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Finding a cure for rheumatoid arthritis

Professor Tom Huizinga (LUMC) specialises in rheumatoid arthritis. He joined forces with alumni and the Natuurwetenschappelijk Gezelschap Leiden, a society that aims to share knowledge of the natural sciences and medicine, to explore the symptoms of the disease. With this form of arthritis the fluid in the joint stops working properly, causing rheumatoid tissue to develop that breaks down the bone. Almost two million people in the Netherlands suffer from a form of arthritis.

Rheumatoid arthritis

With rheumatoid arthritis, the oil fluid that should keep the joint supple stops working properly, causing rheumatoid tissue to develop that then breaks down the bone. The disease is more prevalent in women, and more than 75% of patients are female.

New insights

In the 1940s, rheumatoid arthritis was a very debilitating disease. New insights emerged in the 1990s and the early diagnosis of the disease and treatment with targeted therapy made it much less debilitating. The treatment was constantly adjusted until the patient began to feel better. Within ten years, this resulted in a significant reduction in the debilitating aspects of the disease and even recovery in ten percent of the patients.

Preventing rheumatoid arthritis

The next step is to prevent rheumatoid arthritis. Swedish data has shown that in the year before diagnosis there is already an increase in sick leave. This could help doctors identify and prevent the disease. Research among blood donors has shown that specific antibodies develop four years before diagnosis. Medication that inhibits the development of these antibodies by blocking the required co-stimulation between T-cells and B-cells appears to be very promising.

Treatment based on intuition

A study is currently underway in which patients are treated on the basis of the doctor’s intuition. Huizinga explains that experience leads doctors to develop a gut feeling about patients who do not meet the diagnosis criteria. If doctors think that such patients might have rheumatoid arthritis and their intuition proves right, they can be treated at an early stage. Of the group that tested positive for the antibodies and the inflammation, 35 percent developed rheumatoid arthritis. If these are selected on the basis of clinical considerations and tests and treated effectively for a whole year, this could prevent symptoms. Continuation of the clinical experiments, should provide a better understanding of the disease and enable doctors to provide targeted treatment.

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