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Rheumatoid arthritis drug abatacept may also prevent the disease

By Dennis Thompson, HealthDay News
Abatacept eases symptoms and prevents joint damage in rheumatoid arthritis patients by dampening the immune system, researchers said. Photo by Adobe Stock/HealthDay News
Abatacept eases symptoms and prevents joint damage in rheumatoid arthritis patients by dampening the immune system, researchers said. Photo by Adobe Stock/HealthDay News

Philip Day loved playing soccer so much that the 35-year-old software engineer founded a website -- FootballMatcher.com -- to help people connect for pickup games.

The fun went on pause when Day developed joint pain so bad it kept him from his favorite sport.

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"The pain got so terrible I stopped going to football, and I got lazier and felt progressively worse physically and mentally," Day, who lives in the London district of Eltham, said in a news release.

"The pain was unpredictable," he recalled. "It would show up in my knees one day, my elbows the next, and then my wrists or even my neck."

But Day is now back to playing, thanks to a biologic drug that prevented him from developing full-blown rheumatoid arthritis.

Day participated in a clinical trial that showed the drug abatacept (Orencia) -- which is already used to treat diagnosed rheumatoid arthritis -- also can prevent people from progressing to the painful inflammatory disease.

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Abatacept eases symptoms and prevents joint damage in rheumatoid arthritis patients by dampening the immune system, researchers said.

About 1.3 million Americans live with rheumatoid arthritis, which occurs when the body's immune system starts attacking tissues in the joints, causing inflammation, pain and swelling.

Day's clinical trial showed that abatacept also is effective in preventing the onset of rheumatoid arthritis.

About 6% of patients treated with abatacept developed arthritis compared to 29% given a placebo following a year of treatment, according to clinical trial results published Tuesday in The Lancet.

"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," researcher Andrew Cope, head of the King's College London Center for Rheumatic Diseases, said in a news release.

"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," he continued.

For the clinical trial, researchers recruited 213 patients older than 18 at high risk of rheumatoid arthritis. They all had early symptoms like joint pain, but no swelling that would lead to a formal diagnosis.

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Rheumatoid arthritis most often begins in middle age, but also can affect much younger adults, researchers said.

"Enrolling in the trial was a no-brainer; it was a ray of hope at a dark time," Day said.

Half of the participants were treated with abatacept and the other half with a placebo every week for a year. The drug is given by weekly injections at home or in a hospital via an IV drip.

After a year of treatment, the drug was stopped and patients were monitored to see how many would develop rheumatoid arthritis.

After the full two years, 25% of abatacept patients had progressed to rheumatoid arthritis compared with 37% of those on a placebo.

"The results clearly show that during the treatment period almost all individuals receiving the biologic drug showed no symptoms or signs of RA compared with the control population," Ravinder Maini, an emeritus professor of rheumatology at Imperial College London who was not involved in the research, said of the clinical trial.

"In the follow up period of 1 year off treatment, it is interesting to note that some appeared to go into remission," he added.

Abatacept also improved patient scores on pain, function and quality of life, and reduced inflammation in joints detectable by ultrasound.

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"Within a few months I had no more aches or pains and five years on I'd say I've been cured," Day said. "Now, I can play football with my three-year-old son and have a normal life."

Abatacept isn't cheap, researchers noted. A year's treatment costs about 10,000 pounds in the U.K., equivalent to more than $12,500 in the U.S.

Side effects include upper respiratory tract infections, dizziness, nausea and diarrhea, although researchers said these symptoms are usually mild.

"There are currently no drugs available that prevent this potentially crippling disease," Cope said. "Our next steps are to understand people at risk in more detail so that we can be absolutely sure that those at highest risk of developing rheumatoid arthritis receive the drug."

The clinical trial was funded by Bristol Meyers Squibb, the drug's manufacturer.

More information

The U.S. Centers for Disease Control and Prevention has more about rheumatoid arthritis.

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