Two studies presented on June 13 in Amsterdam at the 2018 Annual European Congress of Rheumatology better understand — and perhaps even identify — which at-risk patients will develop rheumatoid arthritis.

“This is important because it will contribute to the development of early preventative strategies including potential pharmacological treatment to prevent the onset of disease,” said Robert Landewé, chairman of EULAR’s scientific program committee, in a news release.

In one study, researchers removed synovial — connective tissue surrounding joints — from the knees of 67 patients at-risk for rheumatoid arthritis and then observed whether those patients went on to develop RA. For 13 of the 67, the researchers looked at “gene signatures” and found molecular changes appeared in the synovial tissue before arthritis developed.

“The characterization of these gene signatures will enable us to better understand the pathophysiology of the preclinical phase of the disease and potentially identify novel drug targets for preventive intervention,” said principal investigator Lisa van Baarsen, of the Dutch Academic Medical Center, in the release.

In the second study, researchers led by Anne Musters, also of the Dutch medical center, examined a cohort of 129 rheumatoid arthritis-risk patients and validated prior findings that dominant B-cell receptor clones in the blood accurately predict imminent arthritis.

“Our data support a new biomarker that demonstrates better predictive power compared with
other available biomarkers evaluated so far,” Musters said in the release. “We think that peripheral B-cell receptor clones can be used to identify rheumatoid arthritis-risk individuals that will go on to develop arthritis, which will support the evaluation of early interventions to prevent the onset of disease.”

Over the course of two years, the researchers found that just 13 percent of the patients without B-cell receptor clones developed rheumatoid arthritis, while 76 percent of those with the clones developed RA. And within the latter group, 94 percent of those with 10 or more dominant B-cell receptor clones developed rheumatoid arthritis within three years.