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Charting Course on Early Rheumatoid Arthritis Treatment

HSS experts are doing research to make sense of rheumatoid arthritis at a cellular level. The hope of cultivating a more targeted approach to treating it. Forming a deeper understanding could also lead to advances in drug development. Rheumatologists Vivian Bykerk, MD, and Susan Goodman, MD, explain what makes this work so exciting.

Early Rheumatoid Arthritis

I’m a rheumatologist at HSS and my interest for many, many years has been rheumatoid arthritis, and in particular, early rheumatoid arthritis, and that’s because I think the earlier we find rheumatoid arthritis causes, diagnose it, identify it, and treat it, the better people do.

Reasons to See a Rheumatologist

Inside the Joint

Up until now, we really never looked inside the joint to determine what cells are there. We need to know what subtypes are there, how they’re interacting with each other, what they’re making. We’ve done a lot of work using some of our registries and looking retrospectively. One of the things that have become apparent was we really needed to look prospectively and gather our own data to really answer those questions.

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Setting up Consortium

We set up a consortium across the United States to do synovial biopsies of actively inflamed joints in RA. When we did that, we quickly learned that there are basically 4 cellular lineages that are acting in the cells. We want to know how do you translate that into ways to use the information clinically, and we’re just at the beginning of that.

Improving Clinical Outcomes

We’re both learning how to improve clinical outcomes as well as possibly identifying targets for other therapies. The applications of this sort of collaboration have been extraordinarily far-reaching.

The Future

I could see in the future that when we have these biopsies, or even if we take fluid out of the joint, the inflamed fluid, that there will be standard commercial assays that we use that characterize the type or subtype of rheumatoid arthritis and therefore, direct a person to use treatment A, B, C, D, or E.

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