A temporary treatment with methotrexate in the early stages of rheumatoid arthritis resulted in benefits for patients, according to research published in The Lancet. By temporarily prescribing methotrexate in the “pre-rheumatic phase,” patients experienced a reduction long-term joint inflammations, pain and physical limitations.
“At present, methotrexate is only prescribed to the patient following a rheumatoid arthritis diagnosis,” explained Annette van der Helm, Professor of Rheumatology at Leiden University Medical Centre. “But that is too late. By then, the disease is already considered chronic.” The researchers hope to prevent or reduce disease burden by giving methotrexate to patients likely to develop rheumatoid arthritis.
The researchers found that while the development of rheumatoid arthritis was not prevented by early treatment, diagnosis was delayed. Patients that had temporarily received methotrexate also reported less pain, morning stiffness and daily functioning impediments. Fewer joint inflammations were seen in MRI scans. “This is an important step towards reducing disease burden for this group of patients,” said Prof Van der Helm. “Moreover, it serves as initial evidence for initiating treatment in the ‘pre-rheumatic’ phase.”
The 8 year study included more than 230 patients. “All suffered from joint pain and inflammation, which could be seen on the MRI, and was thought to be a rheumatism precursor,” said PhD student Doortje Krijbolder. Rheumatologists are not certain whether this is truly the case, however. Pre-rheumatoid patients were treated with methotrexate or a placebo for one year, and a one year follow-up enabled researchers to see if the effects of the treatment persisted.
“This chronic disease is extremely burdensome to patients and their families. Our study is paving the way toward arthritis prevention,” said Prof Van der Helm. “To achieve this completely, greater understanding of the molecular processes underlying the chronic nature of rheumatoid arthritis is necessary.”
Source: Medical Xpress
