Rheumatoid Arthritis Could Be Prevented If The Timing Is Right

June 21, 2006

By: European League Against Rheumatism on Jun 21 2006 15:35:12

Rheumatoid Arthritis

Patients diagnosed with 'undifferentiated rheumatoid' arthritis could

actually have their disease outlook changed significantly if

treatment is given at the right time, according to the results of a

study presented at the Annual European Congress of Rheumatology on

Wednesday 21 June, by Mrs. Henrike Van Dongen and her colleagues.

The PROMPT-study (Probable rheumatoid arthritis: Methotrexate versus

Placebo Treatment-study) is a double-blind placebo controlled

randomized multicenter trial in 110 patients with undifferentiated

arthritis, which means they have arthritis but the exact diagnosis is

undetermined. The aim of the study was to determine whether the

patients would benefit from treatment with methotrexate (MTX). At the

end of the study, patients were tested with a special antibody blood

test (anti-cyclic citrullinated peptide antibody, anti-CCP) to

confirm a diagnosis of Rheumatoid Arthritis, one of the most

aggressive and debilitating forms of rheumatism.

The study concluded that, in the MTX group, fewer patients developed

Rheumatoid Arthritis during the observed time and more patients

reached remission than in the group receiving placebo. " This data is

excellent news as it shows that methotrexate appears to delay or even

prevent progression to rheumatoid arthritis amongst patients " , said

study investigator Professor Tom Huizinga, Rheumatology, Leiden

University Medical Center, Leiden.

Methotrexate is an antimetabolite drug, which means it is capable of

blocking the metabolism of cells, and is well established in the

treatment of cancer and autoimmune diseases such as Rheumatoid

Arthritis. It acts specifically by inhibiting the metabolism of folic

acid. In rheumatoid arthritis, MTX seems to work, in part, by

altering aspects of immune function which may play a role in causing

the disease.

" One of the most interesting findings from the study was that the

patients who benefited the most were the ones showing a positive anti-

CCP test, which would in general terms show that a patient has a very

high likelihood to develop full-blown Rheumatoid Arthritis. However,

this study indicates that the progression to a full-blown disease

amongst these patients could be influenced " , noted Mrs. Dongen.

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