theguardian.com
Scientists have discovered a jab that could prevent rheumatoid arthritis (RA), a development experts say could offer hope to millions at risk of the disease.
RA is a chronic disease that causes inflammation in the body and triggers pain in the joints. About 18 million people globally are affected by the condition, which can lead to heart, lung or nervous system problems, according to the World Health Organization.
It most commonly begins in middle age, but much younger people can also be affected. No treatment exists that can prevent the disease.
Now researchers have found that an existing drug for RA, which patients can inject into their stomach or thigh, could help slow its progression in those with early symptoms or stop it in its tracks altogether.
A clinical trial found abatacept to be “effective in preventing the onset” of RA. Researchers said the results, published in the Lancet, were “promising” and could be “good news for people at risk of arthritis”.
Abatacept is prescribed to people who already have RA, but a team led by King’s College London explored whether it could prevent it in those deemed at risk.
The drug – administered in hospital through a drip or at home with weekly injections – works by targeting the cause of inflammation.
Two hundred and thirteen patients were recruited from 28 hospital-based early arthritis clinics in the UK and the Netherlands. They were all evaluated to be at early risk of RA by researchers.
Of the total, 110 were given abatacept and the remainder assigned to a placebo group. The estimated proportion of patients remaining arthritis-free at 12 months was 92.8% in the abatacept group and 69.2% in the placebo group.
After two years, 27 (25%) members of the abatacept group had progressed to RA compared with 38 (37%) in the placebo group.
Prof Andrew Cope, of King’s College London, said: “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.”
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 trial also showed other outcomes of using abatacept, such as lower pain scores and higher quality of life measurements among patients.
One patient, Philip Day, 35, of Eltham, south-east 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.
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 three-year-old son and have a normal life.”
Prof Lucy Donaldson, of the charity Versus Arthritis, welcomed the findings, adding: “This research highlights how important it is to spot the early signs of arthritis to give us a chance at stopping it in its tracks, offering hope to thousands of people living with – or at risk of developing – rheumatoid arthritis.”