Study Suggests Treatment to Reduce the Risk of Developing RA

Treatment with abatacept for 6 months among patients who did not yet have a clinical diagnosis of rheumatoid arthritis (RA) presented with decreased  inflammation, clinical symptoms, and risk of development of RA in patients at high risk, according to a study published in The Lancet.

The clinical trial included 98 adults (71% women, average age 50 years) without a clinical diagnosis of RA, but who presented signs of suffering from the disease (pain without clinical signs of inflammation, but with detection of inflammation in the joints, bones, or tendons via magnetic resonance imaging [MRI]). Half the participants were given abatacept 125 mg and the other half were given a placebo every week for 6 months, followed by a 12-month observational period.

The primary outcome was the proportion of participants with any reduction in inflammatory MRI lesions at 6 months.

The findings indicated that 57% of patients on abatacept showed improvement, compared with 31% of the placebo group. At month 18 in the trial, 35% of the abatacept group and 57% of those assigned to placebo had progressed to full-blown RA. Also, 24% of the patients in the placebo group showed improvements of MRI inflammation compared to 51% of the patients in the abatacept group.

No deaths occurred during the study, and there were 12 serious adverse events in 14% of the patients in the placebo group versus 8% in the abatacept group.

After 1 year of the therapeutic intervention, its beneficial effects persisted, with less inflammation in the joints, fewer clinical symptoms, and lowered risk of developing arthritis, the researchers noted.

Reference:
Rech J, Tascilai K, Hagen M et al. Abatacept inhibits inflammation and onset of rheumatoid arthritis in individuals at high risk (ARIAA): A randomised, international, multicentre, double-blind, placebo-controlled trial. Lancet. 2024. DOI: 10.1016/S0140-6736(23)02650-8.