Rheumatoid arthritis causes chronic inflammation of multiple joints throughout the body. This joint inflammation eventually causes the cartilage and bone to break down, and the tendons and ligaments surrounding the joints stretch and become deformed. Consequently, people with rheumatoid arthritis experience pain and loss of function in affected joints.
Unfortunately, rheumatoid arthritis is not just a disease of joints. Rheumatoid arthritis also causes systemic inflammation. People with rheumatoid arthritis commonly experienced fevers, weight loss, and chronic fatigue. Many patients report being achy or stiff apart from joints directly affected by arthritis. Rheumatoid arthritis can cause bone loss, muscle weakness, skin lesions, and kidney disease. Patients may also experience lung, heart, and vascular diseases.
The cause of rheumatoid arthritis is unknown; however, since it is an inflammatory disease, the main treatment for rheumatoid arthritis is an anti-inflammatory medication. Some lifestyle changes may help to ease some of the symptoms but most physicians initially recommend using a disease-modifying antirheumatic drug or DMARD soon after rheumatoid arthritis is diagnosed. DMARDs can modestly reduce symptoms of rheumatoid arthritis and help reduce the risk of patients developing debilitating joint abnormalities. DMARDs include drugs such as methotrexate or biologics such as infliximab or tofacitinib. Patients with rheumatoid arthritis usually also must take glucocorticoids, i.e. steroids to acutely control inflammation. Unfortunately, these agents have considerable side effects, especially when taken for long periods of time. Moreover, the treatments are not curative. As such, researchers are still looking for better treatments for rheumatoid arthritis.
Scientists recently conducted a prospective Phase 1/2 study of umbilical cord mesenchymal stem cells in patients with rheumatoid arthritis. They selected 64 patients with rheumatoid arthritis between the ages of 18 and 64. Volunteers received an intravenous infusion of mesenchymal stem cells and were followed for three years. At both the 1 and 3 years follow up appointments, the rheumatoid arthritis patients treated with mesenchymal stem cells had substantially lower levels of the blood markers that indicate rheumatoid arthritis (namely C-reactive protein, elevated erythrocyte sedimentation rate, rheumatoid factor, and anti-CCP antibody). The test of physical function also significantly improved at 1 and 3 years after stem cell treatment [Health Index (HAQ) and Joint Function Index (DAS28)]. The treatment was also safe, and no serious adverse effects were reported.
The results of this stem cell clinical trial are particularly remarkable because patients received only one intravenous treatment and enjoyed at least three years of improvement in their disease both in the blood markers but also in symptoms and physical functioning. Although not a cure, this study shows the apparent safety of mesenchymal stem cell treatment and the impressive benefits to allow patients to consider researching stem cell therapy as an alternative option for their rheumatoid arthritis symptom management. Indeed, if additional larger studies confirm these impressive results, umbilical cord mesenchymal stem cell treatment may become a possible standard of care in the treatment of rheumatoid arthritis in the future.
Reference: Wang L, Huang S, Li S, et al. Efficacy and Safety of Umbilical Cord Mesenchymal Stem Cell Therapy for Rheumatoid Arthritis Patients: A Prospective Phase I/II Study. Drug Des Devel Ther. 2019;13:4331-4340. Published 2019 Dec 19. doi:10.2147/DDDT.S225613