“When a patient with RA comes in now, their immune system is on fire,” says Richard Keating, MD, a professor of rheumatology at the University of Chicago. “The researchers are working backwards and trying to figure out what started the fire. This will help unlock the pathway involved in how this disease occurs, and may open up new early treatment opportunities.”
Eric Matteson, MD, the chairman of the rheumatology department at the Mayo Clinic College of Medicine, in Rochester, Minn., calls the new findings “a step in the right direction,” but says that it is premature to conclude that a blood test can predict who will develop rheumatoid arthritis with any degree of certainty.
Many of the inflammatory markers measured in the study are not specific to rheumatoid arthritis, Dr. Matteson points out. They reflect “general immune system activation,” he explains, and could indicate a host of other inflammatory autoimmune diseases (such as lupus or psoriasis), or even a viral infection.
Still, he says, “It is exciting to think that…we could be alerted to the fact that [people] may go on to develop RA or another autoimmune disease.”
Blood tests that accurately identify the warning signs of rheumatoid arthritis could eventually help doctors tailor treatment plans to individual patients, Dr. Matteson adds. If researchers are able to pinpoint the blood markers of rheumatoid arthritis, doctors could use that information to assess the severity of individual cases and predict which medications are likely to be most effective for which patients, he says. (This approach is already used to treat other diseases, including some types of cancer.)
However, Dr. Ivashkiv stresses, the blood testing used in the study is not likely to be used by arthritis doctors in the near term. “It is another way of trying to identify patients with early RA, but it is not practical yet,” he says.