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Research on Division of Rheumatoid Arthritis into Two Types

Rheumatoid arthritis (RA) is a chronic autoimmune disease that remains a challenge to manage for both doctors and their patients for years. They have faced the challenge as more research on ways to manage its symptoms and progression is underway. However, recent studies in treatment and medications have brought about positive results and quality of life for patients ailing from the disease. However, emerging research has brought about different and divergent schools of thought to the matter.

Understanding Rheumatoid Arthritis and the Related Studies

Rheumatoid arthritis (RA) is a progressive condition in which types of antibodies produced by a faulty immune system attack a patient’s healthy cells, tissues, organs, proteins along the joints leading to their inflammation. The produced antibodies are referred to as autoantibodies and related to autoimmune system diseases.

A faulty immune system may be characterized by a defect in a patient’s immune system to identify its parts for protection and foreign bodies for an attack. This defect results in a dangerous attack of healthy parts of the body.

Fortunately, the research was conducted by researchers at Leiden University Medical center in the Netherlands, led by Dr. Xanthe Matthijssen and her fellow researchers. The research results of the 1993 to 2016 cohort got published under the journal release, PLOS Medicine.

The scientists have indicated that there are indications that RA may end up divided into two distinct categories: with and without autoantibodies. The article seeks to explore the evidence provided. Below are some of the pointers from the journal PLOS Medicine release:

  • Researchers indicate rheumatoid arthritis should end up divided into two diseases rather than one.

  • They propose the condition to get divided into two types based on patients with and without autoantibodies.

  • Patients with positive autoantibodies have proven to have improved long-term results in the management of rheumatoid arthritis symptoms.

Rheumatoid Arthritis (RA) and the Autoantibodies

In the recent past, researchers have concentrated on identifying the comparison between rheumatoid arthritis patients with autoantibodies evident in their blood and those not detectable. Those not detectable are referred to as autoantibody-negative RA (type 1 RA) and the opposite group being autoantibody-positive RA (type 2 RA).

Recent studies centered on RA autoantibodies have tried to identify the critical role played by immune proteins in the long-term healing and functional disability.

The Rheumatoid Arthritis Autoantibodies Research

According to the Leiden Early Arthritis Clinic, they analyzed 1,285 patients with rheumatoid arthritis (RA) between the period of 1993 to 2016. The research analysis focused on collecting annual data of the symptoms, mortality rate, treatments administered, presence of autoantibodies and, reported disability cases.

Out of the 1285 patients under analysis, 823 reported type 1 RA with 462 resulted in type 2 RA. Type 1 RA patients appeared to be younger with an average age of 55 years vis a vie type 2 RA whose first impression indicated they were old but with an average age of 60 years.

In both identified groups, disease activity improved after a while. A treat to target methodology was introduced- between 2006-2010- in both types of RA patients to analyze the rate of sustained disease-free remission (SDFR). Type 1 RA patients were observed to have an increased rate of SDFR but not identified in type 2 RA patients.

SDFR refers to a unique treatment goal of patients with Rheumatic Arthritis (RA), where the doctor aims at managing the disease progression. Arguably, Treat to Target is more effective since it encourages doctors to conduct frequent tests and be more vigilant. It works by altering an ineffective treatment plan. Moreover, applying a specific remission-based goal stands more useful to rheumatic arthritis patients than a change in the ACR test.

The analysis indicated a decrease in functional disability in type 1 RA patients with the opposite noted in type 2 RA. The introduction of targeted treatment adjustments played a crucial role in decreasing the mortality rate of type 1 RA patients. However, there was no identifiable effect on type 2 RA patients.

The study researchers and authors concluded that significant variance in observations between type 1 RA patients and type 2 RA patients shed more light on the difference between them. The disconnect between them concerning mortality rate, functional disability, and disease activity translates to the conclusion that pathogens in RA patients with and without antibodies are different.

The team proposes Rheumatic Arthritis to be officially categorized into type 1 RA and type 2 RA, with or without autoantibodies, respectively. They explicate that an official scientific subdivision of RA would pave-way for more fixated pathogenic research, treatment approaches easily adapted to disease type, and focused trials by disease type. Proposed changes contribute to exemplary personalized treatment and care for RA patients.

Dr. Matthijssen points out that "In the last decade, research in RA has largely focused on the autoantibody-positive subset. More research on autoantibody-negative RA is urgently needed to identify methods to improve their long-term outcomes."

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