Hope of cure for rheumatoid arthritis
Wednesday 15 September 2010
New research holds out the hope of ending the misery of rheumatoid arthritis (RA) for many thousands of sufferers, it was revealed today.
Scientists have discovered a "three-month window" after the onset of symptoms that offers the prospect of halting or even curing the crippling disease.
Within five years it may be possible to target patients early on with personalised drugs that allow them to lead normal pain-free lives, say scientists.
The new approach should also prevent premature deaths. Typically, a patient with progressive RA dies 10 years earlier than someone who is free of the disease.
Speaking about the developments today Dr Karim Raza, from the University of Birmingham, said: "Recent trial data has shown that there is a three-month window after the start of symptoms and if you look at the molecules in the joints at that time they are different from what they are at a later stage.
"The data suggests that if you intervene within those three months you can very rapidly slow progression of the disease and in some cases halt it.
"There is also a suggestion that if you intervene aggressively you might in a small proportion of people actually switch off the disease.
"We hope as research continues to see that small proportion get larger. That's the Holy Grail. There is a precedent in the cancer literature - the more you understand what's going on in a tumour, the more you're able to target treatments and the better the outcomes. We'd like the same to be true of rheumatoid arthritis."
Dr Raza was speaking today at the British Science Festival at Aston University, Birmingham.
RA is an auto-immune disease in which the body's own defence systems attack the joints, causing swelling and pain.
It is also believed to damage the inner walls of arteries, contributing to heart disease.
The condition affects around 350,000 people in the UK and is distinct from osteoarthritis, which is caused by "wear and tear" of the joints.
Dr Raza pointed out that although many people develop swollen joints only about 20% go on to suffer RA.
His team is looking at ways of better identifying people with early signs of RA by conducting ultrasound scans of their joints and checking their blood for molecular and cell biomarkers.
"What we have shown is that by combining information from ultrasound scans with blood tests you can improve predictive accuracy," he said.
Certain immune system signalling molecules and cells in the blood can indicate how patients are likely to respond to different treatments.
Dr Raza looked forward to a personalised approach that would involve identifying people with RA early on and targeting their disease aggressively with the right drugs.
"I'd say we could see this happening in the next five to 10 years," he said.
"What we want to be able to do is to say 'you should have drug A and you should have drug B'. It would involve a huge change of mindset in terms of the way we manage rheumatoid arthritis."
Today many people wait too long before seeking help for RA, making it harder to treat their condition, said Dr Raza.
A potential problem in future could be the number of "worried well" flooding into GP surgeries, he said.
There are ways of recognising early symptoms of the disease. One of the most typical is a feeling of stiffness in the morning that fades away during daily activity. Another is a diffuse swelling across the knuckle and finger joints.
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