Researchers recently discovered that a certain therapy may slow down the development of arthritis in patients at risk of rheumatoid arthritis (RA).
The double-blind study study included 81 patients who had both anti-citrullinated peptide antibodies and rheumatoid factor but did not have arthritis at baseline. Patients were randomized to receive a singe 1,000-mg dose of rituximab (n = 41) or placebo (n = 40) and were followed for a mean 29 months.
A single infusion of 1000 mg rituximab significantly delays the development of arthritis in subjects at risk of developing RA: the PRAIRI studyhttps://t.co/6E1TReO3MS pic.twitter.com/H5jDnJKchm
— Annals of the Rheumatic Diseases (@ARD_BMJ) December 3, 2018
In total, 30 (37%) patients developed arthritis. In the placebo group, 40% (n = 16) of patients had arthritis at final follow-up, compared to 34% (n = 14) of the rituximab group. Median time to disease development was 11.5 months in the placebo group and 16.5 months in the rituximab group.
The rituximab group had a 55% decreased chance of developing arthritis (HR 0.45, 95% CI 0.154 to 1.322) at 12 months, and a 53% lower risk at 18 months (HR 0.48, 95% CI 0.19 to 1.19) of follow-up. Rituximab-treated patients had a 12-month delay in arthritis development compared to the placebo group at the point when a quarter of placebo patients had developed arthritis.
The PRAIRI study has been published: first experimental evidence for a preventive window of opportunity in rheumatoid arthritis. Up to a new paradigm of much earlier intervention.
Big thank you to the study participants and my colleagues!— Dr. Paul Peter Tak (@paulpetertak) December 2, 2018
“RA is one of the most common chronic immune-mediated inflammatory diseases with a significant impact on the individual patient as well as society,” the researchers wrote. “Current treatment options are still not sufficiently effective as most patients do not achieve disease remission, which is the treatment goal.”
The study was limited by its small sample size, the researchers noted.
“The results presented here are clearly consistent with the critical role of B cells in the pathogenesis of RA during the earliest stages of the disease and support future studies aimed at secondary prevention of RA, including by the use of targeted treatments,” the study authors concluded.
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Source: Annals of the Rheumatic Diseases
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