Decreasing Levels of IgM-RF and Anti-CCP with RA Treatment

From All Joints Considered, rheumatologists are starting to acknowlege that what patients have been saying might be true.  This is SO exciting! 

This may sound familiar to young Rheumatologists and will give seasoned Rheumatologists a feeling of “I told you so”. Here is the scenario: You are seeing a patient with RA, who was previously followed by a retired partner. The patient was diagnosed with RA in the 80’s or early 90’s and you can’t find a RF to speak of. By looking at the patient, you do not see any chronic deformities from RA. The patient has taken the same DMARD for several years. So, you question the diagnosis (as you have been trained to do). You order a RF and anti-CCP and they come back negative. Next, you suggest tapering and discontinuation of the DMARD and next thing you know they come back with horrendous synovitis.

Click here to read the remainder of the article (requires MedScape login).

The AF board occasionally has stories of people who dread moving because a new rheumatologist will run new labs, then discontinue DMARDs — with very very bad results.

My current rheumy repeated all the blood tests that my first rheumatologist ordered (plus a boatload of others).  How can CCP go from 175 to 4?  Rheumy says that doesn’t happen; the first lab must have been wrong.  Fortunately for me, she’s treating me based on symptoms, not based on lab values.  I’m sorta curious what would happen if I stopped all meds (but not so curious that I’m willing to be the guinea pig and actually try it).

It is exciting to see advances made in the understanding of RA.  Sure, a cure would be nice, but I’ll take whatever progress we can get.