Not all joints respond equally to rheumatoid arthritis treatment. A new study found that wrist and certain knuckle joints (MCP2 and MCP3) take longer to reduce swelling after starting biologic or targeted therapies, regardless of the drug class used. Experts suggest evaluating treatment response later when these joints are involved and considering targeted steroid injections to manage lingering inflammation.
Not all joints are created equal when it comes to rheumatoid arthritis (RA) treatment. A new longitudinal study using data from a Swiss registry found that swelling in the wrist and second and third metacarpophalangeal (MCP2 and MCP3) joints — the knuckles closest to the hand — resolved significantly more slowly than other joints in RA patients starting biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs).
The pattern held true across all major drug classes studied, including TNF inhibitors, JAK inhibitors, abatacept, IL-6 receptor inhibitors, and rituximab. Interestingly, right-sided joints also showed slower swelling resolution compared to left-sided joints.
Key Takeaways:
Why it matters: These findings suggest clinicians should adjust their timelines for evaluating treatment success when wrist or MCP2/MCP3 joints are involved — and may want to use bridging steroid injections to manage local inflammation while waiting for systemic therapy to take effect.
