A medication used for rheumatoid arthritis may also shield those considered at risk from developing the condition. Patients with arthritis have hope after learning that the biologic medication abatacept slows the progression of their excruciating chronic inflammatory illness. The results of a Phase 2b clinical trial were published today in The Lancet by researchers led by King’s College London.
Half a million people in the UK suffer from rheumatoid arthritis, which is characterized by joint pain, swelling, and severe disability brought on by the body’s immune system attacking itself. As of right now, there is neither a treatment nor a preventive measure for the condition, which primarily strikes in middle age but can strike at much earlier ages as well.
Now available as a drip injection administered weekly at home or in the hospital, abatacept is an excellent second- or third-line treatment for patients with established rheumatoid arthritis.
To find out if a biologic medication treatment for a year could stop the disease’s progression to rheumatoid arthritis, researchers from King’s College London enrolled 213 patients who were at high risk of developing the condition.
People over the age of eighteen who had early symptoms, such as joint pain but no swelling in the joints, were recruited. Every week for a year, half the participants received the medication, and the other half received a placebo. After the study medicine was discontinued, subjects were observed for an additional year.
6% of patients receiving abatacept experienced arthritis after a full year of treatment, while 29% of patients receiving a placebo experienced this side effect. At 24 months, the inequalities persisted; in the abatacept arm, a total of 25% had progressed to rheumatoid arthritis, compared to 37% in the placebo arm.
The largest rheumatoid arthritis prevention experiment to date, according to Professor Andrew Cope of King’s College London, “shows that a therapy licensed for use in treating established rheumatoid arthritis is also effective in preventing the onset of disease in people at risk.” Given that the medication not only delays the start of the disease during the treatment phase but also reduces symptoms like pain and exhaustion, these preliminary results may be encouraging for those who are at risk of developing arthritis. This is encouraging news for the NHS as well because the condition ages people and will get more expensive to treat as the population ages.”
In addition to lowering scores of inflammations of the joint lining that could be detected by an ultrasound scan, abatacept was linked to improvements in pain, function, and quality of life assessments, according to secondary study findings.
Rheumatoid disease posed a serious risk to Eltham resident Philip Day, 35, the founder of FootballMatcher and a software developer. Being an avid football player, Philip’s joint pain interfered with his daily activities and prevented him from playing. At the age of thirty, he was prescribed abatacept and entered the experiment in 2018.
He claimed, “My physical and mental health deteriorated to the point that I had to quit playing football due to the excruciating discomfort. It would start in my elbows one day, my knees the next, and then my wrists or even my neck. The agony was erratic. I knew that if the illness worsened, my wife and I would not be able to have children soon. Though I knew the agony would prevent me from fulfilling my dream, I had always wanted to be the kind of father who played football with his son.
Participating in the experiment made sense because it offered optimism during a difficult moment. I stopped having aches and pains after a few months, and after five years, I would say that I’ve recovered. I can now play football with my son, who is three years old, and lead a typical life.”
The NHS pays roughly £10,000 for each patient’s year of abatacept medication, which carries some risk. Although they are usually minor, side effects can include diarrhea, nausea, dizziness, and upper respiratory tract infections.
RA (Rheumatoid Arthritis), a disease that remains incurable despite great advances in its treatment in recent years.
When compared to the control group, which included many people with more advanced RA, the results unequivocally demonstrate that nearly all of the patients receiving the biologic medication during the treatment period exhibited no RA symptoms or signs. Remarkably, several seemed to enter remission throughout the one-year follow-up period after stopping treatment.
Naturally, the prevention of illness is a highly desirable goal in order to avoid the debilitating effects of RA, which entail a substantial financial and social cost. This significant study raises a lot of additional questions. Will this preventive method, for instance, be safe and economical if used over the long term, or is it possible to narrow down the acceptable groups to only include those who will most benefit from a brief course of treatment?”
Journal Reference
Kevin C. Zhang et al, Development and Validation of a Risk Score Predicting Death Without Transplant in Adult Heart Transplant Candidates, JAMA (2024). DOI: 10.1001/jama.2023.27029.
