Preventative Approaches in Rheumatoid Arthritis

by Lauren Taylor from In The Cloud Copy

Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease, which means that your body’s healthy cells are attacked by your body’s own immune system, leading to painful inflammation. RA mainly attacks the patient’s joints, but can also attack other tissues throughout the body such as the lungs, heart, and eyes. When the joint is attacked, the lining of the joint becomes inflamed, which causes joint tissue damage. To date, approximately 1.3 million Americans are currently living with RA.

RA is a chronic, currently incurable, disease. But while there isn’t cure for the disease as yet, researchers have found that interventions in the early stages of the disease tend to lead to better clinical outcomes for patients.

Biomarkers and Risk Factors Associated with RA

Researchers believe that RA is caused by both genetic and environmental factors. Smoking tobacco appears to be one of the leading risk factors. Other characteristics that seem to increase risk include age (onset of RA is higher in older patients), sex (higher incidence in females than males), genetics/inherited traits, early life exposures, and obesity. Some environmental exposures that point to the development of RA include exposure to silica/dust and pollution. Other risk factors that have been identified include obesity, diet, and smoking.

More recent findings suggest that having severe, chronic periodontitis may make an individual more susceptible to developing RA. Gut inflammation also appears to be another factor that could lead to RA development.

The biomarkers that are seen in RA are the anticitrullinated peptide antibodies (ACPA) and rheumatoid factor (RF). In blood testing, if these two are present, they may be indicative of development of RA in the future. There are also other autoantibodies that are being studied which may be predictive of the disease.

Preventative Strategies In RA

There is still a large knowledge gap in research in understanding which patients that are in a high-risk group need preventative interventions and which do not. Researchers are still studying the disease to better understand the course of the disease’s progression. This will help clinicians differentiate who may need intervention in order for it to actually be effective.

There have been studies into various pharmacologic interventions in the prevention of RA. One study, with glucocorticoids, was administered to patients who were experiencing undifferentiated arthritis. The glucocorticoids were given either orally or via an IM injection. Unfortunately, intervening with this medication did not yield any significant change in clinical outcomes for these patients.

Another study was administered to patients who were given an infusion of 1 g of rituximab. These patients all had a positive rheumatoid factor (RF) and were also showing some degree of inflammation. While this intervention did not show strong evidence of prevention of disease, it did appear to delay the onset.

There are currently clinical trials being conducted around the world to try to find pharmacologic preventions for the disease. Two noteworthy studies underway are with abatacept, in Great Britain, and a study using hydroxychloroquine, being conducted in the United States.

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