Rheumatoid arthritis treatment has been transformed twice in the past 25 years — first by TNF inhibitors and then by JAK inhibitor pills and other biologics. Most people now reach low disease activity or remission, and research is focused on choosing the right drug faster and on remission-induction strategies.
What's actually going on in research
Trials are testing newer biologics and JAK inhibitors, treatment strategies aimed at remission rather than just symptom control, drug tapering for people in deep remission, and treatments for difficult-to-treat RA. Researchers are also studying prevention in people with early signs and biomarkers, and the role of the gut microbiome.
Treat-to-target
Studies show that adjusting medications until inflammation markers reach a target leads to better long-term outcomes than treating symptoms alone. Trials are refining the right targets.
Drug tapering
For people in long remission, trials are testing whether biologics can be reduced or stopped without flares. The goal is fewer side effects and lower costs.
Prevention
People with anti-CCP antibodies and joint pain often go on to develop RA. Trials are testing whether early treatment can prevent the full disease.
What to know before you search
Eligibility often depends on disease activity, prior medications tried, joint damage on imaging, and antibody status (anti-CCP, rheumatoid factor).
What types of trials are currently open
- New medication trials — Testing biologic injections, JAK inhibitor pills, or new drug classes for rheumatoid arthritis.
- Therapy strategy trials — Testing different treatment combinations and approaches to reach remission faster.
- Tapering trials — Testing whether medications can be reduced or stopped in people in long remission.
- Prevention trials — Testing early treatment in people with positive antibodies or joint symptoms before full RA develops.
- Observational studies — Following people with RA to understand long-term outcomes and identify predictors of response.
Recently added Rheumatoid Arthritis trials
Rheumatoid Arthritis Remission Screening and Prospective Surveillance
HARMONICS is a prospective registry embedded in the routine clinical practice of the Early Arthritis Clinic and the Prospective Remission Clinic at Fondazione IRCCS Policlinico San Matteo, with an associated research biorepository of voluntarily donated biological samples. It is designed to collect and generate long-term longitudinal data from patients with early-treated rheumatoid arthritis (RA) who have achieved stable clinical remission with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and undergo treatment tapering or discontinuation according to local care pathways, following shared decision-making between the patient and the treating rheumatologist. Following enrollment in stable clinical remission, patients are monitored as part of standard of care at regular intervals using clinical, ultrasound, and radiographic assessments to evaluate disease activity and outcomes. Treatment modifications, including tapering, discontinuation, and re-treatment, are recorded longitudinally. Participants are followed in the registry from enrollment for up to 60 months, unless a disease flare occurs earlier. Patients experiencing a disease flare within the initial 60-month follow-up period undergo an additional 12 months of follow-up after flare. The registry aims to provide a comprehensive longitudinal framework of multimodal data to advance the clinical and pathophysiological understanding of remission phenotypes and natural disease trajectories, with the ultimate goals of: * optimizing risk stratification and therapeutic decision-making in patients with RA in remission; and * identifying and exploring novel targets for potential transformative therapies.
Effect of Roflumilast and Desloratadine as Add-On Therapy in Patients With Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory disease that causes joint pain, swelling, and disability. Although standard disease-modifying antirheumatic drugs (DMARDs) are effective for many patients, some individuals continue to experience active disease and inflammation. The aim of this study is to evaluate the effectiveness and safety of adding either roflumilast or desloratadine to standard DMARD therapy in patients with rheumatoid arthritis. Participants will be randomly assigned to receive either roflumilast, desloratadine, or placebo in addition to their usual treatment. The study will assess changes in disease activity, inflammatory biomarkers, and patient-reported outcomes over a three-month follow-up period. The results of this study may help identify new add-on treatment options to improve disease control in patients with rheumatoid arthritis.
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