Hope for thousands of Britons as miracle drug found to prevent rheumatoid arthritis in historic first

RA occurs when your immune system – which usually fights infection – attacks the cells that line your joints by mistake, making them swollen, stiff and painful.

It can affect adults at any age, but most commonly starts around middle age. About three times as many women as men are affected.

There's currently no way of treating the chronic disease, which affects around 18 million people worldwide.

Until now, the same was said about prevention. Now researchers say an existing drug for RA could help slow its progression in those with early symptoms or block its development altogether.

Abatacept is already used to treat RA, but researchers at King’s College London wondered whether the beneficial effects could extend to those at risk.

With that goal in mind, they recruited 213 participants with early symptoms of RA. The participants were then divided into two groups: 110 were given abatacept and the remainder were put on a placebo.

The estimated proportion of patients remaining arthritis-free at 12 months was 92.8 percent in the abatacept group and 69.2 percent in the placebo group.

After two years, 27 (25 percent) members of the abatacept group had progressed to RA compared with 38 (37 percent) in the placebo group.

The trial also found that people taking the drug had an overall better quality of life, less pain and lower levels of inflammation in the lining of their joints during ultrasound scans. The full results are published in the Lancet.

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.”

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Prof Lucy Donaldson, director for research and health intelligence at the Versus Arthritis charity, said that it “offers hope to thousands of people living with – or at risk of developing – rheumatoid arthritis”, adding that it “highlights how important it is to spot the early signs of arthritis to give us a chance at stopping it in its tracks”.

Philip Day, 35, a software engineer who took part in the trial said the treatment gave him “a ray of hope at a dark time”.
He said the pain caused by RA was “terrible” and “unpredictable”.

“It would show up in my knees one day, my elbows the next, and then my wrists or even my neck. At the time, my wife and I wanted to have children and I realised my future was pretty bleak if the disease progressed,” he said.

“Within a few months [of treatment] 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.”

How does the drug work?

Abatacept works by targeting proteins called cytokines, which are responsible for the inflammation caused by the immune system’s response.

In the case of abatacept, the cytokines being targeted are called ‘T cells’ - white blood cells that play various important roles in the immune system.

It's thought that abatecept inhibits the harmful T-cells that send the immune response into overdrive.
During the trial, the patients injected the drug into their stomach or thigh.

It's already available on the NHS as a last resort for patients who have been unresponsive to other arthritis treatments, such as disease-modifying anti-rheumatic drugs.

In light of the new findings, researchers are hoping the drug gets regulatory approval for a wider roll-out on the NHS.