Can an approved arthritis drug stop early joint damage?
NCT ID NCT03747939
First seen Sep 11, 2026 · Last updated Sep 11, 2026
Summary
Researchers are testing whether apremilast helps people with early psoriatic arthritis that affects only a few joints. Participants have had symptoms for five years or less and still have joint pain and swelling despite stable treatment with NSAIDs or one conventional DMARD. The trial compares apremilast to placebo over 16 weeks, measuring who reaches minimal disease activity. About 310 adults worldwide are expected to take part.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- apremilast, an oral drug that tames inflammation
- What this could lead to
- If it works, apremilast could become a standard early treatment for people whose psoriatic arthritis affects only a few joints, helping them reach minimal disease activity before damage sets in.
- What could go wrong
- This is a phase 4 trial, so apremilast is already approved for psoriatic arthritis; the question is whether it helps this specific early, mild group. Some participants may not respond, and apremilast can cause diarrhea, nausea, and headache.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 4
Runs after approval, following long-term safety and how well the treatment works in everyday use.
- Participants
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310 people
The number who actually took part.
- Started
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Dec 2018
- Finished
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Jul 2023
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * ≥ 18 yrs, male or female subject * Subjects must have signs and symptoms of PsA ≤5 years duration at the time of the Screening Visit * SJC AND TJC must be \>1 and ≤ 4 * For all regions, the local Regulatory Label for treatment with apremilast must be followed. * Stable doses of protocol-allowed PsA medications * General good health (except for psoriatic arthritis) as judged by the Investigator, based on medical history, physical examination, and clinical laboratories. (Note: The definition of good health means a subject does not have uncontrolled significant comorbid conditions). * Comply with protocol-required contraception measures * Subject meets the Classification Criteria for Psoriatic Arthritis \[CASPAR\] Criteria for PsA at the Screening visit Exclusion Criteria: * Prior use of \>2 csDMARD to treat PsA * Prior exposure to a JAK-inhibitor and/or a biologic DMARD. * Use of intra-articular (IA) or intra-muscular (IM) glucocorticoid injection within 8 weeks before the Baseline Visit. * Use of leflunomide within 12 weeks of randomization. Subjects who stopped leflunomide and completed 11 days of treatment with cholestyramine (8 g, 3 x daily) prior to the Baseline Visit may enter the study. * Prior use of cyclosporine. * Prior treatment with apremilast, or participation in a clinical study, involving apremilast. * Use of any investigational drug within 4 weeks of the Baseline Visit, or 5 pharmacokinetic/pharmacodynamic half-lives, if known (whichever is longer).
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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AO Ospedale Policlinico Consorziale Di Bari
Bari, 70124, Italy
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Accurate Clinical Research Incorporated Baytown
Baytown, Texas, 77521, United States
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Advanced Rheumatology PC
Lansing, Michigan, 48910, United States
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Advanced Rheumatology of Houston
The Woodlands, Texas, 77382, United States
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Altoona Center for Clinical Research
Duncansville, Pennsylvania, 16635, United States
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Arizona Arthritis and Rheumatology Research, PLLC
Mesa, Arizona, 85202, United States
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Arthritis Group
Philadelphia, Pennsylvania, 19152, United States
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Arthritis and Osteoporosis Center of Southwest Ohio
Middletown, Ohio, 45044, United States
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Arthritis and Rheumatic Disease Specialties
Aventura, Florida, 33180, United States
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Arthritis and Rheumatology Center of Michigan
Lansing, Michigan, 48910, United States
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Arthritis, Rheumatic, and Back Disease Associates
Voorhees Township, New Jersey, 08043, United States
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Assistance Publique- Hopitaux de Paris AP-HP
Paris, 75013, France
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Azienda Ospedaliera Universitaria Federico II
Naples, 80131, Italy
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Azienda Ospedaliera Universitaria Integrata di Verona Ospedale G B Rossi Borgo Roma
Verona, 37126, Italy
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Azienda Ospedaliera Universitaria Pisana
Pisa, 56126, Italy
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Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
Brescia, 25123, Italy
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Baycare Medical Group Inc
Tampa, Florida, 33614, United States
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CH Toulouse Hopital Pierre-Paul Riquet
Toulouse, 31059, France
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Carol and Frank Morsani Center for Advanced Health Care
Tampa, Florida, 33612, United States
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Center for Clinical Studies
Webster, Texas, 92103, United States
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Center for Rheumatology, Immunology, and Arthritis
Fort Lauderdale, Florida, 33309, United States
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Centre Hospitalier Regional dOrleans
Orléans, 45067, France
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Centre Hospitalier Universitaire Brugmann
Brussels, 1020, Belgium
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Charite - Universitaetsmedizin Berlin, Campus Mitte
Berlin, 10117, Germany
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Clinical Pharmacology Study Group
Worcester, Massachusetts, 01605, United States
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Clinical Research Institute of Michigan
Saint Clair Shores, Michigan, 48081, United States
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Clinical Research of West Florida Inc
Tampa, Florida, 33606-1246, United States
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Clinical Research of West Florida, Inc
Clearwater, Florida, 33765, United States
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Clinical Trials Management LLC
Metairie, Louisiana, 70006, United States
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Covina Arthritis Clinic
Covina, California, 91722, United States
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Denver Arthritis Clinic PC
Denver, Colorado, 80230, United States
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Dr Sabeen Anwar Medicine Professional Corporation
Windsor, Ontario, N8X 1T3, Canada
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East Bay Rheumatology Medical
San Leandro, California, 94578, United States
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Eastbourne District General Hospital
Eastbourne, BN21 2UD, United Kingdom
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Encino Research Center
Encino, California, 91436, United States
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Erasmus Medisch Centrum
Rotterdam, 3015 CN, Netherlands
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Florida Center For Dermatology
Saint Augustine, Florida, 32080, United States
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Fondazione Policlinico Tor Vergata
Rome, 00133, Italy
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Graves Gilbert Clinic
Bowling Green, Kentucky, 42101, United States
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Health Research of Oklahoma
Oklahoma City, Oklahoma, 73103, United States
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Hopital Erasme
Brussels, 1070, Belgium
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Hopital Lariboisiere
Paris, 75010, France
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Hospital Galdakao-Usansolo
Galdakao, 48960, Spain
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Hospital Universitario Insular de Gran Canaria
Gran Canaria, 35016, Spain
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Hospital Universitario La Paz
Madrid, Madrid, 28046, Spain
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Hospital Universitario Ramon y Cajal
Madrid, Madrid, 28034, Spain
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Hospital Universitario de Cruces
Barakaldo, Basque Country, 48903, Spain
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Hospital de Merida
Mérida, 06800, Spain
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Humanitas Research Hospital Humanitas Mirasole
Rozzano MI, 20089, Italy
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IRCCS Ospedale San Raffaele
Milan, 20132, Italy
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Inland Rheumatology Clinical Trials Inc
Upland, California, 91786, United States
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Institut de Rhumatologie de Montreal
Montreal, Quebec, H2L 1S6, Canada
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Integral Rheumatology and Immunology Specialists
Plantation, Florida, 33324, United States
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Joint and Muscle Research Institute
Charlotte, North Carolina, 28204, United States
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Kazan State Medical University
Kazan', 420097, Russia
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Kerckhoff-Klinik gGmbH
Bad Nauheim, 61231, Germany
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Kings College Hospital
London, SE5 9RS, United Kingdom
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Klein and Associates MD PA
Hagerstown, Maryland, 21740, United States
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Klein and Associates MD, PA - Cumberland
Cumberland, Maryland, 21502, United States
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Klinikum der Johann Wolfgang Goethe-Universitaet Frankfurt/Main
Frankfurt am Main, 60590, Germany
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Krankenhaus Hietzing
Vienna, 1130, Austria
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Kursk Regional Clinical Hospital
Kursk, 305007, Russia
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Luton and Dunstable University Hosptial
Luton, LU4 0DZ, United Kingdom
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Manitoba Clinic
Winnipeg, Manitoba, R3A 1M3, Canada
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Mechnikov North-Western State Medical University
Saint Petersburg, 191015, Russia
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Medical Center Sanavita
Saint Petersburg, 197341, Russia
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Medisch Spectrum Twente
Enschede, 7512 KZ, Netherlands
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Millennium Clinical Trials
Thousand Oaks, California, 91360, United States
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Moscow Regional Research Institute n a Vladimirsky
Moscow, 129110, Russia
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Municipal Budgetary Healthcare Institution City Emergency Hospital
Rostov-on-Don, 344029, Russia
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New York University Langone Medical Center
New York, New York, 10003, United States
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North Georgia Rheumatology Group PC
Lawrenceville, Georgia, 30046, United States
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OrthoIllinois
Rockford, Illinois, 61114, United States
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Ottawa Hospital
Ottawa, Ontario, K1H 8L6, Canada
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Paramount Medical Research and Consulting LLC
Middleburg Heights, Ohio, 44130, United States
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Piedmont Arthritis Clinic
Greenville, South Carolina, 29601, United States
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Policlinico San Matteo Universita Di Pavia
Pavia, 27100, Italy
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Praxis fur Rheumatologie - Amberg
Amberg, 92224, Germany
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Precision Comprehensive Clinical Research Solutions
Colleyville, Texas, 76034, United States
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Providence Medical Foundation
Fullerton, California, 92835, United States
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RC Rsearch Inc
Hinsdale, Illinois, 60521, United States
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Republican Hospital na VA Baranov
Petrozavodsk, 185019, Russia
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Research Institute of Clinical and Experimental Lymphology
Novosibirsk, 630061, Russia
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Research Institute of Rheumatology named after V A Nasonova
Moscow, 115522, Russia
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Rheumatology Center of San Diego PC
San Diego, California, 92128, United States
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Rheumatology and Pulmonary Clinic
Beckley, West Virginia, 25801, United States
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Rheumazentrum Ruhrgebiet
Herne, 44649, Germany
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Rhode Island Hospital
Providence, Rhode Island, 02903, United States
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Robin K Dore MD Inc
Tustin, California, 92780, United States
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Royal Berkshire Hospital
Derby, DE1 2QY, United Kingdom
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Royal Cornwall Hospitals Trust
Truro, TR1 3LJ, United Kingdom
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Saint Paul Rheumatology PA
Eagan, Minnesota, 55121, United States
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Seattle Rheumatology Associates
Seattle, Washington, 98104, United States
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Service Rheuma Erfurt
Erfurt, 99096, Germany
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Texas Arthritis Center PA
El Paso, Texas, 79902, United States
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Tomsk Regional Clinical Hospital
Tomsk, 634063, Russia
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Torbay Hospital
Torquay South Devon, TQ12 3JX, United Kingdom
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Toronto Western Hospital
Toronto, Ontario, M5T 2S8, Canada
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Universita degli studi Messina
Messina, 98125, Italy
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Universitaetsklinikum Allgemeines Krankenhaus Wien Universitaetsklinik fur Innere Medizin I
Vienna, 1090, Austria
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Universitaetsklinikum Duesseldorf
Düsseldorf, 40225, Germany
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Universitaetsklinikum Tuebingen
Tübingen, 72076, Germany
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Universitair Ziekenhuis Leuven
Leuven, 3000, Belgium
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Universitatsklinikum Freiburg
Freiburg im Breisgau, 79106, Germany
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University Hospitals Cleveland Medical Center
Cleveland, Ohio, 44106, United States
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University of Florida College of Medicine
Gainesville, Florida, 32610, United States
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University of Rochester
Rochester, New York, 14642, United States
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West Tennessee Research Institute, llc
Jackson, Tennessee, 38305, United States
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West Texas Clinical Research
Lubbock, Texas, 79410, United States
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West Virginia Research Institute
Morgantown, West Virginia, 26505, United States
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West Virginia Research Institute
South Charleston, West Virginia, 25309, United States
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Western General Hospital
Edinburgh Scotland, EH4 2XU, United Kingdom
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Wolverhampton Road
Wolverhampton, WV10 0QP, United Kingdom
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Ziekenhuis Netwerk Antwerpen Jan Palfijn
Merksem, 2170, Belgium
More trials for these conditions
Other studies related to the condition(s) this trial covers.
- Nanobody injection put to the test against psoriatic arthritis
- New study to measure drug levels in breast milk of moms on TREMFYA
- New drug shows promise in taming psoriatic arthritis flares
- New injection targets psoriatic arthritis pain in small trial
- New study tracks arthritis drug persistence in daily life
- Scientists probe hidden pain pathways in arthritis