US researchers have identified several factors that predict which patients with early rheumatoid arthritis will experience worsening of their disease.
Predictors of worsening joint damage include
- older age,
- certain gene mutations,
- the presence of a protein called “rheumatoid factor”, and
- certain markers for old immune cells.
During the study period, 52 percent of patients were able to control their disease with standard drugs and did not need steroids, lead author Dr. Jorg J. Goronzy, from the Mayo Clinic in Rochester, Minnesota, and colleagues note.
48 percent of subjects had no evidence of joint erosions throughout the study.
Joint erosions present when the study began were also identified as a predictor of disease worsening on x-ray.
A high frequency of older immune cells was directly associated with the risk of worsening.
Although certain gene mutations seemed to raise the risk of deterioration, a mutation in a gene called uteroglobin actually seemed to lower the risk, the authors found.
There is a need to identify prognostic markers in order to make early treatment decisions in rheumatoid arthritis.
New markers, such as the uteroglobin gene, and biologic markers of (aging cells) show promise and warrant further investigation.