Despite new therapeutics, progress for RA patients has virtually stalled over the past 10 years. In this article, the authors discuss many options to advance to a cure and the evidence for them, including the combination of low-dose methotrexate and anti-TNF; targeting angiogenesis and tissue damage pathways directly; antigen-specific therapy; potential combination of TNF and IL17 blockade; and targeting inhibitory receptors and regulatory T cells.

Early, Aggressive Therapy for RA May Result in Cost Savings Long Term
By considering the long-term damage from early, aggressive rheumatoid arthritis, researchers in the UK were able to develop a model demonstrating the long-term cost effectiveness of more aggressive combination therapies v. short-term treatments…
Depression May Increase Risk of Cardiovascular Disease for RA Patients
(Reuters Health)—Mental health problems, like anxiety and depression, may partly explain why people with rheumatoid arthritis have an increased risk of cardiovascular disease, according to a new study. Researchers linked anger, anxiety, depressive symptoms, job stress and low social support to increasing risk of hardening of the arteries, or atherosclerosis, for people with rheumatoid arthritis…
Oral & Gut Microbiomes Altered in Rheumatoid Arthritis Patients
NEW YORK (Reuters Health)—Patients with rheumatoid arthritis (RA) have alterations in their oral and gut microbiomes that partially normalize with treatment, according to results from a metagenome-wide association study. The microbiota influence metabolic and immune homeostasis, and microbial triggers have been postulated in RA, but little is known about the oral and gut microbiomes of…

RA Diagnosis Uses Lab Tests, Clinical Insight to Rule Out Lyme
What struck me first as I walked by the exam room where Lynn P. sat was the swelling in her fingers and wrists. The bloated hands rested unnaturally on her thighs, palms up, fingers slightly flexed. Her strawberry-blond curls were offset by a high-neck, loose-fitting, burgundy sweater. Her pale skin matched her trim slacks. She had…

Biosimilar Drugs for RA Studied in Multiple Trials
Etanercept Biosimilars A number of Phase 3 trials are ongoing for etanercept biosimilars.1 One evaluation identified three trials in rheumatoid arthritis (RA) patients and one in psoriasis patients. The psoriatic arthritis trial evaluated PASI as a primary endpoint and the following secondary endpoints: PASI50, PASI75, PASI90, PASI score, laboratory values, ECG, adverse events (AEs), injection…

EULAR 2015: RA Research Shows Imperfect Guidelines, Suggests Strategies with Biologics
ROME, Italy—Even with classification criteria that have been updated and refined over time, rheumatoid arthritis is still a diagnosis that ultimately has to be made with clinical judgment, said Ronald van Vollenhoven, MD, PhD, professor of medicine and chief of clinical therapy research in inflammatory diseases at the Karolinska University in Sweden. His remarks came…
Similar RA Outcomes with Abatacept & Tocilizumab
NEW YORK (Reuters Health)—Clinical outcomes of rheumatoid arthritis (RA) are similar with abatacept and tocilizumab treatment, but the factors that predict efficacy differ for the two agents. “The recommendations for RA treatment from the U.S. and EU describe the use of abatacept and tocilizumab as first-line biologics along with anti-TNF (anti-tumor necrosis factor) inhibitors,” Dr….

Heart Rate Variability to Predict Treatment Response in Patients with RA
A growing understanding of the immunomodulatory effect of the autonomic nervous system (ANS) is edging closer to having clinical applications that could one day benefit patients with rheumatoid arthritis (RA). Researchers pursuing this as an alternative path to biomarkers are investigating whether autonomic status can be used to predict response to therapy. Seattle-area rheumatologist and…
Knee Replacement May ‘Turn Back the Clock’ for Arthritis Pain
(Reuters Health)—Knee replacement surgery may significantly ease pain and improve leg function and quality of life in patients with osteoarthritis or rheumatoid arthritis (RA), a new study suggests. While surgery doesn’t restore the same level of comfort and function patients had in their younger years, before they developed arthritis, the authors write in the journal…
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