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Keystone discusses potential window of opportunity in treatment of RA

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CLEVELAND — At the Biologic Therapies VII Summit, Edward Keystone, MD, FRCP(C), professor of medicine at the University of Toronto, discussed the potential window of opportunity in the management of rheumatoid arthritis based on disease duration.

“Do I believe in a window of opportunity? That is the question. Or, do I believe that earlier is just better? My answer is ‘yes,’” Keystone said. “Yes, means I do not know. There is not enough data for me to say one or the other, but there are data potentially for both.”

Edward Keystone

Keystone mentioned a study published in the American Journal of Medicine that evaluated early vs. delayed treatment in patients with recent-onset rheumatoid arthritis (RA). The study demonstrated patients with delayed treatment had a significantly higher disease activity as measured by Sharp score at 12 months and then at 24 months.

Keystone cited another study published in the Annals of Rheumatic Disease that showed disease activity and joint damage were significantly reduced in the group that was treated earlier.

He noted that study published in Arthritis Research & Therapy showed early RA is characterized by a distinct and transient synovial fluid cytokine profile. Another study published in Clinical & Experimental Immunology confirmed this finding, he said, but also showed synovial fluid expression of interferon gamma, interleukin (IL)-10 and IL-12 in early RA was no different from established RA. – by Will Offit

Reference:

Keystone E. Tailoring therapy based on disease duration: Is there a window of opportunity? Presented at: the Biologic Therapies VII Summit; April 4-8, 2017; Cleveland.

Disclosure: Keystone reports consulting for and being a member on the advisory committee or review panel for Merck; consulting for, being a member on the advisory committee or review panel for and teaching and speaking for AstraZeneca, Janssen and Pfizer; being a board member and consulting, teaching and speaking for Lilly; and consulting for Crescendo.