FOCUS OF THE WEEK
The Importance of Early Diagnosis in RA
April 30, 2014, 11:17:37 AM
Katie Sullivan, MA
The early detection of rheumatoid arthritis (RA) in patients is important to reduce the risk for negative long-term outcomes. A recent study suggests that utilizing a risk score based on clinical characteristics, serologic findings, and imaging testing could assist physicians in identifying antibody-positive patients who are likely to develop RA. 

Researchers found that more than half (62%) of patients with nonspecific musculoskeletal pain who were positive for RA-specific anti-citrullinated protein antibodies (ACPA), and who progressed to having RA, had a risk score between 3 and 5. Those with a score of 0 did not progress, and only 31% progressed if their score was 1 or 2.

“Identifying patients at this early phase should produce the best clinical outcome by early diagnosis and treatment and may also permit the possibility of preventive therapy,” said Paul Emery, MD, of the University of Leeds, and one of the study authors.

The findings offer evidence that suggests ACPA-positive patients with musculoskeletal pain and stiffness have a significant likelihood of progressing to RA.

“The risk score derived from this cohort is a step toward achieving a personalized medicine approach to identify those patients at an early stage,” added Dr Emery.

A recent panel discussion from The American Journal of Managed Care (AJMC) also focused on the importance of early diagnosis in RA management and treatment.

Mark Fendrick, MD, co-editor-in-chief of AJMC, joined by Eric Ruderman, MD, professor of medicine, rheumatology, at the Feinberg School of Medicine at Northwestern University; and James O’Dell, professor of internal medicine, division of rheumatology, University of Nebraska College of Medicine, said that early diagnosis, as well as knowing a patient’s risk factor, is key to getting patients with RA started on disease modifying therapy. A risk test can assist physicians in recognizing the early symptoms of RA, and when to recommend that a patient see a rheumatologist.

“It’s incredibly important to know what kind of arthritis you’re dealing with,” Dr O’Dell said. “The expectation should be extremely high for taking someone with rheumatoid arthritis—which is and can be a devastating disease—and making them normal.”

Around the Web

Risk Score Predicts Arthritis Progression [Med Page Today]