Preventive Strategies & Novel Treatments for RA

The latest in rheumatoid arthritis

BARCELONA—Over the past two years, thousands of articles have been published in the medical literature on rheumatoid arthritis (RA). This summer during EULAR 2025, Diane van der Woude, MD, PhD, professor of translational rheumatology at the Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, The Netherlands, reviewed this massive cache of knowledge in her presentation, Rheumatoid Arthritis: What Is New.

Supplements & RA

Dr. van der Woude began her lecture discussing RA prevention.

Vitamin D, she noted, has been of interest to scientists given its role in regulating genes involved in inflammation. In animal models, some studies have shown a possible benefit in the prevention of autoimmune disease, though observational studies in humans have shown conflicting results.^1,2  Fish oil consumption, specifically in the form of omega-3 polyunsaturated fatty acids, has demonstrated immunomodulatory and anti-inflammatory effects that may have implications for autoimmune diseases, such as systemic lupus erythematosus, and type 1 diabetes.^3,4

In the VITAL study from Hahn et al., more than 12,000 men aged 50 and older and more than 13,000 women aged 55 and older were randomized to receive either 2,000 IU/day of vitamin D or matched placebo and 1,000 mg/day of omega-3 fatty acids or matched placebo. Then, participants were asked to report all incident autoimmune diseases from baseline to a median of 5.3 years of follow up. A medical record review was used to confirm the reported histories. In the initial study, vitamin D and omega 3 fatty acid supplementation reduced the autoimmune disease rate by 22% and 15%, respectively.⁵

An additional study during the post-intervention, follow-up period, found the protective effect of vitamin D supplementation on autoimmune disease incidence was no longer observed. Meanwhile, fatty acid supplementation demonstrated a sustained reduction in autoimmune disease incidence.⁶ Dr. van der Woude noted that further studies are needed to evaluate if and when such effects persist over longer periods of time.

Preventive Therapy

Next, Dr. van der Woude tackled the growing number of clinical trials that use existing disease-modifying anti-rheumatic drugs (DMARDs) and biologic therapies for RA prevention.

In the APIPPRA study, more than 200 patients with inflammatory joint pain, antibodies to citrullinated protein antigens (ACPA) and rheumatoid factor were randomized to receive either abatacept or placebo for 12 months. Patients were then followed for an additional 12 months. After 24 months, 37% of patients in the placebo group developed RA vs. 25% of patients in the abatacept group.⁷