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Antibody Test Could Spot Rheumatoid Arthritis Early

FRIDAY, Nov. 9 -- If primary care doctors tested suspected rheumatoid arthritis patients for key antibodies before their first visit to a rheumatologist, it could help promote earlier diagnosis and treatment of the disease, British researchers report.

Patients with suspected rheumatoid arthritis are often tested for anti-cyclic citrullinated (anti-CPP) antibodies as part of their initial evaluation by a rheumatologist but not by the primary care doctor who may first have detected the condition, the researchers noted.

They retrospectively tested for anti-CPP in the blood samples of 98 newly-diagnosed rheumatoid arthritis patients. The blood samples hadn't been checked for anti-CPP before the patients' first visit with a rheumatologist. The researchers compared the actual treatment strategies without the anti-CPP results to treatment strategies proposed by three rheumatologists and a registered nurse who reviewed the patients' records and were given the retrospective anti-CPP test results.

The study found that prior knowledge of the anti-CPP results would have approximately doubled from seven to 13 the number of patients immediately discharged. It would also have halved (from 45 to 23) the number of patients given a trial of corticosteroids and have increased by 50 percent (from 19 to 28) the number of patients started on disease-modifying antirheumatic drugs (DMARDs) at the first rheumatologist visit. Earlier detection of the antibodies would have also led to a more intensive treatment regimen from the outset for eight patients.

"Having the results of this relatively inexpensive test available at the time of their first assessment of patients with a possible early inflammatory polyarthritis would allow rheumatologists to make a faster diagnosis and shorten the delay before treatment starts," lead investigator David O'Reilly, of West Suffolk Hospital, said in a prepared statement.

The study was expected to be presented Nov. 10 at the American College of Rheumatology meeting in Boston.

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Posted: November 2007