Treat Rheumatoid Arthritis Early
Studies Show Early, Aggressive Treatment May Lead to Remission
WebMD News Archive
Nov. 13, 2006 (Washington) -- Two studies suggest that treating rheumatoid
arthritis (RA) early and aggressively may change its course.
The findings were presented at the 2006 annual meeting of the American
College of Rheumatology.
Rheumatoid arthritisis an
autoimmune disease caused by the immune system attacking the lining of the
joints. It can lead to long-term joint and bone damage and affects 2.1 million
Americans, mainly women.
The disease can result in chronic pain, loss of function, and disability,
according to the Arthritis Foundation.
There is no cure for the disease. Treatments are aimed at reducing joint
inflammation and restoring joint function to near-normal levels.
Early Evidence of Rheumatoid Arthritis
In one study, Dutch researchers studied people with early evidence of
rheumatoid arthritis. The researchers show that treating these individuals with
the drug methotrexate can possibly prevent the disease from progressing to
And in a second study, investigators report that early treatment with
methotrexate plus Remicade may result in a drug-free remission in people with
rheumatoid arthritis. Remicade is one of a newer category of medications that
target specific chemicals that lead to inflammation.
The first study -- called PROMPT -- comprised 110 people with arthritis from
an early arthritis clinic in the Netherlands. They received methotrexate or a
placebo for one year. Researchers measured joint damage every six months by
taking X-rays of the hands and feet -- the joints most commonly affected by
People who received methotrexate showed less X-ray damage to the joints
after 30 months compared with their counterparts who received a placebo. They
were also less likely to develop rheumatoid arthritis, but only if they tested
positive for an antibody known as anti-CCP. Anti-CCP antibodies are blood
markers that may predict the development of rheumatoid arthritis.
Role of 'Personalized' Medicine
These findings point to a role for personalized medicine, says researcher
Tom W.J. Huizinga, MD, chairman of rheumatology at Leiden University Medical
Center in the Netherlands. "If you have autoantibodies to anti-CCP and are
treated with methotrexate, you don't develop RA," he says.
"The bottom line is that patients should be referred to a rheumatologist
early and if they are CCP positive, they should be treated," he says.
Steven B. Abramson, MD, the director of rheumatology at New York University
and the Hospital for Joint Diseases in New York City, agrees. "This is a
very exciting article [and] it clearly needs to be validated," he says.
"This is the beginning of personalized medicine.
"Patients today should want to know if they are CCP positive and if they
are, they should make sure their doctors treat them if they have any
symptoms," he says.