Rheumatoid arthritis (RA) may be linked to family history, but a recent study showed that family history may predict lack of response to RA treatments, too.

For decades, the possibility of rheumatoid arthritis having a genetic or hereditary link has been explored.

Many studies indicate that RA may have a familial component, with family history being a potential predictor of disease risk or development.

Now, researchers have found that family history may predict not only the illness itself, but also if patients will respond to — or stick with — treatments.

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A Swedish study, published in the Annals of the Rheumatic Diseases, concludes that, when it comes to RA, treatment response and/or compliance may indeed be familial.

The study’s goal was to assess whether or not a family history of rheumatoid arthritis had an effect on the clinical presentation and treatment response of the patient.

Authors of this study, including lead author Dr. Thomas Frisell of Karolinska University Hospital, Stockholm, scoured the Swedish Multi-Generation and Patient Registry to look for RA patients who had a first-degree relative who also had the ailment.

These patients had early-stage RA and were studied from 2000 to 2011 for response to methotrexate (MTX) and anti-TNF treatments (TNFi), as well as for clinical presentation.

The study concluded that the clinical presentation was not affected by the familial link to another patient with RA. They also were not able to predict how effectively MTX or TNFi would work in these patients.

However, they did conclude that the lack of response to these medications or discontinuation of the medications may in fact be linked to familial factors, but more work would need to be done to examine this link.

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It’s unclear how or why these behaviors and responses (or lack thereof) are linked.

Certified health and wellness coach Lauren Bines of Beaver Falls, Pennsylvania, stated that she sees similar behaviors in clients who are related and living with the same diseases.

“If a patient or client is diagnosed with, for example, RA or fibromyalgia, and her daughter is, too, if the mother is lax about sticking to treatments, the daughter will likewise often be less compliant with managing her conditions,” said Bines, who is an arthritis patient herself.

Bines noted that patients obviously won’t respond to treatments if they discontinue them. However, patients often discontinue treatments because they feel the treatment isn’t working.

“So it’s hard to say if lack of compliance caused them to stop or slack on treatments, causing inefficiencies, or, if the inefficiency of the medication is what caused them to give up on it, in a sense,” Bines said.

Regardless of the reason, the results of the Swedish study remain clear: Having a first-degree relative with RA who discontinued anti-TNF treatment within a year increased the odds of related patients doing exactly the same.

This fact stands even in the midst of a lack of hereditary correlations in disease activity. Studies like this one will likely be just one part of a long line of research based on familial involvement in RA disease activity and biologic treatments.

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