A class of drugs that has been successfully treating patients with severe rheumatoid arthritis should be made available for moderate suffers, too, University of Manchester scientists say.

A study led by Dr. James Gwinnutt reveals that some rheumatoid arthritis patients who do not qualify for biological treatments on the NHS have high levels of disability caused by the condition. It is published in the journal PLOS ONE. The research, funded by Versus Arthritis, is part of the Moderate Disease Activity in Rheumatoid Arthritis Study (MODRAS) directed by Dr. Suzanne Verstappen from The University of Manchester.

Biologics are genetically engineered compounds which work on our immune system to reduce inflammation. They have revolutionized rheumatoid arthritis treatment since they were introduced in the late 1990s.

Using data from 1,274 patients from the British Society for Rheumatology Biologics Register—Rheumatoid Arthritis (BSRBR-RA), the team looked at disability scores over 3 years of patients with moderate disease activity receiving conventional treatments for rheumatoid arthritis.

The study of the BSRBR-RA, whose chief investigator was professor Kimme Hyrich, included researchers from the University of Manchester and King's College London.

The data revealed that over 3 years, some of the people with moderate disease that didn't fulfill the NHS criteria for biologic treatment had very high levels of disability. Previous randomized trials assessed by the team also showed that the treatments can help patients with moderate disease activity.

The NHS currently uses a disease activity score to assess if a patient is eligible for biological therapy treatment. The measure incorporates swollen and tender joint counts, a blood test of inflammation, and the patient's assessment of their disease. Only patients with a score greater than 5.1 who have undergone two failed conventional therapies are currently able to receive treatment with biologics.

Lead researcher Dr. Gwinnutt said, "Our study has shown that there is a definite mismatch between the levels of disability some patients endure and the criteria by which the NHS measures their eligibility for biological treatments. This research does seem to suggest that [...] this group of patients with moderate rheumatoid arthritis should be entitled to the biological therapies other suffers get. Better access to these successful drugs has the potential to change these peoples' lives for the better."