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Blood
Test May Predict
Rheumatoid Arthritis
Excerpt
by Serena Gordon,
HealthDay
The presence of certain antibodies in
the blood may signal the development of rheumatoid arthritis years
before symptoms begin.
That's the conclusion of a new
study published in the October issue of Arthritis and Rheumatism,
which found one-third of people with rheumatoid arthritis had
antibodies, called anti-CCP antibodies, in their blood long before
they ever felt the first symptoms of the disease.
Currently, doctors diagnose rheumatoid
arthritis based on symptoms and the presence of rheumatoid factor
in the blood. This means that most people aren't diagnosed with
the disease until they've had the disorder for some time. Additionally,
not everyone who has rheumatoid arthritis tests positive for rheumatoid
factor.
"The anti-CCP test may help
us detect patients who have early rheumatoid arthritis better
than rheumatoid factor, and it may also predict patients who have
more progressive disease," says Dr. Clifton O. Bingham III,
director of the Seligman Center for Advanced Therapeutics at the
NYU-Hospital for Joint Diseases in New York City.
More than 2 million Americans have
rheumatoid arthritis, according to the Arthritis Foundation. Nearly
three times as many women as men have the disease. The disease
begins most often in middle age, but can be seen in children and
young adults.
Common symptoms of rheumatoid arthritis
are joint stiffness, particularly in the small joints like those
in the fingers and wrists, joint pain and swelling. Bingham says
if you have joint stiffness when you first wake up and it lasts
for more than a half an hour, and this symptom has been occurring
for more than six weeks, you should be evaluated by a doctor.
In the current study, researchers
from University Hospital in Umea, Sweden, examined data from the
Northern Sweden Health and Disease Study and the Maternity cohorts
of Northern Sweden. They found 83 people who had donated blood
several years before being diagnosed with rheumatoid arthritis.
The researchers analyzed samples
of the blood taken from these 83 people before they had symptoms
of rheumatoid arthritis. The average time between when the blood
sample was taken and the diagnosis of rheumatoid arthritis was
2.5 years.
Thirty-four percent of the people
who developed rheumatoid arthritis tested positive for anti-CCP
antibodies. And the closer the blood samples were taken to the
onset of symptoms, the more frequently the blood tested positive
for anti-CCP antibodies.
When the researchers looked for
the presence of anti-CCP antibodies in conjunction with rheumatoid
factor, their ability to predict who would eventually develop
rheumatoid arthritis was nearly 100 percent.
Finding rheumatoid arthritis early
is very important, Bingham says.
"Joint damage and destruction
occur early in the disease process," he says, adding that
"a growing body of data is showing that early treatment will
lead to a better long-term prognosis."
Not everyone believes an additional
test is necessary, however.
Dr. Berj Nercessian, a rheumatologist
at William Beaumont Hospital in Royal Oak, Mich., says he doesn't
believe this test would help him diagnose rheumatoid arthritis
more efficiently.
"The diagnosis of rheumatoid
arthritis is based on a whole constellation of symptoms that are
present and by blood tests," says Nercessian. "The blood
test is just an additional test to confirm the diagnosis."
However, he does say it might be
helpful in situations where a diagnosis is not clear. For example,
he says that many times it's difficult to tell if someone has
lupus or rheumatoid arthritis, since many of the symptoms and
blood tests are similar. If anti-CCP antibodies are exclusive
to rheumatoid arthritis, then Nercessian says it could help doctors
distinguish between the two diseases.
But, he adds, whether these antibodies
are exclusive to rheumatoid arthritis is a question that still
needs to be answered.
Bingham says there are some limitations
to this test because some people who have rheumatoid arthritis
won't test positive for these antibodies and a few people who
do test positive may never develop rheumatoid arthritis.
Still, Bingham says, "the
anti-CCP antibodies test is going to be very useful as a diagnostic
test."
More information
To learn more about rheumatoid
arthritis, visit the Arthritis
Foundation or the National
Institute of Arthritis and Musculoskeletal and Skin Diseases.
Reference
Source 101
For more information on how to prevent other diseases, use
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