RA drug may help stop disease progression in people at higher risk

Medical News Today Article By Dan Gray on February 15, 2024 — Fact checked by Jennifer Chesak, MSJ

Researchers in the United Kingdom are reporting that a drug used to treat rheumatoid arthritis (RA) may also proactively prevent the disease before it’s diagnosed.

In their findings, published in the medical journal The Lancet, a phase 2b clinical trial of more than 200 people in the U.K. and the Netherlands showed that abatacept – a drug used to treat RA – was also effective at preventing onset of the disease in at-risk people.

“In pretty simple terms, the drug reduced the rates of progression to RA by about 80 percent compared to placebo,” explained Dr. Andrew Cope, a lead study author and a professor of rheumatology and head of the Centre for Rheumatic Diseases at King’s College London. “There’s a subset for whom we’re just delaying the disease, but there’s another subset who continued to do well.”

 

Delaying or preventing rheumatoid arthritis

 

Abatacept, sold under the brand name Orencia, first received approval from the U.S. Food and Drug Administration (FDA) in 2005 and has been used as a treatment for people with moderate to severe RA.

Researchers said they were intrigued to find that the drug – delivered via weekly injection – showed promise as a preventative measure as well. In other words, it could delay the eventual progression to RA or hold it off altogether.

Cope told Medical News Today that it’s critical for clinicians and patients to recognize the early symptoms of RA, so they might be able to take steps to prevent it from getting worse.

“It’s crucial for physicians to understand and down the line for the regulators to understand as well that these people have symptoms,” he said. “It’s a disease. It’s just that it hasn’t evolved fully.”

Cope and his colleagues plan to continue their research in this area. One important area to sort out, says Cope, is risk stratification.

“We still need this because it will give us the confidence to say, ‘You’re going to get this disease, you need this drug.’ We’re not there yet,” Cope said.

“But what I can tell you is that as the immune system matures, people respond much, much better. There will be things we can measure that will give us the confidence that people are going to progress,” he added.

 

Living with RA

 

The study offers some hope that proactively prescribing abatacept could prevent RA in at-risk people.
However, this doesn’t change the fact that RA is a painful and all-too-common ailment.

Data from a National Health Interview Survey (NHIS), conducted by the U.S. Centers for Disease Control and Prevention, shows that more than one in five adults in the United States has been diagnosed with some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia.

Dr. Teja Kapoor, a rheumatologist and assistant professor of medicine at Columbia University Irving Medical Center in New York who was not involved in the study, told Medical News Today that she advises patients to monitor for early symptoms of RA.

These include joint pain and stiffness, joint swelling, fatigue, joint warmth, joint deformity, symmetrical symptoms (joints on both sides of the body), and systemic symptoms such as fever, lack of appetite, and weight loss.

“It’s important to seek medical attention if you are experiencing any of these symptoms, as early diagnosis and treatment can help manage RA and prevent long-term joint damage and disability,” Kapoor explained. “If you have concerns or suspect you may have RA, I encourage you to schedule an appointment with a rheumatologist for further evaluation and guidance.”

It’s possible to proactively manage your risk of developing RA through lifestyle interventions such as quitting smoking, maintaining a healthy weight, exercising regularly, and eating a balanced diet.

For those who’ve been diagnosed with RA, Kapoor emphasizes the importance of sticking to their treatment plan, as the best path forward often requires a combination approach involving medication, physical therapy, lifestyle modifications, and ongoing monitoring.

“While living with RA can be challenging, there are many effective treatment options available, and ongoing research continues to improve our understanding of the disease and develop new therapies,” Kapoor said. “Rheumatoid arthritis is a very different disease today than it was 50 years ago. With proper management and support, many patients with RA can lead fulfilling lives and maintain good joint function.”

 

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