ACPA–negative individuals with clinically suspect arthralgia had reduced rates of RA development when treated with a 1-year course of methotrexate, compared with placebo.
in at-risk individuals who test negative for anti-citrullinated protein antibody , according to 4-year results from the TREAT EARLIER study., researchers risk-stratified patients in this most recent data. The previous study also grouped all individuals together, while this new analysis separated patients by seropositivity.
The clinical utility of this finding is also unclear, he noted, as it would be an"extensive process" for all ACPA–negative individuals with joint pain to undergo MRI screening, he continued. Of the 182 ACPA–negative participants in the study, none were considered high risk, 66 were at increased risk, and 116 were at low risk.Of these ACPA–negative patients stratified as increased risk, 3 of 35 in the treatment group developed RA, compared with 9 of 31 in the placebo arm developed RA during 4 years of follow-up. However, van der Helm-van Mil noted that the 2-year data showed treatment improved the severity of subclinical inflammation and symptoms over time in these patients.
"There is an ongoing debate whether people with arthralgia at risk for RA should be treated with DMARDs ; however, the economic effects of an intervention in the arthralgia at risk phase are unknown."
RA - Rheumatoid Arthritis Rheumatoid Arthritis (RA) Arthritis Joint Inflammation Arthralgia Painful Joint Joint Pain Pain Pain Management Colorado Biomarker Biological Marker Multi-Biomarker Disease Activity MBDA Multibiomarker Disease Activity Chronic Disease Chronic Illness Disease-Modifying Antirheumatic Drugs Dmards DMARD Glucocorticosteroids
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