Treating people before rheumatoid arthritis (RA) fully develops might give them something rare in medicine: time. A new long-term study shows that for those at high risk, early treatment with abatacept can delay the disease's start for years. The benefits even continue after the drug is stopped.
This study from King's College London was published in The Lancet Rheumatology. It builds on earlier results from the same team in 2024.
Lasting Effects of Early Treatment
The original trial followed 213 people in the UK and the Netherlands for two years. This new analysis extends that follow-up to between four and eight years. This makes it one of the longest studies of people at risk for RA.
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Start Your News DetoxRA is a chronic autoimmune disease affecting about 500,000 people in the UK. It happens when the immune system attacks the joints, causing pain, swelling, tiredness, and long-term disability. People at risk often leave their jobs before symptoms even begin, which adds to financial stress.
While treatments exist for established RA, no approved therapy currently prevents the disease in those at risk.
Researchers found that the benefits of 12 months of abatacept lasted long after treatment ended. Participants who received the drug developed RA much later than those given a placebo. The disease's onset was delayed by as much as four years after treatment stopped.
Professor Andrew Cope, a lead author from King's College London, noted that early intervention can have lasting benefits. He explained that this approach is safe and can prevent the disease while patients are on treatment. It also greatly relieves symptoms and can delay RA onset for several years, even after treatment stops. This could reduce how long people live with symptoms and improve their quality of life.
Who Benefits Most
The study showed that abatacept worked best for individuals at the highest risk of developing RA. These people were identified using a blood test that finds specific autoantibodies.
Even though these individuals were more likely to get RA, they also gained the most from early treatment. During this at-risk stage, abatacept reduced joint pain and tiredness and improved overall well-being. However, after treatment stopped, symptom levels became similar between the treatment and placebo groups. This suggests that ongoing immune support might be needed to keep symptoms under control.
Researchers reported that abatacept was safe. Both the treatment and placebo groups had similar rates of serious side effects, and no safety concerns were linked to the drug.
These findings suggest that early, targeted immune therapy can delay RA onset in high-risk individuals. This supports more research into ways to prevent autoimmune diseases.
