A New Target for Early RA
The PRAIRI study explored biomarkers predictive of arthritis development and investigated the effects of B cell-directed therapy in subjects at risk of developing autoantibody positive RA who had not experienced inflammatory arthritis.
The findings are based on results from 81 subjects with arthralgia and without evidence of clinical arthritis in 66 joints examined. These patients were recruited from seven rheumatology outpatient clinics across The Netherlands between January 2010 and December 2013. The patients tested positive for IgM-RF, as well as ACPA (a-CCP2; Immunoscan CCPlus [Euro Diagnostica No RA-96plus] ELISA tests), and had never experienced inflammatory arthritis or been treated with a disease-modifying anti-rheumatic drug (DMARD). The subjects all had C-reactive protein (CRP) levels greater than 0.6 mg/L at screening (the lower limit of detection of the high-sensitivity CRP assay) or subclinical synovitis, as determined by ultrasound or MRI using gadolinium performed in the context of routine clinical care.
The subjects were randomized in a 1:1 ratio to receive either 1,000 mg of rituximab or placebo intravenously. Patients also received 100 mg methylprednisolone prior to treatment to prevent infusion-related adverse events. Randomization was stratified by age (older or younger than 40 years), as well as sex.