People at high risk of developing rheumatoid arthritis (RA) may be able to postpone the disease for years if treated early, according to new research from King’s College London. The study found that one-year administration of the biologic drug abatacept significantly delayed the onset of rheumatoid arthritis, with effects lasting long after treatment ended.
Published in lancet rheumatologythis study expands on earlier clinical trial results reported by Dr. King researchers in 2024. The first study followed 213 participants from the United Kingdom and the Netherlands for two years. The latest analysis followed participants for four to eight years, making it one of the longest follow-up studies ever conducted in people at risk of rheumatoid arthritis.
Early treatment slows rheumatoid arthritis
Rheumatoid arthritis is a long-term autoimmune disease that affects around 500,000 people in the UK. This condition occurs when the immune system mistakenly attacks the joints, causing pain, swelling, fatigue, and, over time, permanent joint damage and disability.
People at risk of developing rheumatoid arthritis often experience difficulties even before they are diagnosed. Many quit their jobs before the disease has fully progressed, causing financial and employment hardship.
Although some treatments are available for people who already have rheumatoid arthritis, there are currently no approved treatments to prevent the disease in people known to be at increased risk.
Researchers found that participants who received abatacept for 12 months developed rheumatoid arthritis much later than those who received a placebo. In some cases, disease progression has been delayed by up to four years over the treatment period.
This drug could not completely prevent the development of rheumatoid arthritis. However, the results suggest that by intervening before the disease appears, it is possible to significantly change the course of the disease, potentially reducing the number of years people live with symptoms and associated complications.
Professor Andrew Cope, Professor of Rheumatology at King’s College London’s Center for Rheumatic Diseases and lead author of the study, said: “Early intervention in people at high risk of rheumatoid arthritis may have lasting benefits. This approach is safe and “We have shown that the disease can be prevented and symptoms can be significantly alleviated while patients are on treatment. Importantly, the onset of rheumatoid arthritis can be delayed for several years even after treatment is discontinued. This may shorten the time people live with symptoms and symptoms.” Reduce complications and significantly improve quality of life. ”
Maximum effects seen in patients at highest risk
The study found that abatacept is most effective in people who are most likely to develop rheumatoid arthritis. These individuals were identified through blood tests that detect specific autoantibodies associated with the disease.
Although this group faced the greatest risk of progressing to rheumatoid arthritis, they also experienced the greatest benefit from early treatment.
During the period before the onset of rheumatoid arthritis, participants who received abatacept reported improved symptoms such as joint pain and fatigue, as well as improved overall health. However, after treatment ended, symptom levels eventually became similar between the abatacept and placebo groups. According to the researchers, this suggests that continued immune system modulation may be required to maintain symptom relief.
Long-lasting effects and no new safety concerns
Researchers also reported that abatacept appears to be safe. Serious adverse events occurred at similar rates in both the treatment and placebo groups, and no new drug-related safety issues were identified.
The research team believes this finding strengthens the case for treating autoimmune diseases before they develop fully. Researchers say the results provide important evidence that targeted immunotherapy can slow rheumatoid arthritis in those most at risk and support further research into strategies to prevent autoimmune diseases.
