Is It Time to Classify Rheumatoid Arthritis Into Two Distinct Types?
A new study by Xanthe Matthijssen and colleagues of Leiden University Medical Center, Netherlands, which was published this week in PLOS Medicine, showed that patients with rheumatoid arthritis (RA) with and without antibodies are two distinct conditions.
Although most patients with RA experience decrease disease activity over time, long-term outcomes are significantly higher in patients with autoantibodies.
Rheumatoid arthritis is the most common type of autoimmune arthritis that happens when the body's immune system does not work correctly and ends up attacking the synovium - the lining surrounding your joints.
This inflammation causes the synovium to thicken, weakening the tendons and ligaments holding the joint together. Over time, the joint becomes deformed and loses its alignment.
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Over the last decade, studies have clearly shown differences in RA patients with and without RA-associated autoantibodies. The presence of these autoantibodies may form immune complexes in the joint that can attract immune cells. RA patients can be distinguished as autoantibody-positive and negative depending on the presence of these autoantibodies.
In this new study, researchers followed 1,285 RA patients between 1993 and 2016, among which 823 patients had autoantibody-positive RA, and 462 patients had autoantibody-negative RA. The researchers noticed a significant decrease in disease activity in both groups.
Studying these autoantibodies can provide useful information on disease outcomes and further the understanding of the development of RA and its underlying pathophysiological processes.
According to the authors, the findings of this new study show that it is time to divide RA into type 1, with autoantibodies, and type 2, without autoantibodies. This way, it can lead to a stratified treatment in autoantibody-positive and autoantibody-negative RA.
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Rheumatoid Arthritis
Rheumatoid arthritis affects more than 1.3 million Americans, and although it usually begins between the ages of 30 and 50, it can start at any age and is more prevalent among women. It is a chronic inflammatory disorder associated with symptoms like joint swelling and stiffness, causing decreased movement of the limbs.
This stiffness in active RA is more prominent in the morning or after periods of inactivity. This is referred to as morning stiffness and post-sedentary stiffness, which may last for 1-2 hours or even the whole day.
The early stages of RA show symptoms similar to other diseases, which makes it hard to diagnose. A rheumatologist may ask you to undergo different types of tests to confirm its diagnosis.
It is best to diagnose RA within the first six months of the onset of symptoms so that treatment can begin early on and can slow or stop disease progression.
There is currently no cure available for RA, but there various treatments available for its proper management. Most of the treatment is directed at managing pain and controlling inflammatory response to reduce the chances of remission and prevent further joint and organ damage.
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Sep 23, 2020 07:40 AM EDT
