in the 1980s, practicing rheumatologists like Dr. Stefan Simianer were accustomed to seeing patients hospitalized.
“You had all the records of those patients at your hands; you’d have a big bag with X-rays in it, and you could see over the years how those patients systematically deteriorated, how their X-rays got worse and worse,” says Simianer, now vice president, international R&D and general manager, Ludwigshafen, Germany, AbbVie. “Basically, this was a document of failure … Rheumatology was quite demanding for physicians because there was really not much help you could offer.”
Lori Anne utilized available treatments, which allowed her to get out of bed and go to school. But she was still exhausted, unable to play tennis or basketball, which she’d once loved, and her body showed the effects of the disease. Upon returning to her small, private school, she noticed a teacher quickly turning away.
“She was crying, she was so upset. I had lost so much weight because I really didn’t eat,” Lori Anne says. “That’s how drastic it was and how quickly it happened.”
A simple research question that would change RA
Meanwhile, at what would later become AbbVie’s research center in Germany, scientists were studying a protein in the body called Tumor Necrosis Factor alpha, or TNFα. In acute conditions like septic shock, TNFα levels were extremely high; the body was sending extra TNFα to fight the infection.
What they were surprised to learn was that the protein was also prevalent in people with RA. These people didn't have infections, so why were their levels of TNFα so high?
The research team had already developed a TNF antibody that worked in septic shock, but they quickly discovered it couldn’t be used for a chronic condition like RA, as long-term use triggered antibodies that made the drug ineffective. So, the scientists started down a new – and completely uncharted – path, working with research colleagues in Massachusetts.
Jochen Salfeld, vice president, global biologics discovery and distinguished research fellow, AbbVie, who led the Massachusetts team at the time, explains: