The exact cause of rheumatoid arthritis (RA) is not yet known, so it isn’t possible to completely prevent RA. Rheumatoid arthritis is an autoimmune disease that affects the joints. Normally, the immune system makes antibodies to fight infections from viruses and bacteria. In autoimmune diseases, however, the immune system makes antibodies that target the body. The target of the autoimmune attack in RA is joint tissue, causing inflammation, joint pain, and irreversible joint damage.

Experts don’t fully understand what triggers the autoimmune response in RA, but rheumatologists (scientists who study musculoskeletal diseases like RA) and other researchers are constantly working to increase their understanding of RA to help prevent and treat joint damage in people who have RA or who are at risk.

How Can RA Be Prevented?

The best way to prevent RA is to work with your doctor to identify if you’re at high risk of developing RA and then treat RA before the disease starts. The science behind predicting who will get RA is unclear, but there are promising advances.

Risk Factors for RA

Risk factors that may increase a person’s chance of developing RA include:

• Older age — RA onset is highest in adults in their 60s.
• Gender — Females are two to three times more likely to have RA than males.
• Genetics — A family history of RA can increase your risk, and some genes may make RA worse.
• Smoking or exposure to tobacco smoke at a young age
• Obesity
• Exposure to occupational dust (silica) or air pollution
• Consuming a lot of sodium, red meat, or iron
• Having low levels of vitamin D
• Infections, like those involved in gum disease

Certain factors are associated with a decreased risk of RA, such as moderate alcohol intake and a healthy diet that includes eating fish and omega-3 fatty acids.

You cannot change some risk factors like your genetics and age. But several risk factors can be avoided to help decrease your risk. Lifestyle changes such as quitting smoking and maintaining a healthy weight can help reduce some RA risk. The American Lung Association has a free helpline for people who are trying to quit smoking. A healthy diet with enough omega-3 fatty acids and vitamin D (which you can also get from sun exposure) may also help decrease your RA risk.

A healthy lifestyle not only reduces your risk of RA but also generally improves your overall quality of life. If you think you are at high risk for RA, talk to your doctor for their medical advice.

What Does the Research Say About Prevention?

Although it is not currently possible to completely prevent RA, research is looking into what makes RA develop. As the field of rheumatology advances, experts may one day be able to identify people at high risk for RA and prevent the disease before it starts.

More research needs to be done to discover treatments that might prevent RA. There is some evidence that RA does not start in the joints but may start in other parts of the body, like the mucosal areas of the lungs and gut — this makes it challenging to target RA before it starts. Other barriers to prevention include the side effects of some medications, which may cause someone who is not actively experiencing RA symptoms to feel like taking the medication is not worth it.

Research on Predicting RA

Some studies have attempted to predict which people will get RA by looking at their family history of RA and environmental factors like smoking. These early prediction models are a good start, but researchers say they still need work to be more accurate.

In early rheumatoid arthritis or preclinical RA, blood tests might also be able to reveal that a person has an increased risk of having RA before symptoms begin. There appear to be changes in the blood and immune system of people long before they develop symptoms of RA. People may have changes in autoantibodies and inflammatory markers three to five years before they are classified as having RA. Levels of certain antibodies involved in RA inflammation, called rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP), may increase years before RA symptoms appear. Other markers of inflammation — like C-reactive protein, cytokines, and chemokines — are also higher before a person develops RA. Experts suggest that detecting any of these markers in the blood is an indication to start early treatment, which may lead to better outcomes.

The methods for detecting preclinical RA are not perfect, but continuing to study the signs that a person is likely to develop RA can help doctors provide early treatment that could prevent RA completely.

Current Treatments for RA

There is currently no cure for RA, but remission (periods of having few or no arthritis symptoms) is possible with early and aggressive treatment. Treatment for RA includes disease-modifying antirheumatic drugs (DMARDs). Conventional DMARDs such as methotrexate, biologic DMARDs such as Humira (adalimumab), and targeted synthetic DMARDs such as Xeljanz (tofacitinib) improve symptoms of rheumatoid arthritis. Biologic DMARDs and targeted synthetic DMARDs are a type of DMARD that interfere with specific parts of the immune system. These treatments are meant to slow down RA and reduce disease activity so that the joints are protected. Medications like nonsteroidal anti-inflammatory drugs (NSAIDs) may also be used to help relieve arthritis pain and reduce inflammation. There are more than 10 different DMARDs and you should work with your physician to find the correct medication.

Find Your Team

On myRAteam, you can join a social network for people with rheumatoid arthritis and their loved ones. More than 151,000 members come together to ask questions, give advice, and share their stories with others who understand life with RA.

Are you living with RA? Share your experience in the comments below, or share your story on myRAteam.