| atoid arthritis (RA) is the most common inflammatory | | | | protein (CRP) can also be effective in roughly |
| form of arthritis. It affects roughly 2 million Americans. It | | | | quantitating the amount of inflammation present. |
| is a chronic, systemic, autoimmune disorder for which | | | | British researchers presented new findings at the |
| there is no known cure. However, there are very | | | | American College of Rheumatology meeting held in |
| effective medicine regimens that can control the | | | | Boston in November 2007 that could greatly facilitate |
| disease and get it into remission. | | | | early detection. |
| The major reason, RA is not put into remission more | | | | Patients with suspected rheumatoid arthritis are often |
| often is the lack of a precise diagnosis. While there are | | | | tested for anti-cyclic citrullinated (anti-CCP) antibodies |
| many criteria that can point towards the diagnosis, it is | | | | as part of their initial evaluation by a rheumatologist but |
| often difficult early on to make sure a given person | | | | not by the primary care doctor who may first have |
| has the disease. | | | | detected the condition. |
| Multiple criteria established by the American College of | | | | The scientists retrospectively tested for anti-CCP in |
| Rheumatology can suggest the probability of RA. | | | | the blood samples of 98 newly-diagnosed rheumatoid |
| These include: | | | | arthritis patients. The blood samples hadn't been |
| • Morning stiffness lasting more than one hour | | | | checked for anti-CCP before the patients' first visit |
| • Simultaneous arthritis affecting three or more | | | | with a rheumatologist. The researchers compared the |
| joints | | | | actual treatment strategies without the anti-CCP |
| • Arthritis affecting the knuckles | | | | results to treatment strategies proposed by three |
| (metacarpophalangeal joints) and close in finger joints | | | | rheumatologists and a registered nurse who reviewed |
| (proximal interphalangeal joints) | | | | the patients' records and were given the retrospective |
| • Symmetric arthritis | | | | anti-CCP test results. |
| • Rheumatoid nodules | | | | The study found that prior knowledge of the anti-CCP |
| • Positive test for rheumatoid factor in the | | | | results would have increased by 50 percent (from 19 |
| blood | | | | to 28) the number of patients started on |
| • X-ray changes. | | | | disease-modifying antirheumatic drugs (DMARDs) at |
| These criteria were formulated in the late | | | | the first rheumatologist visit. Earlier detection of the |
| 1980’s and things have changed quite a bit. | | | | antibodies would have also led to a more intensive |
| First, x-ray changes are late and these cannot and | | | | treatment regimen from the outset for eight patients. |
| should not be used to establish an initial diagnosis. Both | | | | "Having the results of this relatively inexpensive test |
| magnetic resonance imaging and ultrasound are much | | | | available at the time of their first assessment of |
| more sensitive.They are also more sensitive to subtle | | | | patients with a possible early inflammatory polyarthritis |
| changes. | | | | (arthritis affecting many joints) would allow |
| Secondly, the use of blood testing has also improved. | | | | rheumatologists to make a faster diagnosis and |
| Rheumatoid factor is present in only about 80 percent | | | | shorten the delay before treatment starts," lead |
| of people with RA. It can also be present in people | | | | investigator David O'Reilly, of West Suffolk Hospital, |
| with other diseases such as bacterial endocarditis, | | | | said in a prepared statement. |
| syphilis, sarcoidosis, leprosy, and other chronic | | | | So... as our ability to make the diagnosis earlier |
| inflammatory conditions. | | | | becomes better, the chance for getting RA into |
| Erythrocyte sedimentation rate (ESR) and C-reactive | | | | remission and possibly curing it increases. |