“Unpredictable” is often a word patients and doctors use to describe rheumatoid arthritis. But new research shows RA may be able to be predicted after all.
Rheumatoid arthritis (RA) is often thought of as a frustrating — and unpredictable — disease. But now, researchers are finding new ways to predict who’ll develop RA early on.
Two new studies presented at the annual European League Against Rheumatism (EULAR) Conference showed some insight into certain molecular changes that were found before the onset of RA.
The research may mean people can get treatment for the disease earlier, and new treatments could be developed to help keep those at risk for RA from developing debilitating symptoms in the first place.
The data supported the idea of developing early interventions to possibly prevent the onset of arthritis. The research findings also suggested that by predicting RA, people could be prescribed a more tailored treatment by using precision medicine and genomics.
In the first study, a type of connective tissue called synovial tissue and their gene expressions were examined.
The tissue samples were taken from the knee joints of 67 individuals who were considered to be at high risk for developing RA. Participants were then followed to see if they did, in fact, develop RA.
A genome-wide exploratory study profiled 13 of these participants to see if there was a clinically significant association with the development of RA. Those gene signatures were then validated and, “measured,” in order to look at changes taking place within the cells of these participants.
Lisa van Baarsen, PhD, of the Amsterdam Rheumatology and Immunology Center in the Netherlands and principal investigator of this study, addressed the EULAR conference and released a statement to the media, stating:
“Our results clearly show molecular changes appearing in the synovial tissue before the onset of arthritis. The characterization of these gene signatures will enable us to better understand the pathophysiology of the pre-clinical phase of the disease and potentially identify novel drug targets for preventative intervention.”
Baarsen added that the discovery that autoantibodies may be detected before an RA diagnosis means people could receive early treatment even before they have symptoms.
“In patients with established disease, the target tissue of RA, the synovial joints, is characterized by cellular infiltration and inflammation,” Baarsen said. “Moreover, successful therapy decreases this synovial inflammation.”
In the second study, researchers examined B-cell receptors (BCR). These are biomarkers naturally found in blood that work with the immune system.
Researchers followed 129 individuals at risk for RA to see if clones of BCR were higher in people who went on to develop RA.
“Our data support a new biomarker that demonstrates better predictive power compared with other available biomarkers evaluated so far,” Dr. Anne Musters of the Amsterdam Rheumatology and Immunology Center at the Academic Medical Center in the Netherlands said in a EULAR press statement.
She added this biomarker can help “identify RA-risk individuals that will go on to develop arthritis.”
The team found the higher the number of BCR clones, the higher likelihood the person would develop RA.
The study also found the number of dominant BCR clones was notably increased in people who were at risk for RA, and they developed arthritis within three years.
The study adds to recent findings that dominant BCR clones in blood could accurately predict imminent onset of arthritis in these people.
Those who were BCR-negative didn’t develop arthritis during the three-year study period.
What does this mean for people with RA?
While these studies will have to be replicated, using these biomarkers could mean doctors in the future may be able to detect who will end up getting RA and start working with them before they develop symptoms.
By working with these individuals early, doctors may be able to delay or even prevent RA symptoms from occurring.
Molly Lewis of Pittsburgh, Pennsylvania, has RA and osteoarthritis. She says she’d be interested in hearing more about any kind of research on preventive medicine for these diseases.
“If I knew a treatment or therapy could help prevent arthritis, I’d be all over it, even if it was still considered an investigative approach,” she told Healthline.