Materiały źródłowe

• #1 Rheumatoid arthritis prevention – steps to reducing the risk for those at risk – Frazer Institute – University of Queensland

  https://frazer.uq.edu.au/article/2022/06/rheumatoid-arthritis-prevention-%E2%80%93-steps-reducing-risk-those-risk

  Quitting smoking and taking a daily walk can do more than just protect your heart, they also help protect from developing rheumatoid arthritis. […] These are two of 10 steps someone at risk can take to delay or prevent the onset of the often-debilitating autoimmune disease. […] What most people dont know is that there are some lifestyle changes you can make to reduce your risk of developing rheumatoid arthritis, Dr Koller-Smith said. […] In fact, new evidence shows that about 40 per cent of cases of rheumatoid arthritis are caused by lifestyle risk factors, which are things that you can change. […] But steps like quitting smoking, maintaining a healthy weight, exercising, adding more omega-3 or fish into your diet and cutting down on sugar-sweetened drinks lower your risk of rheumatoid arthritis.

• #2 Rheumatoid arthritis is a preventable disease: 11 ways to reduce your patients’ risk – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34553824/

  New evidence shows that up to 40% of rheumatoid arthritis (RA) cases are attributable to exposure to potentially modifiable factors. […] Counselling these patients to act to modify factors known to be associated with RA risk could prevent the development of RA, and evidence shows that informing individuals of their risk and of ways to reduce it leads to positive behavioural change and is not harmful. […] These evidence-based recommendations are: (i) cease smoking; (ii) reduce exposure to inhaled silica, dusts and occupational risks; (iii) maintain a healthy weight; (iv) increase leisure time physical activity; (v) maintain good dental hygiene; (vi) maximise breastfeeding if able; (vii) maximise dietary quality and avoid high-salt diets; (viii) consume high levels of omega-3 fatty acids and fish; (ix) reduce consumption of sugar-sweetened soft drinks; (x) consume moderate levels of alcohol; and (xi) remain vitamin D replete.

• #3 Pre-rheumatoid arthritis and its prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5473457/

  Pre-rheumatoid arthritis (pre-RA) is the preclinical period of the disease that precedes the onset of clinically apparent RA. […] Identifying and modifying risk factors such as smoking, periodontitis, obesity, viral infections, and hormonal or dietary factors will be useful in preventing RA in susceptible population. […] A number of environmental risk factors clearly contribute to RA susceptibility, including smoking, infections, periodontitis, obesity, and hormonal and dietary factors. […] Management of periodontitis may reduce the risk of developing RA. […] Prevention of RA by modifying environmental factors is emerging as a cheap and effective strategy to prevent RA.

• #4 Preventing rheumatoid arthritis: Steps to take

  https://www.medicalnewstoday.com/articles/rheumatoid-arthritis-prevention

  Rheumatoid arthritis (RA) has several risk factors that increase a persons chance of developing the condition. While an individual may not be able to prevent RA, they can take steps to help reduce their chances of developing it. […] Modifiable risk factors that a person can change include steps such as stopping smoking, maintaining a healthy weight, and more. […] To reduce the risk of developing RA, a person should avoid or quit smoking. […] Having obesity can increase a persons risk of developing RA. […] Exposure to pollutants and other environmental conditions may increase a persons risk of developing RA. […] Good dental hygiene and regular visits to the dentist may reduce the risk of developing gum disease that can increase the risk for RA. […] To help maintain a healthy gut microbiome, a person can try the following: Increase their intake of dietary fiber.

• #5 Steps to Take to Prevent Rheumatoid Arthritis

  https://www.verywellhealth.com/preventing-rheumatoid-arthritis-5096031

  Rheumatoid arthritis (RA) is a chronic autoimmune condition in which the body attacks its own cells, causing pain and inflammation. While there is no known way to prevent rheumatoid arthritis altogether, certain behaviors may help delay disease onset and minimize its impact on your quality of life. […] Smoking and exposure to cigarette smoke is a major risk factor for RA. One study found that the risk of developing RA was approximately twice as high for smokers as it was for nonsmokers. Quitting smoking and avoiding secondhand smoke might be helpful in preventing the development of RA. […] Some studies have found a protective effect among people who consume low to moderate levels of alcohol. In fact, long-term moderate alcohol consumption has been linked to lower RA risk in women. […] You can help prevent or slow down RA-associated bone loss by: Making sure your diet is rich in calcium or vitamin D, Engaging in weight-bearing exercise, Avoiding smoking, Taking supplements for bone health (after consulting with a medical provider) if these nutrients aren’t part of your diet, Getting guidance from your healthcare provider to avoid the progression of your RA, Avoiding long-term use of glucocorticoids.

• #6 Steps to Take to Prevent Rheumatoid Arthritis

  https://www.verywellhealth.com/preventing-rheumatoid-arthritis-5096031

  Environmental pollutants like chemicals used in cleaning and manufacturing have been shown to trigger a host of health problems—especially in people with certain genes. […] A 2015 meta-analysis indicated that breastfeeding for any length of time was moderately linked to a decreased risk of RA, with one study suggesting that women who breastfed were half as likely to develop RA. […] If you think you have RA or are at risk of developing the condition, talk with your healthcare provider. Early diagnosis and immediate and aggressive treatment with medications that help stop inflammation is key to preventing severe joint damage or damage to other organs. […] It’s not possible to prevent rheumatoid arthritis entirely, but a number of lifestyle factors that contribute to the risk of developing RA can be modified. Smoking, for example, is believed to be implicated in 20% of all RA cases. Choosing a healthier diet and higher levels of physical activity are some of the changes you can make to limit RA symptoms or slow the disease progression.

• #7 Rheumatoid Arthritis | Arthritis | CDC

  https://www.cdc.gov/arthritis/rheumatoid-arthritis/index.html

  Smoking can increase your risk of getting rheumatoid arthritis and can make arthritis worse. […] Smoking can also make it harder to be physically active, which is important for managing arthritis symptoms. […] It’s important to get diagnosed with RA as soon as possible so you can start treatment. […] Early treatment helps prevent symptoms from getting worse and doing damage to your joints. […] Besides medicines, there are things you can do on your own to manage RA. […] Be physically active. […] Keep a healthy weight. […] Avoid injuries to joints or doing activities that have repetitive motions like repeated knee bending. […] Stop smoking.

• #8 Rheumatoid arthritis prevention – steps to reducing the risk for those at risk – Frazer Institute – University of Queensland

  https://frazer.uq.edu.au/article/2022/06/rheumatoid-arthritis-prevention-%E2%80%93-steps-reducing-risk-those-risk

  These are things people can do themselves or in consultation with their GP, and apart from making a real difference in reducing the risk of autoimmune disease, these lifestyle changes also have positive overall health benefits. […] UQs Arthritis Queensland Chair of Rheumatology at the UQ Diamantina Institute Professor Ranjeny Thomas said while currently there was no cure for rheumatoid arthritis, taking preventive steps to reduce the risk of developing disease was the best way to reduce the need for lifelong medication. […] Here are 10 steps to lower your risk of rheumatoid arthritis. […] 1. Dont smoke […] 2. Eat a Mediterranean diet high in vegetables, fruit, olive oil, nuts and wholegrains. […] 3. Exercise 20-30 minutes a day […] 4. Avoid high salt in your diet […] 5. Add more fish and omega-3 to your diet

• #9 Steps to Take to Prevent Rheumatoid Arthritis

  https://www.verywellhealth.com/preventing-rheumatoid-arthritis-5096031

  To help prevent inflammation, keep your teeth and gums in good shape (to minimize the bad bacteria), and see your dentist regularly to prevent chronic oral health problems or infections that could trigger RA symptoms. […] Research suggests that eating fish several times each week may be protective against RA. […] A healthy diet can be beneficial when it comes to preventing RA. Obesity has been linked to the condition, and maintaining a healthy weight may reduce your risk of RA. […] People with RA should maintain good hygiene (including good oral health to prevent bad bacteria from causing inflammation) and talk to their medical provider about which vaccines they should get and when. […] Regular exercise—even low-impact exercise—can help with chronic disease prevention and reduces stress that can contribute to RA flares.

• #10 How to prevent rheumatoid arthritis – 12 preventative measures | King Edward VII’s Hospital

  https://www.kingedwardvii.co.uk/health-hub/how-to-prevent-rheumatoid-arthritis-12-preventative-measures

  High consumption of sugar-sweetened soft drinks can exacerbate rheumatoid arthritis symptoms. These beverages often lead to increased inflammation and weight gain, which puts additional stress on the joints. […] While moderate consumption may have some anti-inflammatory effects, excessive alcohol can exacerbate RA symptoms and interfere with medications. […] Environmental factors are often overlooked, yet they play a crucial role in influencing the risk and severity of rheumatoid arthritis. Notably, the interaction between genetic predispositions, such as the HLA gene, and environmental pollutants like dioxin and cigarette smoke can significantly increase the risk of developing RA. […] Oral health is surprisingly linked to rheumatoid arthritis. Poor dental hygiene can lead to periodontal disease, which is associated with an increased risk of developing RA.

• #10 How to prevent rheumatoid arthritis – 12 preventative measures | King Edward VII’s Hospital

  https://www.kingedwardvii.co.uk/health-hub/how-to-prevent-rheumatoid-arthritis-12-preventative-measures

  Smoking is a formidable adversary in the battle against rheumatoid arthritis. It not only heightens the risk of developing RA but also aggravates its symptoms, potentially leading to more aggressive joint damage. […] Diet plays a pivotal role in managing rheumatoid arthritis. Nutritious food can help reduce inflammation, a key culprit in RA, and support overall joint health. […] Regular exercise enhances joint flexibility, strengthens muscles supporting the joints, and reduces overall inflammation, alleviating RA symptoms. […] Excessive salt intake can exacerbate rheumatoid arthritis symptoms by promoting inflammation and fluid retention, which can increase joint pressure and pain. […] Omega-3 fatty acids, prevalent in fish, are known for their anti-inflammatory properties, which can be particularly beneficial for rheumatoid arthritis sufferers. They help reduce joint stiffness and pain.

• #11 Rheumatoid Arthritis and diet – BDA

  https://www.bda.uk.com/resource/rheumatoid-arthritis-diet.html

  Up to 75% of people living with RA believe diet plays a key part in their symptoms. […] Available evidence does not support dietary change as a substitute for medication but you may find these tips helpful. […] The most important relationship between diet and arthritis is weight. Excess weight can make some specialist medications ineffective. It may increase disease activity and delay remission. […] People with RA have a higher risk of developing heart disease than those who don’t have the disease. […] Reducing your intake of saturated fat and replacing it with a smaller amount of unsaturated fats may help to maintain normal blood cholesterol levels. […] Salt (sodium chloride) intake above 6g per day may promote inflammation due to changes in the immune system. […] In addition to their heart health benefits, fish oils have been shown to help dampen general inflammation and may help to reduce joint pain and stiffness.

• #12 11 Risk Factors for Rheumatoid Arthritis and How to Reduce Your Risk | Arthritis Foundation

  https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/11-risk-factors-rheumatoid-arthritis-reduce-risk

  You can take measures to help prevent this autoimmune disease. […] A healthy lifestyle can help prevent RA, no matter what your genetic risk. Some rheumatologists say the new paradigm for RA is to treat it as a preventable condition, much like heart disease, in part because its possible to control some common risk factors, including: […] Smoking. Tobacco smoke is a known risk factor for RA as well as heart disease and a host of other chronic conditions. […] Obesity. Excess weight can trigger systemic inflammation because fat cells release inflammatory proteins called cytokines, which play a fundamental role in the destruction of joint tissue. […] Food. Although there is no specific arthritis diet, the type of food you eat affects every aspect of your health. Avoiding some foods, such as red meat, dairy products, sugar and high-fructose syrup, and emphasizing fish, vegetables and olive oil, may make a difference in whether you develop arthritis as well as improve existing symptoms. […] Given that these and other risk factors for RA are within your control, you have every reason to feel positive about your ability to help you and your family stay healthy.

• #13 Can You Prevent Arthritis?

  https://www.healthline.com/health/arthritis-prevention

  Maintaining the recommended weight for your age and height can help ease arthritis pain and potentially reduce your chances of developing the condition. […] According to the Arthritis Foundation, losing just 1 pound of body weight may relieve 4 pounds of pressure on the knees in people with knee OA. […] Exercise relieves the stress of excess weight on joints and strengthens the muscles around them. […] Different types of exercises may have different effects on your body. Experts recommend you engage in all of these if possible: […] To reduce the risk of injury, always warm up before playing sports and use the proper safety equipment. […] Using the right techniques when you sit and lift can help protect your joints from everyday strains. […] Some of these germs can also affect your joints and trigger some types of arthritis.

• #14 Can You Prevent Arthritis?

  https://www.healthline.com/health/arthritis-prevention

  A strong association also exists between periodontitis (a severe infection of the gums) and RA symptoms. […] Its not always possible to stop arthritis, but you can slow its progression by maintaining a balanced lifestyle. This includes maintaining a moderate weight, exercising regularly, protecting your joints from injury, and managing your blood sugar. […] Its not always possible to prevent arthritis, but some lifestyle modifications could reduce the chance of severe arthritis symptoms and complications.

• #15 Rheumatoid arthritis prevention – steps to reducing the risk for those at risk – Frazer Institute – University of Queensland

  https://frazer.uq.edu.au/article/2022/06/rheumatoid-arthritis-prevention-%E2%80%93-steps-reducing-risk-those-risk

  6. Cut down on sugar-sweetened soft drinks […] 7. Only moderate alcohol consumption […] 8. Avoid exposure to inhaled silica dusts, and wear protective equipment if in contact with them […] 9. Keep your teeth happy! Brush, floss and treat any tooth or gum disease […] 10. Maintain vitamin D in a healthy range.

• #16 RA Prevention and Treatment | PCE

  https://practicingclinicians.com/activities/internal-medicine/ra-prevention-and-treatment/100009380/content

  Rheumatoid Arthritis Prevention and Treatment: My Top Studies From EULAR 2020 […] In thinking about the natural history of RA, we now have an established concept of the continuum between genetic risk, environmental risk, and the development of clinical disease. […] At EULAR 2020, there were numerous virtual abstracts that, I think, put this continuum and the potential implications for prevention at the forefront of current research. […] These interesting results suggest that intervening with dental hygiene may be one way to reduce or retard progression to RA in at-risk patients. […] We should not allow patients to endure years without optimal treatment. […] Clearly, the data on ultrasound demonstrate that we have a relatively straightforward screening test that can improve our identification and management of at-risk patients. […] Further support of this concept came from Garcia-Montoya and colleagues, who reported that at-risk patients who progress to inflammatory arthritis have higher levels of interferon-stimulated gene expression prior to clinical synovitis and ultrasound signal.

• #17 How to prevent rheumatoid arthritis – 12 preventative measures | King Edward VII’s Hospital

  https://www.kingedwardvii.co.uk/health-hub/how-to-prevent-rheumatoid-arthritis-12-preventative-measures

  Vitamin D is essential for bone health and has anti-inflammatory properties, which can help alleviate RA symptoms. Vitamin D deficiency is also linked to an increased risk of autoimmune diseases, including RA. […] Stress management is a vital, yet often overlooked, aspect of living with rheumatoid arthritis. Chronic stress can exacerbate RA symptoms by triggering inflammation and pain. Effectively managing stress can lead to better disease control and an improved quality of life. […] Rheumatoid arthritis is a chronic and progressive condition, notorious for leading to significant joint damage if left unchecked. Initial symptoms often manifest as morning stiffness, typically easing within an hour. This early sign should not be overlooked. If you suspect that you might be developing rheumatoid arthritis, or if you’re at an increased risk, it’s crucial to consult with your healthcare provider promptly. Initiating early and aggressive treatment is paramount in halting inflammation, a key factor in preventing extensive joint damage or harm to other organs.

• #18

  https://www.who.int/news-room/fact-sheets/detail/rheumatoid-arthritis

  Several key prevention strategies have been proposed to prevent rheumatoid arthritis and control the disease progression. In particular, reducing exposure to inhaled silica, dusts and occupational risks, and lifestyle related behaviours (e.g., prevention of/stop smoking, healthy nutrition, physical activity, maintaining a normal body weight, maintaining good dental hygiene) play an important role. Some evidence also suggests breastfeeding may be protective to the mother. […] Early diagnosis and management can reduce symptoms, slow the disease and prevent disability. […] It is important to keep a healthy lifestyle. Education and counselling are important to help people manage their symptoms and work-related tasks. […] Education and support help people with rheumatoid arthritis to develop strategies to cope with the disease. It is important to maintain a healthy lifestyle with regular physical activity and a nutritious diet.

• #19

  https://www.nhs.uk/conditions/rheumatoid-arthritis/

  A flare can be difficult to predict, but with treatment it’s possible to decrease the number of flares and minimise or prevent long-term damage to the joints. […] Diagnosing rheumatoid arthritis quickly is important, because early treatment can prevent it getting worse and reduce the risk of joint damage. […] However, early diagnosis and appropriate treatment enables many people with the condition to have periods of months or even years between flares. This can help them to lead full lives and continue regular employment. […] Making sure that rheumatoid arthritis is well controlled can help to reduce your risk of these complications.

• #20 Preventing rheumatoid arthritis: Steps to take

  https://www.medicalnewstoday.com/articles/rheumatoid-arthritis-prevention

  Early treatment can help: suppress disease activity, provide relief from symptoms, prevent joint damage, achieve drug-free remission. […] There is no way to prevent RA, but a person can take some steps to help reduce their risk. This includes avoiding or quitting smoking, achieving and maintaining a healthy weight, and avoiding high levels of air pollution when possible.

• #21

  https://www.nhs.uk/conditions/rheumatoid-arthritis/treatment/

  Treatments for rheumatoid arthritis can help reduce inflammation in the joints, relieve pain, prevent or slow down joint damage, reduce disability and enable you to be as active as possible. […] Although there’s no cure for rheumatoid arthritis, early treatment and support (including medicine, lifestyle changes, supportive treatments and surgery) can reduce the risk of joint damage and limit the impact of the condition. […] There are medicines available to help stop rheumatoid arthritis from getting worse and reduce your risk of further problems. […] DMARDs work by blocking the effects of the chemicals released when your immune system attacks your joints, which could otherwise cause further damage to nearby bones, tendons, ligaments and cartilage. […] Once you and your doctor find the most suitable DMARD, you’ll usually have to take the medicine long term.

• #22 Rheumatoid arthritis prevention: any takers? | RMD Open

  https://rmdopen.bmj.com/content/7/1/e001633

  Our understanding of biological mechanisms operating at articular and extra-articular sites in individuals at risk of rheumatoid arthritis (RA) has increased significantly over recent years. […] This has opened up an agenda for research on possibilities for intervention in pre-RA phases, and opportunities for both primary and secondary prevention have been identified. […] Intervention at the very earliest stages of disease development could, in theory, control symptoms such as arthralgia and fatigue that often precede the development of clinical arthritis, delay the onset of RA, reduce the likelihood of RA developing and/or reduce the severity of RA if it were to develop. […] While the evidence base to support such strategies is in its infancy, B-cell depletion, with a single infusion of 1000mg of rituximab, has been shown to significantly delay the onset of RA in individuals with autoantibody-positive arthralgia and either an inflammatory response as measured by C-reactive protein or subclinical synovitis on imaging.

• #23

  https://journals.lww.com/co-rheumatology/fulltext/2020/05000/preclinical_rheumatoid_arthritis_and_rheumatoid.12.aspx

  This review is to provide an update on the current understanding of rheumatoid arthritis (RA) development related to disease development prior to the onset clinically apparent synovitis (i.e. Pre-RA), and opportunities for disease prevention. […] The discovery of Pre-RA has also underpinned the development of several clinical prevention trials in RA; specifically, the PRAIRI study demonstrated that a single dose of rituximab can delay the onset of clinically apparent IA in at-risk individuals. Additional studies are evaluating the ability of drugs including abatacept, hydroxychloroquine and methotrexate to prevent or delay future RA. […] The results from ongoing natural history and prevention trials in RA should further inform several critical issues in RA prevention including identification and enrolment of individuals at high-risk of imminent RA, the efficacy, safety and cost-effectiveness of prevention, and potentially the identification of new targets for prevention.

• #24 Abatacept in Individuals at Risk of Developing Rheumatoid Arthritis: Results from the Arthritis Prevention in the Pre-clinical Phase of RA with Abatacept (APIPPRA) Trial – ACR Meeting Abstracts

  https://acrabstracts.org/abstract/abatacept-in-individuals-at-risk-of-developing-rheumatoid-arthritis-results-from-the-arthritis-prevention-in-the-pre-clinical-phase-of-ra-with-abatacept-apippra-trial/

  Abatacept in Individuals at Risk of Developing Rheumatoid Arthritis: Results from the Arthritis Prevention in the Pre-clinical Phase of RA with Abatacept (APIPPRA) Trial […] The definition of higher risk states for rheumatoid arthritis (RA) has been refined in more recent years through inclusion of serum autoantibodies and symptom complexes, such as inflammatory joint pain. […] These combined features have provided a framework for the design of interception studies, aimed at delaying or preventing RA. […] We set out to evaluate the feasibility, efficacy and acceptability of T-cell co-stimulation modulation with abatacept in individuals at risk of developing RA in the Arthritis Prevention In the Pre-clinical Phase of RA with Abatacept (APIPPRA) study. […] Therapeutic intervention during the RA at risk phase is feasible, with acceptable safety profiles. […] T cell co-stimulation modulation with abatacept for 52 weeks showed a reduction in the development of RA over two years.

• #25 RA Prevention: A Decade of Trials Provides Insights on What’s to Come | MDedge

  https://www.mdedge.com/familymedicine/article/271448/rheumatoid-arthritis/ra-prevention-decade-trials-provides-insights

  However, the 2-year results from the TREAT EARLIER trial showed that compared with patients given placebo, those given MTX showed improved MRI-detected joint inflammation, physical functioning, and reported symptoms. […] The 4-year analysis of the trial further risk stratified participants and found that MTX showed a preventive effect in anti–citrullinated protein antibody (ACPA)–negative participants at an increased risk for RA. […] Abatacept also showed promise in preventing RA in two separate trials. In the ARIAA trial, compared with placebo, 6 months of treatment with abatacept reduced MRI inflammation and symptoms and lowered the rates of progression to RA. […] In the APIPPRA trial, 12 months of treatment with abatacept improved subclinical inflammation and quality-of-life measures in participants and reduced the rates of progression to RA through another 12 months of observation.

• #26 StopRA | Rheumatoid Arthritis Prevention Study

  https://stop-ra.org/

  StopRA is the first prevention research study for rheumatoid arthritis (RA) conducted in the United States. […] Currently, there are a range of medications used to treat RA once someone develops the synovitis of RA, although there are not yet any proven ways to prevent RA. However, StopRA is studying if a medication called hydroxychloroquine (HCQ) that is already used in the treatment of RA, can prevent RA in people who have high levels of anti-CCP in their blood but dont have synovitis or a diagnosis of RA. […] You can participate in StopRA by first getting your blood tested for anti-CCP. Then, if your blood level of anti-CCP is high, you could participate in the medication part of StopRA. StopRA will test anyone 18 years or older for anti-CCP. However, because RA can run in families, StopRA is particularly interested in testing anti-CCP in family members of people who have RA.

• #27 School of Medicine doctor tests rheumatoid arthritis prevention

  https://news.cuanschutz.edu/news-stories/school-medicine-doctor-tests-rheumatoid-arthritis-prevention

  Dr. Kevin Deane is the principal investigator of the StopRA clinical trial, which is testing a drug that could prevent rheumatoid arthritis. […] The StopRA clinical trial, short for Strategy for the Prevention of Onset of Clinically-Apparent RA, is the first clinical trial of a drug that could prevent RA conducted in the U.S. […] Deane and a team of researchers are testing to see if hydroxychloroquine, an anti-inflammatory drug already used to treat patients experiencing RA flareups, can also be used to prevent it. […] If Deane and his colleagues’ hypothesis is correct, doctors in the future could give hydroxychloroquine to patients who test positive for anti-CCP but before arthritis occurs. The drug could reset the immune system so the joint pain, stiffness and swelling never develop.

• #28 Rheumatoid arthritis prevention in arthralgia: fantasy or reality? | Nature Reviews Rheumatology

  https://www.nature.com/articles/s41584-023-01035-y

  The concept of a window of opportunity in treating a disease assumes the existence of a time frame during which the trajectory of the disease can be effectively and permanently modified. […] Several proof-of-concept trials of treatment during the arthralgia phase of RA have been completed in the past 4 years, with the underlying notion that temporary treatment at this stage could prevent the development of RA or induce a sustained reduction in the burden of disease. […] Overall, the majority of symptomatic at-risk individuals could benefit from a fixed period treatment, even if RA does not develop. […] The first proof-of-concept prevention trials suggest that disease modification could be possible with temporary treatment initiated in an at-risk pre-arthritis phase. […] Nonetheless, treatment in a symptomatic at-risk phase without clinical arthritis is not yet recommended by any treatment guideline. […] Before findings can be implemented, validated tools are needed for risk stratification to guide treatment-start decisions and for monitoring (a disease activity score for clinically suspect arthralgia) to guide treatment-withdrawal decisions.

• #29

  https://link.springer.com/article/10.1007/s10067-020-05016-4

  Rheumatoid arthritis (RA) is the most prevalent cause of chronic arthritis worldwide and contributes substantial health burden and socioeconomic costs, issues that are magnified by the aging population. […] Despite significantly improved outcomes in the management of RA with earlier diagnosis and advances in treatment, there is still no cure and disease prevention remains an area of intense interest. […] Studies examining different treatment regimens in varied subsets of patients with pre-clinical RA have been able to delay but not prevent onset of frank RA. […] The authors correctly point out that seropositivity has been inconsistently defined in pre-clinical RA trials thus far. […] The all-important question of when exactly within the spectrum of pre-clinical RA patients transition from being at-risk to destined to develop RA is unknown.

• #30

  https://link.springer.com/article/10.1007/s10067-020-05016-4

  However, these tools require additional validation and refinement. […] Until we have better prediction models, we are left wondering which exact patients to target in RA prevention trials. […] While intervening at this early stage may be more likely to prevent the development of subsequent RA, it is also reasonable to assume that many of these patients will never progress to chronic recognizable RA. […] The fact remains that no pre-clinical RA trial to date has been able to prevent the development of RA in a population of patients. […] It is possible that the lack of success among existing RA prevention trials is because the exact subgroup of patients, timepoint to intervene, specific intervention, follow-up duration, or some combination thereof has yet to be identified. […] Further data on the impact of RA prevention through lifestyle modification among at-risk populations is also needed, to determine if a non-pharmacologic approach may succeed.

• #31

  https://link.springer.com/article/10.1007/s10067-020-05016-4

  We close with several thoughts. First, the RA research community should collaboratively and uniformly classify the subset of patients with pre-clinical RA to be included in future prevention trials. […] Identifying this exact subset of patients and timepoint within the trajectory toward RA has thus far been elusive. […] Ultimately, there are no easy answers, but these are issues worth a much broader discussion.

• #32 How to Prevent Rheumatoid Arthritis Flares: Exercise, Stress Relief, Medicine, and More

  https://www.webmd.com/rheumatoid-arthritis/ra-prevent-flares

  Know What Triggers Your Flares […] Once you learn your triggers, you can take steps to avoid them. […] The most important thing you can do to avoid a flare is to take your medicine on time. […] When you’re stressed out, it’s not just in your head. […] You can help prevent it if you take better care of yourself when you know that you have stressful events coming up, like work deadlines. […] If you’re having trouble getting some shut-eye, ask your doctor about ways to break the pattern. […] If you want to adjust your diet, its probably fine. […] Be careful not to do too much. […] These simple methods may work: […] To protect yourself, make sure you get a flu shot each year. […] Work with your doctor to control symptoms. […] If you want to quit but are having a hard time, your doctor may be able to help. […] Avoiding triggers is important, but you also need to understand the limits of what you can do to stop flares.

• #33 Reducing Risk of Infection in People With Rheumatoid Arthritis

  https://www.hss.edu/conditions_reducing-risk-of-infection-with-rheumatoid-arthritis.asp

  People with rheumatic diseases like rheumatoid arthritis (RA) are often at increased risk of infections because they may take immunosuppressive drugs to treat their disease. […] Different medications you take may have an impact on your risk for infection. […] Anti-TNFs increase the relative risk of infection, especially in the first year of use. […] Simple things, such as dental cleanings, are some of the best things you can do prevent infection. […] There are many ways to prevent and treat infections, and your rheumatologist can help you make informed choices. […] Talk to your doctor about vaccines. […] People with RA should not take live vaccines, only killed vaccines. […] Of note, there’s no better way to prevent respiratory infections than to receive influenza and pneumococcal vaccines.

• #34 Reducing Risk of Infection in People With Rheumatoid Arthritis

  https://www.hss.edu/conditions_reducing-risk-of-infection-with-rheumatoid-arthritis.asp

  The best protection against the flu is the influenza vaccine. […] Always discuss vaccinations with your doctor since they are aware of helpful guidelines regarding the best options for you. […] If you have hepatitis B that hasn’t been treated, you should be concerned when you take anti-TNF medications, and you must discuss this with your doctor. […] Similar to others, you cannot take this as live vaccine, but there is a newer non-live vaccine (Shingrix) available which you can discuss with your doctor. […] For most patients with rheumatoid arthritis (and other autoimmune diseases), the COVID-19 vaccine is recommended.

• #35 Rheumatoid arthritis secondary prevention – wikidoc

  https://www.wikidoc.org/index.php/Rheumatoid_arthritis_secondary_prevention

  Effective measures for the secondary prevention of rheumatoid arthritis include calcium and vitamin D supplementation to prevent osteoporosis. To prevent cardiovascular complications and recurrent attacks of RA, effective methods include exercise, smoking cessation, and dietary control. […] Effective measures for the secondary prevention of rheumatoid arthritis include: […] Bone protection is very important due to the prolonged use of glucocorticoids. […] Supplements of calcium 1000 to 1200 mg/day and vitamin D intake of 600 to 800 international units/day is recommended for patients using prolonged glucocorticoids. […] The following measures are helpful to prevent cardiovascular complications associated with rheumatoid arthritis: […] Smoking cessation […] Dietary control to prevent hyperlipidemia, hypertension. […] Exercise

• #36 How to Reduce Your Risk of Arthritis | Arthritis Foundation

  https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/reduce-your-risk

  Even if you cant prevent it, you might be able to lower your chances of developing some forms of arthritis. […] The fact is, there is no sure way to prevent arthritis. But you can help reduce your risk and delay the potential onset of certain types of arthritis. […] Risk factors that are considered modifiable are the behaviors and circumstances that can be changed in order to reduce risk, delay onset or even prevent arthritis. […] Rheumatoid arthritis: Do not smoke. […] However, there is hope that someday some or all types of arthritis and related conditions could be prevented. […] Research that is going on today may open the door to treatments and prevention measures to reduce or even eliminate some forms of arthritis in the future.

• #37 Striking a balance in rheumatoid arthritis prevention trials | Nature Reviews Rheumatology

  https://www.nature.com/articles/s41584-021-00627-w

  The discovery that autoantibodies and other factors can predict the future onset of rheumatoid arthritis (RA) has encouraged the development of clinical trials looking at RA prevention. […] Although an exciting area of research, finding an approach that results in the successful completion of an RA prevention trial is challenging.

• #38 Rheumatoid Arthritis Prevention: catalysing PlatfORm Trial delivery (RAPPORT).

  https://www.dev.fundingawards.nihr.ac.uk/award/NIHR153955

  Rheumatoid arthritis (RA) is a common long-term condition in which the immune system causes damage to the joints, causing pain, swelling, and reduced wellbeing. […] Recent advances in our understanding of the biological processes that lead to RA have helped us understand that some people without the condition are nonetheless at increased risk of developing it in the future compared with the general population. […] Doctors have yet to understand how best to help them, but strongly suspect treatments could not only relieve their symptoms but also prevent them from going on to develop RA itself. […] Taking all this into account, there is a need for the research community and the public to come together to devise a coordinated approach to designing trials of prevention treatments. […] Our ambition is to deliver a pan-European precision medicine platform for preventative interventions in people at risk of rheumatoid arthritis (RA) a disease of immune dysregulation in which destructive joint inflammation impairs quality of life.

• #39 Enhancing the gut microbiome for rheumatoid arthritis prevention – Hospital Healthcare Europe

  https://hospitalhealthcare.com/clinical/rheumatology/enhancing-the-gut-microbiome-for-rheumatoid-arthritis-prevention/

  Unlocking the key to early prevention of rheumatoid arthritis would be a real game-changer and researchers have found what could be central to this: enhancing the gut microbiome. […] The main risk factor is having [cyclic citrullinated peptide] CCP antibodies along with joint pain and joint stiffness. […] The aim is to take these observations forward and develop personalised interventions to prevent rheumatoid arthritis onset and progression, explains Professor Mankia. […] If we can understand microbiome changes that underpin the development of rheumatoid arthritis and compare those to people who appear safe from progression, this would hopefully lead to an interventional approach, he says. […] We want to see whether if we change the gut microbiome itself, not just supplementing the molecules, whether this would make a difference, he explains. […] In rheumatology, there is a strong interest in non-pharmaceutical approaches to autoimmune condition management. […] Being aware that, as we go forward, there will be more data around non-pharmaceutical approaches so they can advise patients about these right from the beginning of their disease.

• #40 Potential Role of Dietary Phenolic Compounds in the Prevention and Treatment of Rheumatoid Arthritis: Current Reports

  https://www.mdpi.com/1424-8247/17/5/590

  Rheumatoid arthritis (RA) is a complex illness with both hereditary and environmental components. […] Phenolic molecules are the most prevalent secondary metabolites in plants, with a diverse spectrum of biological actions that benefit functional meals and nutraceuticals. […] These compounds have received a lot of attention recently because they have antioxidant, anti-inflammatory, immunomodulatory, and anti-rheumatoid activity by modulating tumor necrosis factor, mitogen-activated protein kinase, nuclear factor kappa-light-chain-enhancer of activated B cells, and c-Jun N-terminal kinases, as well as other preventative properties. […] Among the new and most promising availability strategies, special attention has been given to bioactive molecules largely found in nature, namely, polyphenols, since their chemical structure with catechol methoxy and pyrogallol groups confer them notable health benefits, like antioxidant, anti-inflammatory, anti-bacterial, and antiproliferative activities, as well as the capacity to prevent neurological and cardiovascular pathologies, promote gastrointestinal health and vision without, it is believed, side-effects, and enhance wound healing.

• #41 Potential Role of Dietary Phenolic Compounds in the Prevention and Treatment of Rheumatoid Arthritis: Current Reports

  https://www.mdpi.com/1424-8247/17/5/590

  In this disease, there is a verified network of inflammatory components, degrading enzymes, angiogenic molecules, and cells. […] Therefore, it is not surprising that their interest is increasing worldwide, especially in preventing and/or attenuating several diseases, especially those without medical cures, like RA. […] Phenolics have shown potential to counteract oxidative stress levels and downregulate exacerbated inflammatory responses, and thus, their use as adjuvant therapy and/or combined with chemical pharmaceutics can be very useful. […] As expected, their benefits are closely linked to their chemical structure and quantities. […] Therefore, it is not surprising that their interest is increasing worldwide, especially in preventing and/or attenuating several diseases, especially those without medical cures, like RA.

• #42 Potential Role of Dietary Phenolic Compounds in the Prevention and Treatment of Rheumatoid Arthritis: Current Reports

  https://www.mdpi.com/1424-8247/17/5/590

  Polyphenols assume a prominent interest since they have already been shown to possess notable capabilities to restore oxidative stress and inflammation near basal levels by interacting with Keap1 protein, avoiding its linkage with its binding site in Nrf-2. […] The capacity of resveratrol to activate caspase-3, and consequently inhibit the proliferation of synoviocytes and induce cell apoptosis in synoviocytes in RA, was already reported. […] Resveratrol can also diminish urban particulate matter-induced COX-2/PGE2 release in human fibroblast-like synoviocytes by inhibiting the activation of NADPH oxidase/ROS/NF-κB. […] The daily consumption of cherries (280 g) by women can reduce plasma C-reactive protein and nitric oxide radicals 3 h after intake. […] Resveratrol was shown to be a promising strategy for attenuating RA in a mice model. […] Resveratrol at 10 mg/kg/day alleviates adjuvant arthritis-interstitial lung disease in rats with induced RA, namely, by preventing the production of pro-inflammatory by modulating the JAK/STAT/RANKL signaling pathway.

• #43 How to prevent arthritis: Top 11 Prevention Strategies

  https://snsrheumatology.com/how-to-prevent-arthritis/

  Nutrition for joint health: Eat foods good for joints such as seeds and nuts, olive oil, whole grains, cruciferous vegetables, and garlic. […] Quit smoking: The carcinogens in smoke are fatal for joints. So, avoid its use. […] Manage stress: Stress initiates pain in the joints that make the symptoms of arthritis worse. Hence, stress management is necessary to prevent arthritis. […] Regular health check-ups: In case of arthritis, one must consult a healthcare advisor and attend regular follow-up sessions to know joint progress. […] Stay hydrated: Drink at least 8-12 glasses of water every day to retain joint flexibility and lubrication. […] Avoid overuse of joints: Don’t involve your joints in extensive exercises as it can cause stress on the joints and make arthritis symptoms worse.

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