Share on PinterestDrug treatment before rheumatoid arthritis sets in may delay onset, new research finds. Image credit: Maryna Terletska/Getty Images
- As of 2021, about 17.9 million people around the world were living with rheumatoid arthritis.
- There is currently no way to prevent rheumatoid arthritis, especially if it runs in your family.
- A new study has found that treating people at high risk of developing rheumatoid arthritis with a rheumatoid arthritis medication may help delay disease onset for several years.
As of 2021, about 17.9 million people around the world were living with rheumatoid arthritis, an autoimmune disease causing inflammation, pain, and swelling in the joints.
While the exact cause of rheumatoid arthritis is currently unknown, scientists believe that risk is based on a number of factors, including genetics and environmental factors like smoking.
There is also currently no way to prevent rheumatoid arthritis, especially if it runs in your family.
Now, a study recently published in the journal The Lancet Rheumatology has found that treating people at high risk of developing rheumatoid arthritis with a rheumatoid arthritis-specific medication may help delay disease onset for several years.
Early treatment with abatacept delays rheumatoid arthritis up to 4 years
This study builds upon a previous clinical trial conducted in March 2024, which looked at the use of the rheumatoid arthritis drug abatacept as a treatment for arthritis prevention after a 2-year follow up.
This new research extends the follow up to between 4 and 8 years.
At the end of this study, researchers concluded that the benefits of receiving abatacept therapy for 12 months went beyond the treatment period, as these participants took significantly longer to develop rheumatoid arthritis, when compared to those given a placebo, with disease onset delayed by up to 4 years after the treatment period.
While early intervention with abatacept didn’t completely stop rheumatoid arthritis, researchers believe this early treatment may help alter the course of the disease by delaying its development, helping to potentially lower the number of years a person has to live with this condition.
Early treatment most effective in participants with highest risk
Scientists also found that abatacept treatment was the most effective in participants with the highest rheumatoid arthritis risk, which was identified by detecting specific antibodies via a blood test.
Although these study participants had the highest chance of developing rheumatoid arthritis, they were also the ones that benefited the most from early abatacept intervention.
Researchers also reported that abatacept helped reduce symptoms like joint pain and fatigue with treatment during the at-risk phase.
And once treatment was halted, symptom levels turned similar to those between the treatment and placebo groups. According to researchers, this may suggest that continued immune modulation may be needed to maintain symptom control.
“Intervening early in people at high risk of [rheumatoid arthritis] can have lasting benefits,” Andrew Cope, PhD, a professor of rheumatology in the Centre for Rheumatic Diseases at King’s College London, in the United Kingdom, and first author of this study, said in a press release.
“We have shown that this approach is safe and can prevent disease while patients are on treatment as well as substantially relieve symptoms. Importantly, it can also delay the onset of [rheumatoid arthritis] for several years, even after treatment has stopped. This could reduce how long people live with symptoms and complications, drastically improving their quality of life,” Cope explained.
Not all high-risk people go on to develop arthritis
Medical News Today had the opportunity to speak with Arthur Kavanaugh, MD, professor at UC San Diego and rheumatologist at UC San Diego Health — who was not involved in this study — about these research findings.
“It is a critically important topic: How do we identify patients at risk of developing [rheumatoid arthritis] at the earliest possible stage,” Kavanaugh explained. “This study provides very good information. As with all good studies, it also raises further questions.”
“For many diseases, treatment is more efficient at the earliest stages,” he continued.
“Therefore, it is of great relevance to see the results of studies that treat patients with clinically suspect arthralgia (CSA) to see if [rheumatoid arthritis] can be prevented or delayed. The challenge is that a number of patients with CSA do not go on to develop [rheumatoid arthritis], so this raises ethical questions about treating patients to prevent a disease that they may never develop.”
– Arthur Kavanaugh, MD
From study findings to standard clinical practice
MNT also spoke with Orrin Troum, MD, a board-certified rheumatologist at Providence Saint John’s Health Center in Santa Monica, CA — who was also not involved in this study — about this research.
Troum recalled that his first reaction back in 2024 was of cautious optimism, seeing a “proof of principle” for a paradigm shift in treating patients at high risk for rheumatoid arthritis.
“After the 2026 publication, I see the extended results of the King’s College London APIPPRA trial as definitive proof for delaying the onset of autoimmune diseases,” he continued.
“While the original trial followed 213 participants from the U.K. and the Netherlands for 2 years, the new study reports outcomes from an extended follow-up period (between 4 and 8 years), making it one of the longest follow-up studies of its kind in people at risk of [rheumatoid arthritis],” Troum explained.
“The benefits of just 12 months of abatacept therapy persisted well beyond the treatment period and people who received the drug took significantly longer to develop [rheumatoid arthritis] than those given placebo, with disease onset delayed by up to four years beyond the treatment period,” he added.
Troum said that finding new ways to delay the onset of rheumatoid arthritis is critical because it addresses the lifelong burden of a chronic, incurable disease before irreversible damage occurs.
“Continued research into delay strategies is important for preserving joint function and mobility, improving quality of life, preventing systemic complications, sustaining employment and productivity, reducing long-term healthcare costs, and optimizing personalized medicine,” he detailed.
As for the next steps in this research, Troum said he would like to see these findings translated into standard clinical practice, saying: “Key research and implementation goals should include refining risk stratification, determining optimal duration, expansion of precision medicine, screening and referral infrastructure, exploring non-drug interventions, and digital and decentralized trial models.”
