Drug treatment shows promise for preventing rheumatoid arthritis
A number of injectable medications have been approved to provide some relief from rheumatoid arthritis. But researchers believe that one of them may actually prevent the disease from progressing, if given early enough.
A clinical trial found abatacept “effective in preventing the onset” of rheumatoid arthritis. The study was published in the journal The Lancet.
Abatacept is marketed as Orencia to treat symptoms. Rheumatoid arthritis is a chronic autoimmune disease that primarily affects joints. It occurs when, instead of protecting the body, the immune system attacks its own tissues, causing pain, swelling, stiffness and loss of function in the joints, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
The phase 2b clinical study was led by researchers at King’s College London. They recruited 213 study participants who were deemed high risk of developing rheumatoid arthritis to see if a year-long treatment with weekly injections could prevent progression to the full disease. Patients were then randomly assigned to receive the study drug or a placebo.
After 12 months, 6% of those who received abatacept had progressed to arthritis, compared to 24% who received a placebo. When they followed them for another year, the difference remained significant: 25% of those who received abatacept had arthritis, compared to 37% of those who received a placebo.
A King’s College London news release said the drug is “currently used as an effective second or third line treatment for people living with established rheumatoid arthritis and is given by weekly injections at home or in hospital via a drip.”
“This is the largest rheumatoid arthritis prevention trial to date and the first to show that a therapy licensed for use in treating established rheumatoid arthritis is also effective in preventing the onset of disease in people at risk. These initial results could be good news for people at risk of arthritis as we show that the drug not only prevents disease onset during the treatment phase but can also ease symptoms such as pain and fatigue,” said Andrew Cope, professor of rheumatology from School of Immunology & Microbial Sciences at the university.
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He added, “There are currently no drugs available that prevent this potentially crippling disease. Our next steps are to understand people at risk in more detail so that we can be absolutely sure that those at highest risk of developing rheumatoid arthritis receive the drug.”
The Guardian reported one study participant’s experience: “One patient, Philip Day, 35, of Eltham, southeast London, was enrolled in the trial in 2018 and prescribed abatacept. Joint pain had prevented the once-keen footballer from taking part in the sport.”
Per the article, “Day described the trial as a ‘ray of hope at a dark time.’ He added: ‘Within a few months I had no more aches or pains and five years on I’d say I’ve been cured. Now, I can play football with my 3-year-old son and have a normal life.’”
In the study, a year’s treatment cost 10,000 pounds, which is about $12,543 U.S. dollars. What the price in the U.S. would actually be is unknown. There can be side effects, including upper respiratory infections, dizziness, nausea and diarrhea, though they were described as generally mild.
The researchers said that “secondary outcomes for the trial showed that abatacept was associated with improvements in pain scores, function and quality of life measurements, as well as lower scores of inflammation of the lining of joints detectable by ultrasound scan.”
