© F. Hoffmann-La Roche, Ltd.

Thirteen years ago, when Steve Robson was 35 years old, he casually tried out a jackhammer while working on a jobsite in Dublin, Ireland. The next morning, Robson's left hand wouldn't work. Everyone assumed that the jackhammer was to blame, and that his hand would soon be fine. It wasn't. In fact, it wasn't the jackhammer at all. Rheumatoid arthritis (RA) caused the trouble. Moreover, the trouble with Robson's hand turned out to be just the beginning. Over time, RA affected many of Robson's joints. He's had one hip replaced, a carpal-tunnel operation, and dealt with enormous pain.

Robson's ordeal echoes the twisted and often discouraging path that many people with autoimmune diseases experience when they seek diagnosis and relief. Since his left hand was still useless on the Monday after using the jackhammer, Robson made an appointment with his doctor, who prescribed topical medications. When those didn't work, Robson went to a specialist for blood tests and X-rays. They were all normal.

"It was a year before I was diagnosed," he says.

Unhappy with his local care, Robson switched to a hospital in Cambridge, where for years he tried various remedies, none of which helped much. "It would take me five minutes to stand up," he says. "My five-year-old boy had to put on my socks and tie my shoes. And I should have been putting on his shoes," he remembers. The pain robbed him of sleep. "I must admit," he says, "that on a couple of occasions in those dark days, if that little button to end it all was in front of me, I would have pushed it."

He eventually volunteered for a double-blind clinical trial on the use of MabThera/Rituxan (rituximab) for RA. MabThera/Rituxan is a monoclonal antibody, originally designed to decrease the number of specific B cells in people with non-Hodgkin lymphoma, while leaving the immune system intact. During cancer trials for the drug, though, researchers noticed a serendipitous improvement in study subjects with RA, where B cells are also implicated in the destruction of joint tissue.

After Robson's first infusion of MabThera/Rituxan, he felt immediate relief. "When I got home, the family was out and there was some washing up to do. I'd never been able to wash up because I was always dropping cups, but I had so much strength in my hands [that night] I wanted to smash a cup with my bare hands," he says.

Much of that initial relief came from the steroids administered along with MabThera/Rituxan, so it was hard to know if the drug was really working. However, he received another infusion two weeks later, and in about three months he felt sustained relief that lasted two years. Last December, Robson experienced a return of some pain and received another round of MabThera/Rituxan, and the relief has been just as immediate and sustained.

"It was a new lease on life," he says. "I wouldn't swap it for anything."