Does Treating Undifferentiated Arthritis Delay RA Development?

Largest effect seen with methotrexate
Largest effect seen with methotrexate

For patients with undifferentiated arthritis, early treatment may potentially delay subsequent progression to rheumatoid arthritis (RA), according to a study published in Arthritis Care & Research.

To evaluate the effects of treatment on patients with undifferentiated arthritis, researchers conducted an extensive literature search which identified 9 studies; RA development was considered the primary outcome. Among these studies, treatments included methotrexate, abatacept, infliximab, glucocorticoids (intra-articular or intramuscular), and radiation synovectomy. 

The results showed that compared to patients who received placebo or no treatment, those who were treated had lower rates of RA at 12 months (odds ratio (OR) 0.49; 95% CI 0.26–0.90). The largest effect was seen in patients treated with methotrexate versus those not receiving treatment (OR 0.13, 95% CI 0.03–0.48), however this effect was no longer significant at 30 or 60 months. 

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Regarding studies with indirect comparisons, while most of the interventions were associated with reduced risk of RA development, treatment with methotrexate (OR 0.16, 95% CI 0.08–0.33) and intramuscular methylprednisolone (OR 0.72, 95% CI 0.53–0.99) were found to have statistical significance.

"These findings suggest that there is a window of opportunity to treat patients with [undifferentiated arthritis] early, to delay subsequent progression to RA," the authors concluded.

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