DIY jab for achy joints could cut arthritis risk

A medicine licensed to treat rheumatoid arthritis can also help prevent the condition.

British researchers have found that giving the drug, which patients inject themselves at home, to those who don't have the disease but have symptoms that suggest they are at high risk – such as severe joint stiffness with no apparent cause – could keep it at bay slow down completely or significantly.

This would save many from the irreversible damage caused by rheumatoid arthritis, which can be disfiguring and disabling.

The condition, which affects around 600,000 people in Britain, occurs when the immune system attacks cells that line the inside of joints, such as the knees, hips, wrists and fingers.

This causes painful inflammation that makes the joints stiff, swollen and immobile. Other common symptoms include fatigue and fever, as the inflammation affects other parts of the body. It is not known what causes rheumatoid arthritis, but a family history is a key factor, while common infections such as colds or exposure to environmental toxins can also be possible catalysts for the malignant immune response.

A drug licensed to treat rheumatoid arthritis may also help prevent the condition (stock image)

British researchers have found that administering the drug can keep the drug at bay completely, or significantly delay its onset (stock image)

British researchers have found that giving the drug can keep the drug at bay completely, or significantly delay its onset (stock image)

Treatment includes anti-inflammatory painkillers, such as ibuprofen, and disease-modifying drugs (e.g. methotrexate) to slow disease progression.

Newer medications have come to market that can partially reverse some of the damage, relieve inflammation and restore mobility.

These include abatacept, which works by reducing the activity of immune cells involved in promoting joint inflammation.

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Abatacept (brand name Orencia) has been approved as a treatment since 2007 and comes in the form of a pre-filled, pen-like device that patients use at home to inject into their abdomen or thigh.

Meanwhile, JAK inhibitors – including upadacitinib and baricitinib – help by interrupting the signaling between cells that sends the immune system into overdrive.

But none are a cure – and they are not effective in 20 to 40 percent of patients.

Following earlier smaller studies suggesting that abatacept could help prevent rheumatoid arthritis, researchers from several British universities – led by King's College London – recruited more than 200 people at high risk for the condition.

The participants reported unexplained, frequent joint stiffness and pain, and had elevated levels of rheumatoid factor (a protein released by the immune system as it prepares to attack healthy joints) in their blood.

Research shows that 50 percent of patients with these symptoms develop full-blown rheumatoid arthritis within two years.

During the year-long study, half of the participants received a weekly injection of abatacept and the other half received a dummy drug with an identical injection device.

Results presented in October at the American College of Rheumatology conference in San Diego showed that a year later, ultrasound revealed that only 6 percent of patients taking abatacept showed signs of joint damage from rheumatoid arthritis, compared with 29 percent of those who received a placebo.

Treatment includes anti-inflammatory painkillers, such as ibuprofen, as well as disease-modifying medications (for example, methotrexate) to slow disease progression (stock image)

Treatment includes anti-inflammatory painkillers, such as ibuprofen, as well as disease-modifying medications (for example, methotrexate) to slow disease progression (stock image)

Researchers said the findings warrant large-scale studies to see if abatacept can help thousands of others prevent or delay rheumatoid arthritis. The research was funded by the drug manufacturer Bristol Myers Squibb.

Dr. Wendy Holden, honorary rheumatologist and medical adviser to the charity Arthritis Action, said: 'This is exciting news as it could delay or even stop some people from developing rheumatoid arthritis.'

But she warned that abatacept's side effects — including throat infections, headaches and nausea — could keep many otherwise healthy people from taking it for years, as many might not develop rheumatoid arthritis at all.

  • Fat cell punctures are used to treat knee osteoarthritis, where wear and tear damage in joints causes pain and stiffness. In a trial at the Rizzoli Orthopedic Institute in Italy, 200 patients will receive a single injection of cells from their abdominal fat into their affected knee – and be monitored for symptom changes for up to a year. Body fat (or adipose tissue) is rich in stem cells and growth factors that are thought to help regenerate damaged tissue.