ARCTIC REWIND

Study on stepping up treatment for rheumatoid arthritis without loss of disease control.

Project managers

Professor | Center Director REMEDY

Espen A. Haavardsholm, specialist in rheumatology | PhD

Senior researcher | Vice Director REMEDY

Senior researcher Siri Lillegraven, MD PhD

Post doc

Specialist in Rheumatology | PhD

Nina Paulshus Sundlisæter

PhD fellow

Doctor in specialization

Kaja Kristiane Eriksrud Kjørholt

Nurse

Karen Holten

ABOUT THE PROJECT

Rheumatoid arthritis is an inflammatory disease that affects 0.5-1% of the population. The disease is characterized by joint swelling and pain, which can lead to joint damage and reduced functional level. With the use of modern treatment strategies, which include disease-modifying drugs, good disease control without signs of inflammation has become an achievable goal in an ever-increasing number of people. However, there has been no professional consensus or clear guidelines on how this group should be treated further; should one continue with a stable dose of drugs, or taper and possibly discontinue treatment?

ARCTIC REWIND is a randomized controlled multicenter trial with the primary objective of investigating whether a strategy of tapering and possibly discontinuing disease-modifying therapy is not inferior to continued stable treatment in terms of maintaining good disease control. In addition, the study will contribute much-needed data for research into more personalized treatment.

WHO CAN JOIN?

The study included adults with rheumatoid arthritis who had not shown signs of disease activity in the previous 12 months. Both recruitment and follow-up of those included have been completed.

WHAT DOES THE STUDY INVOLVE?

In one study arm, treatment was tapered and possibly discontinued, in the other, participants continued unchanged treatment. Both groups were followed with regular check-ups every 4 months for 3 years with thorough mapping of signs of flare-up of disease activity (clinical examination, blood tests and patient-reported outcome measures), as well as recording and management of potential side effects. In addition, ultrasound examination, X-ray of hands and feet, MRI of dominant hand and biobank were performed annually.

The study was divided into two; one part included people using synthetic disease-modifying therapy, the other included people using biological drugs (TNF inhibitors).