Rheumatoid arthritis can be prevented if the timing is right

Methotrexate shown to delay and prevent RA progression

Patients diagnosed with "undifferentiated rheumatoid" arthritis could actually have their disease outlook changed significantly if treatment is given at the right time, according to the results of a study presented at the Annual European Congress of Rheumatology on Wednesday, June 21, by Mrs. Henrike Van Dongen and her colleagues.

The PROMPT-study (Probable rheumatoid arthritis: Methotrexate versus Placebo Treatment-study) is a double-blind placebo controlled randomized multicenter trial in 110 patients with undifferentiated arthritis, which means they have arthritis but the exact diagnosis is undetermined. The aim of the study was to determine whether the patients would benefit from treatment with methotrexate (MTX). At the end of the study, patients were tested with a special antibody blood test (anti-cyclic citrullinated peptide antibody, anti-CCP) to confirm a diagnosis of RA, one of the most aggressive and debilitating forms of rheumatism.

The study concluded that, in the MTX group, fewer patients developed RA during the observed time and more patients reached remission than in the group receiving placebo. "This data is excellent news as it shows that methotrexate appears to delay or even prevent progression to rheumatoid arthritis amongst patients", said study investigator Professor Tom Huizinga, Rheumatology, Leiden University Medical Center, Leiden.

Methotrexate is an antimetabolite drug, which means it is capable of blocking the metabolism of cells, and is well established in the treatment of cancer and autoimmune diseases such as RA. It acts specifically by inhibiting the metabolism of folic acid. In rheumatoid arthritis, MTX seems to work, in part, by altering aspects of immune function which may play a role in causing the disease.

"One of the most interesting findings from the study was that the patients who benefited the most were the ones showing a positive anti-CCP test, which would in general terms show that a patient has a very high likelihood to develop full-blown RA. However, this study indicates that the progression to a full-blown disease amongst these patients could be influenced", noted Mrs. Dongen.

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Henrike Van Dongen was one of only 12 scientists to be awarded Clinical Science Winner at this year's Annual European Congress of Rheumatology as a result of this research. This work was also supported by The Dutch Arthritis Association.

For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress press office on:

Email: eularpressoffice@uk.cohnwolfe.com

Jim Baxter - Onsite tel: +44 (0) 7900 605652
Jo Spadaccino - Onsite tel: +44 (0) 7773 271930
Mia Gannedahl - Office tel: +44 (0) 20 7331 2325

Abstract number: OP0001

About EULAR

  • The European League Against Rheumatism (EULAR) is the organization which represents the patient, health professional and scientific societies of rheumatology of all the European nations.
  • The aims of EULAR are to reduce the burden of rheumatic diseases on the individual and society and to improve the treatment, prevention and rehabilitation of musculoskeletal diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with musculoskeletal diseases by the governing bodies in Europe.
  • Diseases of bones and joints, such as rheumatoid arthritis and osteoarthritis cause disability in 4 - 5 % of the adult population and are predicted to rise as people live longer.
  • As new treatments emerge and cellular mechanisms are discovered, the 7th Annual European Congress of Rheumatology in Amsterdam (EULAR 2006) brings together more than 10,000 experts - scientists, clinicians, healthcare workers, pharmaceutical companies and patients - to share their knowledge in a global endeavour to challenge the pain and disability caused by musculo-skeletal disorders.
  • To find out more information about the activities of EULAR, visit: www.eular.org.


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