TY - JOUR T1 - Rheumatoid arthritis prevention: any takers? JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2021-001633 VL - 7 IS - 1 SP - e001633 AU - Marie Falahee AU - Karim Raza Y1 - 2021/04/01 UR - http://rmdopen.bmj.com/content/7/1/e001633.abstract N2 - 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.1 In parallel, there has been significant progress in the prediction of RA development in those at risk.2 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.3–5Intervention 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,6 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 1000 mg 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.7 Similarly, the impact of time-limited courses of other immunomodulatory therapies, including abatacept8 and hydroxychloroquine,9 on arthritis and RA development is being assessed in other at-risk groups. Results of these … ER -