“Family history of RA is not itself enough to change a clinical decision,” Dr. Frisell said. “We do not yet have evidence enough to be sure if a patient’s family history of response to specific treatments is predictive of treatment response, but our data was in line with this, and it may be expected from several genetic studies.”
Dr. Frisell’s message to patients: “The fact that you have ‘familial’ RA does not mean that you will have a more aggressive disease, or that it will be more difficult to treat.”
Dr. Jeffrey A. Sparks from Brigham and Women’s Hospital’s division of rheumatology, immunology, and allergy in Boston told Reuters Health by email, “There have been studies that show that familial RA occurs earlier and is more often seropositive, which typically has a more severe disease course. Given the size of this study, I was somewhat surprised that those with family history had fairly similar courses compared to those without family history.”
“However, there might be other differences that family history does not adequately measure or might even improve,” Dr. Sparks said. “For example, those with family history are already familiar with the signs and symptoms of RA so might present earlier when treatment is more effective. However, based on self-reported symptoms prior to RA diagnosis, this did not seem to explain the findings of this study.”
“Another previous study found that a particular gene controlling immune function was associated with worse outcomes in RA patients,” Dr. Sparks said. “While family history by itself did not correlate with worse outcomes in RA in this study, there may be particular genes or lifestyle factors that might be important in determining the disease course for RA.”
