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Cognitive function improved for RA patients treated with adalimumab

Patients with rheumatoid arthritis displayed significant improvement in cognitive function following treatment with adalimumab, according to study results.

In an open-label, pilot study, researchers in the United Kingdom reviewed 13 patients (mean age, 48.92 years; 12 women) with rheumatoid arthritis (RA), based on 1987 American College of Rheumatology criteria. Patients had not previously received anti-tumor necrosis factor therapies or had contraindications to cerebral MRI scans. Patients received 40 mg adalimumab every 2 weeks by subcutaneous injection. Before and 12 weeks into therapy, researchers administered Disease Activity Score 28 (DAS28); a fatigue questionnaire, Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F); a panel of psychometric tests to measure cognitive function; and MR perfusion imaging to gauge patients’ regional cerebral blood flow (CBF).

At baseline, patients displayed high levels of disease activity and fatigue. After treatment, patients showed gains in DAS28 (P=.002) and FACIT-F score (P=.002). Researchers also observed a direct correlation between baseline DAS28 and baseline FACIT-F (P=.018), along with an inverse relationship indicating increased patient age and reduced baseline FACIT-F score (P=.03).

Following therapy, significant gains in cognitive function were observed in scores for Full Scale IQ, Verbal IQ, and, in particular, Performance IQ (raw data, P=.004; normalized data, P=.002). Reduced fatigue after 3 months of therapy correlated with lower CBF in white (P=.014) and grey (P=.005) matter.

“Our small pilot study has demonstrated an apparent improvement in cognitive function with effective treatment of RA,” the researchers concluded. “We could not link changes to CBF with improved cognitive function despite a possible influence on fatigue. Future studies need to confirm and address the specificity of this treatment effect, as well as seeking earlier treatment-related changes to CBF.”

Disclosure: Researcher John D. Isaacs received a speaker fee from Abbott in 2010.