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Enbrel, Humira and Remicade can successfully treat painful, swollen joints due to rheumatoid arthritis, but the medications carry risky — and potentially fatal — side effects.

“The biggest side effect we worry about is infection because these drugs are immunosuppressants,” said Dr. Michael Ward of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. “People may have bronchitis and it may turn into pneumonia,” for example.

There’s also a link between long-term use of RA medications and an increased risk of lymphoma and leukemia.

That’s why Ward and other scientists at the National Institutes of Health (NIH) are launching a clinical trial to determine whether people whose RA is in remission can stop taking their medication.

About 300 people 18 and older will be enrolled in the randomized, blind trial. Participants will make six visits in one year to NIH in Bethesda, Maryland, and then a seventh and final visit a year later.

“Most of the visits are about a half hour. It’s a quick joint exam and questionnaire about symptoms and a blood test,” Dr. Ward said. The second visit, which lasts four hours, will include an x-ray and sonogram.

Who is eligible?

Patients are eligible for the study if their RA has been in remission for at least six months and if they are taking some RA medication in addition to Enbrel, Humira or Remicade (most patients also take methotrexate or Plaquenil).

Participants will be compensated $30 per visit (more for the ultrasound visit), and free parking is provided in addition to free lab tests, x-rays and medication. Free taxi service is available for D.C. metro residents.

After the first year of the study, patients can re-evaluate their medications with their rheumatologist to determine whether or not they should continue taking them.

Two study goals

The study has two main goals, Ward said. First, it will determine whether or not RA flares up without medication.

“Once people have been in remission a while, are we overtreating them? Can they get by just as well without medication?” Ward said. “We are trying to fine-tune the levels of treatment to the levels that their arthritis warrants.”

In addition, the study will analyze the immune system makeups of its participants to track patterns in remission and flare-ups, Dr. Ward said. “Are there subsets of people with a certain immune system makeup that can successfully come off the medication?”

For more information or to volunteer to enroll in the study, call (202) 877-6274 or (301) 451-4383.