Rheumatoid arthritis

11 ways to stop pre-RA turning into RA

Rheumatoid arthritis is potentially preventable and the burden of disease could be reduced by as much as 40% with lifestyle intervention measures in areas such as diet and exercise, according to Australian rheumatologists.

Dr Louise Koller-Smith and Professor Ranjeny Thomas at the University of Queensland Diamantina Institute say that it is now possible to identify high risk individuals with ‘pre-RA’ based on their family history, risk factors, autoantibodies and symptoms.

Once identified, these individuals could be targeted for counselling to adopt lifestyle and health changes to modify factors known to be associated with RA risk, they suggest.

“Currently, RA is incurable, and long-term treatments carry toxicities, but evidence is growing that RA can be prevented,” they write in a review published in Internal Medicine Journal.

“There is a window of opportunity to intervene prior to clinical disease in people at risk of RA, and an important part of this intervention will be addressing lifestyle factors.”

They provide evidence-based recommendations on 11 changes that could be made to address modifiable factors for RA.

  1. Stop smoking
  2. Maintain a healthy weight Increase leisure time physical activity
  3. Maintain good dental hygiene
  4. Maximise breastfeeding if able
  5. Adopt healthy eating patterns and avoid high salt diets
  6. Consume high levels of Omega-3 fatty acids and fish
  7. Reduce consumption of sugar-sweetened soft drinks
  8. Consume moderate levels of alcohol
  9. Avoid exposure to inhaled silica, dusts and occupational risks such as shift work
  10. Remain Vitamin D replete

The review authors acknowledge that the absolute risk reduction for RA from individual measures may be relatively modest, but the interventions have no real risk of harm and will have multiple benefits on other areas of  overall health and wellbeing.

They add that for tor the remaining RA risk, “symptomatic pre-RA presents a great opportunity for trials of immunotherapeutic interventions to prevent progression to RA. With multi-pronged effort, RA prevention in the next 10 years is within our reach – we can play our part today towards that goal.”

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