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GPs should not rely on rheumatoid factor test to rule out arthritis

Family Doc

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A recent study suggests that GPs should not rely on rheumatoid factor (RF) test to rule out arthritis. Though RF test results are used in referral decisions, RF antibodies are only present in 8 out of 10 patients with arthritis and may not always show up in the early stages of the disease. Researchers found that people who received false negative test results waited over six weeks longer before being referred to an arthritis specialist.

According to GP Online, the researchers of the study were from the Universities of Oxford and Bath. They looked at data from the GP records of 64,000 patients who were given the RF test between 2000 and 2008. Of the 1,800 diagnosed with rheumatoid arthritis within two years, 800 showed a negative result on the RF test. Compared to those who had a positive test result in the RF test, patients with a negative result waited an average of 45 days more before referral.

In an interview with GP Online, Dr. Chris Deigton, president of the British Society for Rheumatology, cautions: “GPs should realize that the diagnosis of early inflammatory arthritis is largely a clinical one, relying on symptoms and signs of inflammation, rather than tests which may be misleading.”

In the December 2007’s issue of JointHealth™ monthly, Arthritis Consumer Experts highlighted the importance of a timely treatment for arthritis. Below are some of the concerns highlighted in the newsletter:

  • Research has proved that starting aggressive treatment for inflammatory arthritis within the first three months of disease onset is the best way to prevent irreversible joint damage.
  • Current guidelines recommend that treatments should be started within 6 months, with 3 months begin the ideal “window of opportunity”. Eighty seven percent of the delay occurred before referral to a rheumatologist.
  •  Numerous studies have shown that a class of arthritis medications called disease-modifying anti-rheumatic drugs (also known as “DMARDs”), can help to prevent joint damage if taken within the first three months of disease onset.