Results of a study presented at the Annual European Congress of Rheumatology by Henrike Van Dongen, MD, Leiden University Medical Center, Netherlands, and her colleagues on June 21, 2006, suggests that people diagnosed with undifferentiated rheumatoid arthritis could have their disease outlook changed significantly if the proper treatment is given at the right time.
The PROMPT-study (Probable rheumatoid arthritis: Methotrexate versus Placebo Treatment-study), a double-blind, placebo controlled, randomized, multicenter trial in 110 participants with undifferentiated (having an undetermined diagnosis) rheumatoid arthritis (RA), was conducted to determine whether participants would benefit from treatment with methotrexate.
The study concluded that the methotrexate group had fewer patients develop RA during the observed time and more participants 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 another member of the study Tom Huizinga, MD, Leiden University Medical Center, Netherlands.
Methotrexate is a disease modifying anti-rheumatic drug (DMARD) and is well established in the treatment of cancer and autoimmune diseases such as RA. In rheumatoid arthritis, methotrexate 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 RA. However, this study indicates that the progression to a full-blown disease amongst these patients could be influenced,” noted Dr. Dongen.
"This is an important study," said John H. Klippel, MD, President and CEO, Arthritis Foundation, "which suggests that there may be a window very early in the development of rheumatoid arthritis in which treatment significantly alters the course of the disease. Identifying patients in this phase of the disease and instituting treatment is an important public health goal."