Health
Are Rheumatoid Arthritis Two Different Diseases?
Disease activity in most rheumatoid arthritis (RA) patients improves over time, but long-term results improve only in RA patients with autoantibodies, according to a new study published this week. PLOS medicine By Xanthe Matthijssen of the Leiden University Medical Center, the Netherlands, and colleagues. The findings add to the increased evidence that RA is two different conditions with or without autoantibodies.
Rheumatoid arthritis is the most common type of autoimmune arthritis, which occurs when the immune system attacks healthy cells in the inner layers of the joints. Over the last decade, it has become clear that RA patients differ with and without detectable RA-related autoantibodies in their blood. In a new study, researchers followed 1,285 RA patients between 1993 and 2016 through the Leiden Early Arthritis Clinic Cohort. Data on patient symptoms, treatment, autoantibody status, disability, and mortality were collected annually.
In total, 823 patients had autoantibody-positive RA and 462 patients had autoantibody-negative RA. In both groups, disease activity decreased significantly over time. Patients with RA who were autoantibody-positive but not autoantibody-negative maintained a drug-free remission rate as new targeted therapy strategies became common between 2006 and 2010. In addition, treatment and target adjustment reduced mortality and dysfunction in autoantibody-positive patients only.
“The relationship between improved disease activity in RA without autoantibodies and subsequent improvement in long-term outcomes suggests that the underlying etiology of RA with and without autoantibodies is different,” the authors said. Have stated. “We propose that it is time to formally classify RA into type 1 with autoantibodies and type 2 without autoantibodies, hoping that it will lead to stratified treatment of autoantibody-positive and autoantibody-negative RAs. . “
Dr. Matthijssen said: “The last decade of research on RA has focused primarily on the autoantibody-positive subset. Further research on autoantibody-negative RA is urgently needed to identify ways to improve long-term results as well. is.”
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Research paper
Peer-reviewed; observational studies; people
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Funding: Studies leading to these results include the Dutch Arthritis Foundation and the European Research Council (ERC,) https: /
Competing Stakeholders: I read the journal policy and the author of this manuscript is the following competing stakeholders: TH is a member of the editorial board PLOS medicine..
Quotes: Matthijssen XME, Niemantsverdriet E, Huizinga TWJ, van der Helm-van Mil AHM (2020) Strengthening treatment strategies and clear disease outcomes in patients with autoantibody-positive and negative rheumatoid arthritis for over 25 years: Longitudinal in the Netherlands Cohort study. PLoS Med 17 (9): e1003296. https: /
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