In late 2019, the American College of Rheumatology (ACR) had its annual meeting and included information on guidelines for rheumatoid arthritis (RA) treatment and also mentioned interesting information based on updated research. Going forward, this information may initiate change in both treatment and research into medications.
Tapering May Not Be Wise
Every rheumatologist will have their own theories on how to best treat and address the maintenance of RA, which is influenced by treatment guidelines, their experience treating patients, and the unique issues a specific patient might face. One issue that has been debated for a while is whether patients who are stable on their medication should taper their dose. The benefits of tapering can include fewer risks of side effects, especially those that are dose-dependent, and in some instances, there can be less of a financial burden on patients, especially with more expensive medications. The downside of tapering a dose when a patient is otherwise stable is their disease may flare-up and returning to their previous dose of an effective medication may no longer be helpful. According to the ACR, the risk of flare-ups was approximately four times higher in those who tapered down to half their original dose.
Improved Research Into Treatments
Research into new RA treatments is important, but the quality of the research is in the spotlight. There are several groups of people that have been underrepresented in RA research, which can mean these groups benefit less from emerging treatments. For example, studies into new medications often have participants that lack enough diversity in race and age. Another concern is people with seronegative RA, meaning they are RF and anti-CCP negative, are often not included in research, although they are representative of 30% of people with RA. The lack of seronegative participants may explain why they may not experience similar benefits to medications already on the market and their disease may respond differently to treatment.
More Attention To The Lung/RA Relationship
As far as autoimmune diseases and their effects on organ systems go, most people only think about lupus as affecting other parts of the body. With more attention drawn to a link between some lung diseases and RA, not only does the information bring awareness to the possibility RA can affect many areas of the body, but more RA patients and their medical providers need to pay attention to signs of lung disease. Researchers have established a bidirectional relationship between RA and lung disease, meaning people with RA develop lung disease at significantly higher rates than the normal population. Additionally, those with lung diseases go on to develop RA at significantly higher rates.
Paying attention to what transpires from the ACR annual meetings can mean new approaches to RA treatment. Patients and doctors alike can benefit from increased awareness of new information and how it may affect current treatment decisions or additional conditions that should be on the radar. Contact a rheumatologist today to learn more.