Early Treatment of 'Pre-RA' Patients May Reduce Risk of Rheumatoid Arthritis
Early treatment intervention in patients with "pre-rheumatoid arthritis" (pre-RA) significantly lowered the risk of RA occurrence in patients at 52 weeks and beyond. The full findings of the meta-analysis were presented at the Annual European Congress of Rheumatology (EULAR) 2017 in Madrid, Spain.
Pre-RA is defined as undifferentiated arthritis or very early RA, a point where early intervention could be more effective. Study authors searched PubMed, Embase, and Cochrane databases as well as the EULAR and ACR congress abstracts. They identified two congress abstracts and nine randomized controlled trials: eight of which were related to undifferentiated arthritis, and one which was related to very early RA.
Of the total patient sample (n=1,156), the majority were female and the mean symptom duration was 16.2 weeks. Early intervention in these pre-RA patients included methylprednisolone, methotrexate, TNF-blockers, abatacept or rituximab. Findings from the review showed a significant reduction in the risk of RA occurrence at 52 weeks or more "although there was no statistically significant difference in the absence of disease progression as seen on X-ray between those taking active treatments or placebo due to the disease being at such early stage," noted lead author Dr. Stephane Hilliquin, from the Pitié Salpêtrière University Hospital, Paris, France.
The authors concluded that the literature review of the available data supports the rationale for early intervention in these patients. The benefit to risk profile and the feasibility of early treatment of pre-RA in clinical settings still warrant further research.
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