A new study from King’s College London has found that treating people who are at high risk of developing rheumatoid arthritis (RA) can delay the disease for several years.
This early treatment may also reduce symptoms and improve quality of life—benefits that can continue even after treatment ends.
The study looked at the effects of a drug called abatacept. This medication is a biologic therapy that works by calming down the immune system, which is overactive in people with RA. The study was published in The Lancet Rheumatology and builds on earlier trial results from 2024.
RA is a serious autoimmune condition that affects around half a million people in the UK. It happens when the immune system mistakenly attacks the joints, causing pain, swelling, tiredness, and long-term damage. Even before the disease fully begins, people at risk often experience pain and may have to stop working, which can affect their income and quality of life.
Currently, there are good treatments for people who already have RA, but no approved medicine exists to stop the disease from developing in the first place. This new research could change that.
In the original trial, 213 people from the UK and the Netherlands were followed for two years. The new study tracked them for up to eight years—making it one of the longest follow-up studies ever for people at risk of RA.
Participants took abatacept for just one year. Researchers found that those who took the drug were less likely to develop RA and had fewer symptoms during treatment. More importantly, even after they stopped taking the drug, they remained free of the disease for much longer than those who received a placebo. In some cases, RA was delayed by up to four years.
While the treatment didn’t completely stop RA, delaying its onset means people may live fewer years with joint pain, disability, and complications. This could make a big difference in their lives.
The study also found that abatacept worked best in people who were at highest risk for RA. These individuals were identified using a blood test that looked for certain autoantibodies—markers that show the immune system may be gearing up to attack the joints. These high-risk people benefited most from early treatment.
During the time they took abatacept, patients also had less joint pain, less fatigue, and felt better overall. However, once treatment stopped, their symptoms slowly returned to similar levels as those in the placebo group. This suggests that some people might need ongoing treatment to manage symptoms.
Importantly, the study showed that abatacept was safe. Serious side effects were rare and similar in both the treatment and placebo groups.
Researchers say the findings support more research into how to prevent autoimmune diseases like RA before they fully develop. The idea of treating people early—when they are just starting to show signs—could lead to better long-term health and fewer people living with painful symptoms.
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The study is published in The Lancet Rheumatology.
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