Date Published: 15 September 2010

Research could lead to *Switching off* Early Stage Rheumatoid Arthritis

Rheumatologists at the University of Birmingham have identified a window in the progression of rheumatoid arthritis (RA) when the disease could be more effectively controlled and even ‘switched off’.

Working with international colleagues Dr Karim Raza has also discovered that the development of rheumatoid arthritis in patients with early joint inflammation can be quite accurately predicted using simple tests.

Rheumatoid arthritis is a painful and often debilitating disease in which inflammation of the joints can eventually lead to bone and cartilage destruction. The longer the disease is active the more destructive the damage to the joints.

Dr Raza and his colleagues have identified that the first 3 months of the onset of RA represent a transient phase in the disease that is different to that in established RA . These early months are crucial in terms of getting a diagnosis and receiving treatment.

Dr Raza, lead investigator from the University of Birmingham’s Medical School, said,

" Early diagnosis of RA is essential as we have shown that the processes occurring in the joints of patients in the earliest clinically apparent stage of the disease are different from those occurring later. This raises the possibility that the early phases may be more responsive to treatment and that the disease, if caught in time, could be switched off.

Delays in the initiation of therapy for RA are associated with worsening outcomes. "

Unfortunately many patients do not seek early medical attention and delay for an average of 3 months before seeing their GP, due to a lack of knowledge about the disease.

" The ‘earlier the better principle’ is applied almost universally by physicians in the context of the initiation of therapy in cancer It is not only recognised by clinicians but is firmly embedded in the psyche of the general population and is championed by the Department of Health whose targets make access to therapy a key priority, and we should be applying the same principle for RA.

Effective public engagement and raising awareness of the disease is the key to translating advances in the research in the disease into benefit for patients with new onset RA."

The team are particularly concerned about patients of South Asian origin as they delay seeking medical help longer than those from other backgrounds.

Dr Raza and his team want to start clinical trials in selected patient groups to test the ability to target interventions to significantly regulate the course of the disease.

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