Clinical trials are research studies that investigate newer and better ways to treat medical conditions, including rheumatoid arthritis (RA) treatments.
New therapies, new ways to use existing therapies, or comparisons between therapies are the most common subjects studied in current clinical trials, says Eric Ruderman, MD, a rheumatologist and professor of medicine in the division of rheumatology at Northwestern University's Feinberg School of Medicine in Chicago. "Trials are designed to look at both efficacy and safety for the treatments being studied.”
What Rheumatoid Arthritis Trials Have Discovered
Not every clinical trial yields positive results, but very important discoveries have been made, leading to better rheumatoid arthritis treatments and better pain management for people with severe rheumatoid arthritis symptoms.
"All current therapies for RA were developed in clinical trials," says Dr. Ruderman. So they've played a key part in advancing what experts know about rheumatoid arthritis and treating it. "Without these, we would not have any of the biologics, or methotrexate for that matter," he says.
Clinical trials even go beyond new treatments. They also show better ways to use existing treatments to get the most from them — for instance, how and when they should be administered for the best rheumatoid pain relief.
"Clinical trials have shown us the importance of early treatment and the importance of treating with a goal in mind, and have provided information on appropriate monitoring for different treatments," explains Ruderman.
Clinical Trials for RA: Pros and Cons
Clinical trials may not be appropriate for everyone, but may be right for people who struggle with finding relief from their rheumatoid arthritis symptoms: those who have tried every drug and every rheumatoid arthritis treatment yet still experience severe pain in their joints.
"For people who have not responded to existing treatments (a smaller and smaller number in recent years), clinical trials may provide access to newer, potentially effective treatments," says Ruderman.
Benefits for Others With RA
One important benefit of participating in clinical trials is to make life better not just for yourself, but also for other individuals with rheumatoid arthritis today and in the years to come. "There is an altruistic component to clinical trials, as this is the method that allows us to advance therapies in RA that may help others with this disease in the future," says Ruderman.
One significant point to keep in mind is that there is no guarantee that the rheumatoid arthritis treatment being tested will actually be better than what is currently available. "The caveat is that the newer treatment may not actually work, which is why the trial is done in the first place," Ruderman explains.
Don't Forget About Placebo Groups
There are possible negatives to consider before joining a clinical trial. First, even though you agree to participate, you may not actually get the new medication under review.
Trials often have a placebo group, so it's possible that participants may not be getting active therapy for some of the time. As we've learned the value of aggressive therapy for RA, the time frame for the placebo portion of the study has been shortened to the minimum possible time necessary to provide the scientific answer," says Ruderman. "Since disease activity is not always stable, it is typically important to have a placebo group to be sure that any improvement seen with the study treatment is not due to chance."
In addition to the drug not being effective for a particular individual, Ruderman says there's also the risk of unforeseen side effects — another reason clinical trials are necessary before a medication can be put on the market.
Should You Enroll in a Clinical Trial?
Your doctor may be able to tell you about current clinical trials. You can also search for clinical trials to see if any trials for which you meet the criteria are accepting applicants. "This site, which is sponsored by the National Institutes of Health, can be searched by disease, medication, or location," notes Ruderman.
There is no easy answer to the question of whether a clinical trial is right for you. Any consideration of joining a clinical trial requires a conversation between you and your doctor to weigh all the benefits and any possible risks associated with it. Ruderman says that patients considering participating in a rheumatoid arthritis trial should also consider any alternative treatments that might be more appropriate for you.