New Score Helps Spot Rheumatoid Arthritis Sufferers

Early detection is important to safe, effective treatment, experts say.

By Jeffrey Perkel
HealthDay Reporter
Tuesday, January 30, 2007; 12:00 AM

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TUESDAY, Jan. 30 (HealthDay News) -- Dutch researchers may have a new method of predicting whether patients with arthritic symptoms will progress to the autoimmune form of the disease, rheumatoid arthritis.

By differentiating those patients who will develop full-blown rheumatoid arthritis from those who will not, the new formula could speed earlier treatment of rheumatoid arthritis patients, reducing damage to their joints while sparing those who will not develop the disease the side effects sometimes associated with rheumatoid arthritis drugs.

"You don't want to give treatment to patients who will spontaneously remit, because they will not get the benefit," explained lead researcher Dr. Annette van der Helm-van Mil, a rheumatologist at Leiden University Medical Center in the Netherlands. "You want to give it only to the patients who have a high chance of progressing to rheumatoid arthritis."

The findings are published in the February issue of Arthritis & Rheumatism.

According to the Arthritis Foundation, rheumatoid arthritis is an autoimmune disease that affects some 2.1 million Americans, most of them women. The disease often presents first as "undifferentiated arthritis," a condition that lacks the criteria for a more definitive diagnosis. Up to 50 percent of patients with undifferentiated arthritis will spontaneously go into remission, while another third will progress to rheumatoid arthritis.

The problem, said van der Helm-van Mil, is that treatment of rheumatoid arthritis with the rug methotrexate at this point can reduce future joint damage but is also potentially toxic. That's why spotting patients with true rheumatoid arthritis early is so important.

In their study, the Dutch group studied a cohort of 570 patients who presented to the Leiden Early Arthritis Clinic with undifferentiated arthritis, 177 of whom progressed to rheumatoid arthritis within one year.

They identified nine variables, including gender, age, the number and distribution of stiff and swollen joints, and three laboratory tests. When factored into an algorithm, these factors could predict the likelihood of developing rheumatoid arthritis with nearly 90 percent accuracy.