Rheumatoid Arthritis Research Provides New Insights on Risk Factors, Identification Tools, Intervention

The goal of all preclinical testing and risk assessment is to intervene earlier and manage RA more effectively, says Prof. Emery.

“Given the potential for a major change in the outcome of the disease, there is justification for earlier biomarker testing, although the research is relatively new,” he says. Early intervention strategies could include advising patients of how to modify known risk factors, like quitting smoking, losing excess weight, or treating periodontal disease or gut dysbiosis. A second, possible intervention strategy is to start disease-modifying drug therapy earlier, because systemic autoimmunity may begin well before clinical disease, Ms. Mankia and Prof. Emery say. Currently, trials of abatacept and rituximab to prevent arthritis development in the at-risk population are both in progress.

Early intervention—and potentially changing RA’s course—is now a “realistic goal,” says Prof. Emery. Communication with at-risk patients and other care providers who may see these patients before referral to a rheumatologist may help us reach this goal, he adds.

“Rheumatologists can encourage an earlier achievement of prevention by making people aware of the evidence now available, and using this information to develop links with primary care.”

Susan Bernstein is a freelance medical journalist based in Atlanta.

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