From the Guidelines
Alpha-2-macroglobulin (A2M) is not recommended as a primary treatment for joint arthritis based on the most recent and highest quality evidence available, which prioritizes disease-modifying antirheumatic drugs (DMARDs) and other established therapies over emerging treatments like A2M. The 2017 update of the EULAR recommendations for the management of early arthritis 1 emphasizes the importance of early referral to a rheumatologist, prompt initiation of DMARDs, and the use of methotrexate as the anchor drug in patients at risk of persistent disease. While A2M may have shown promise in reducing pain and improving function in patients with osteoarthritis, the current evidence base does not support its use as a primary treatment for joint arthritis.
Key considerations in the management of joint arthritis include:
- Early referral to a rheumatologist and prompt initiation of DMARDs in patients at risk of persistent disease 1
- Use of methotrexate as the anchor drug in patients at risk of persistent disease 1
- Monitoring of disease activity and adjustment of treatment strategies to achieve clinical remission 1
- Consideration of non-pharmacological interventions, such as dynamic exercises and occupational therapy, as adjuncts to drug treatment 1
In contrast, the evidence for A2M in treating joint arthritis is limited and emerging, and more large-scale clinical trials are needed to establish standardized protocols and demonstrate its efficacy and safety in comparison to established treatments. Therefore, established therapies like DMARDs and other recommended treatments should be prioritized over A2M in the management of joint arthritis, with A2M potentially considered as an adjunctive or alternative therapy in specific cases where established treatments are contraindicated or ineffective.
From the Research
Efficacy of Alpha-2 Macroglobulin (A2M) in Treating Joint Arthritis
- The efficacy of Alpha-2 Macroglobulin (A2M) in treating joint arthritis has been studied in various research papers 2, 3, 4, 5, 6.
- A study published in 1991 found that neutrophils play a predominant role in the inactivation of A2M in arthritic joints, which could contribute to the progression of joint damage 2.
- In contrast, a review published in 2019 suggested that A2M has anti-inflammatory properties and can help preserve cartilage in patients with osteoarthritic knee pain, making it a potential treatment option 3.
- Another study published in 2000 found that A2M levels in serum and synovial fluid were not significantly related to inflammation activity in patients with rheumatoid arthritis or osteoarthrosis 4.
- Research published in 1984 detected A2M-associated proteases in the plasma of patients with rheumatoid arthritis, which could contribute to the inflammatory and autoimmune phenomena in the disease 5.
- A study published in 1990 found that A2M concentrations in synovial fluid were increased in patients with rheumatoid arthritis and were related to acute phase reactants, local inflammatory parameters, and joint damage 6.
Key Findings
- A2M has anti-inflammatory properties and can help preserve cartilage in patients with osteoarthritic knee pain 3.
- Neutrophils play a role in the inactivation of A2M in arthritic joints, which could contribute to joint damage 2.
- A2M levels in serum and synovial fluid are not significantly related to inflammation activity in patients with rheumatoid arthritis or osteoarthrosis 4.
- A2M-associated proteases are present in the plasma of patients with rheumatoid arthritis and could contribute to the inflammatory and autoimmune phenomena in the disease 5.
- A2M concentrations in synovial fluid are increased in patients with rheumatoid arthritis and are related to acute phase reactants, local inflammatory parameters, and joint damage 6.