Treating rheumatoid arthritis (RA) early and aggressively is vitally important and can help to prevent crippling joint damage. Today specialists recommend a treatment plan that includes education, medication-often a combination of several different types of medication will be used in a person’s treatment plan-social support, appropriate amounts of range-of-motion, cardiovascular and muscle strengthening exercises, rest, vitamins and mineral supplements and a well-balanced diet. Biomarker tests may also help to detect RA and prevent further joint damage.
Rheumatologists test the blood for certain biomarkers that are characteristic of RA to detect RA and measure its progression. Several biomarker tests are available to test for inflammation, including the erythrocyte sedimentation (sed) rate, the C-reactive protein (CRP), and rheumatoid factor (RF); however, these tests are non-specific to RA. The Arthritis Today magazine provided a summary of more specific biomarker tests that can be used to diagnose and monitor RA disease activity (check with your rheumatologist to see if the tests listed below are available in your area):
- Polyglutamate Testing measures the effectiveness of methotrexate, a disease-modifying anti-rheumatic drug (DMARDs). When methotrexate enters the cells, it is converted to methotrexate polyglutamates. Arthritis Today magazine states that “because 30-40% of patients do not respond to methotrexate, the measurement of methotrexate polyglutamates in the blood may show if a person is being adequately or inadequately treated.” For this test, the measurement is taken three months after someone begins taking methotrexate. It will help rheumatologists understand earlier whether methotrexate works on the patient and enable them to develop a personalized dosage or determine if a change in medication is required.
- The multi-biomarker test Vectra DA is a blood test that measures 12 biomarkers of RA and helps to monitor disease activity and predict joint damage once RA has been diagnosed. It is the first test that measures multiple biomarkers for RA at once. It predicts joint damage and flares that correlates with ultrasound and MRIs (magnetic resonance imaging). Please note the test is only needed when there is uncertainty about how active the RA is of if the doctor is unsure whether to change medication.
- Antibodies of cyclic citrullinated peptides (CCP) are often present in the early stages of RA, even before clinical signs of RA appear. The Anti-CCP2 Test was developed by selecting the CCPs that best detected RA. It is a more sensitive and specific test, and therefore, more accurate.
- The Anti-MCV Test is a blood test that checks for antibodies to mutated citrullinated vimentin (MCV), a protein “that drives RA”. Because MCV antibodies are highly specific and may be detectable several years before the RA, it is a better predictor of aggressive disease or erosions. In most cases, the CPP test and MCV test are both given along with a test for rheumatoid factor.