New arthritis research studies

11th February 2021

New arthritis research studies from St. Vincent’s University Hospital highlight importance of continued focus on understanding mechanism of inflammation, metabolism and joint damage to improve treatment options

Two new studies led by Prof. Doug Veale at SVUH offer new insights into treatment options for patients with RMD and RA disease

Study 1: Lower rates of COVID-19 symptoms shown in patients on one or more immunosuppressive medications

Rheumatic musculoskeletal disease patients (RMD) undergoing treatment are in part protected against Covid-19 infection according to a study released in December 2020 in PMC.

The study suggests that patients are in part protected through the disease-modifying anti-rheumatic drugs administered in the treatment or that the patients have taken extra care with measures of social distancing and hygiene.

The research was conducted amongst 1381 respondents via the Arthritis Ireland website between 28 April and 5 May 2020. 87.8% were female and 12.2% were male. The study also showed that:

• Adherence to RMD medications was reported at 84.1%
• Of those who adhered, 57.1% used HSE guidelines for information on medication use
• Of those who did not adhere to medication, infection was the most common reason for non-adherence
• Respondents with spondyloarthropathies had higher rates of COVID-19 symptoms than other RMDs

Study 2: Biologic therapies improve outcomes in arthritis patients with 91% in long-term remission

Patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) have excellent long term outcomes from biologic therapies. It is the first study to show a better response in PsA patients.

The study published in BMC in January 2021 was conducted among 403 patients (274 RA and 129 PSA).

Biologic therapies have greatly improved outcomes in RA and PSA – yet the ability to predict long term remission and persistence or continuation of therapy remains limited. This study compares clinical, laboratory and epidemiological characteristics of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients commencing Biologic disease modifying anti-rheumatic drugs (bDMARDs). Outcomes at 1 year and 12 years are reported

This is the first study that looks at the long term remission of these patients, comparing outcomes at 1 year and 12 years. It reveals that PsA patients have better outcomes with 60% v 34% (PsA v RA) at year one and 91% v 60% at year 12. Findings also show:

• The prevalence of inflammatory arthritis (IA) in patients with psoriasis, maybe over 10x higher compared with a general population estimate of 2 to 3%.
• A greater percentage of PsA patients achieve remission on bDMARD therapy compared to RA patients (91% v 60%, at 12 years).
• Both achieve higher frequencies of remission compared to previous analyses of csDMARD therapy alone.

Commenting on the studies, Prof Douglas Veale, said “These studies are reassuring during this unprecedented pandemic, that patients with rheumatoid arthritis taking disease modifying therapy are not at an increased risk of Covid-19 and should continue to take their medication. The long term data is also very important as it provides a measure of how useful these therapies continue to be over a 16 year period, suggesting good value to society and the exchequer, but also that they are well tolerated and very safe over this time frame”.