Rheumatoid arthritis (RA) is a chronic disease characterized by inflammation of the joints and is caused by the immune system mistakenly attacking healthy tissues, especially the synovial membranes that line the joints, causing inflammation, pain, swelling and, over time, can lead to bone erosion and joint deformity. It is estimated that around 300,000 people in Spain and more than two million in Europe suffer from this disease, which can also affect other organs and systems of the body, such as the skin, eyes, lungs and heart.
Although its exact causes are not known, it is believed that genetic, environmental and hormonal factors can significantly influence its development. Now, the results of a phase 2b clinical trial have opened a path of hope for patients at high risk of arthritis by demonstrating that the biological drug abatacept reduces the progression of this painful chronic inflammatory disease for which until now there is no cure or prevention.
Abatacept is already used today as an effective second- or third-line treatment for patients with established rheumatoid arthritis, and is administered by weekly injections at home or in hospital via a drip. The study was led by researchers at King’s College London, who selected 213 patients at high risk of developing the disease to determine whether a one-year treatment with this biological drug could prevent progression to rheumatoid arthritis. The findings have been published in The Lancet.
Prevent the development of rheumatoid arthritis in people at risk
Participants were men and women over 18 years old with early symptoms of RA, such as joint pain, but no joint swelling. They treated 110 of these people with the drug and 103 with a placebo every week for a year. The study medication was then stopped and participants were monitored for an additional 12 months.
After twelve months of treatment, 6% of patients treated with abatacept developed arthritis, compared to 29% in the placebo group. At 24 months, the differences were still significant, with a total of 25% progressing to rheumatoid arthritis in the abatacept group compared to 37% in the placebo group.
Secondary outcomes from the trial showed that abatacept was associated with improvements in pain, function, and quality of life scores, as well as lower joint lining inflammation scores detectable by ultrasound.
The drug has some side effects, including upper respiratory tract infections, dizziness, nausea, and diarrhea, but they are generally mild.
“This is the first trial to demonstrate that a therapy licensed for the treatment of established rheumatoid arthritis is also effective in preventing the onset of the disease in people at risk.”
“This is the largest rheumatoid arthritis prevention trial to date and the first to demonstrate that a therapy licensed for use in the treatment of established rheumatoid arthritis is also effective in preventing the onset of the disease in people at risk.” . “These initial results could be good news for people at risk of arthritis, since we show that the drug not only prevents the onset of the disease during the treatment phase, but can also relieve symptoms such as pain and fatigue,” said Andrew Cope, professor of Rheumatology at the School of Immunology and Microbial Sciences, and author of the study.
“This is also promising news for the NHS, as the disease affects people as they age and will become more expensive to treat with an increasingly aging population,” adds Cope. . And he concludes: “There are currently no drugs available to prevent this potentially disabling disease. “Our next steps are to understand those at risk in more detail so we can be absolutely sure that those most at risk of developing rheumatoid arthritis receive the drug.”
