Laura S. Chapman

Credit: Research Gate

A new study has identified three types of individuals at risk for rheumatoid arthritis (RA) based on how they can take preventive measures to reduce or prevent the disease from developing.¹ These types were characterized as “active blockers, change considerators, and fearful avoiders.”

“Our study is the first to investigate at-risk individuals’ perceptions of measures aimed at addressing dysbiosis of gut bacteria that is associated with the development of rheumatoid arthritis.” write researchers led by Laura S. Chapman of the Institute of Rheumatology and Musculoskeletal Medicine. University of Leeds, UK.

According to the Arthritis Foundation, many risk factors can increase your chances of developing rheumatoid arthritis.² The organization lists several uncontrollable risk factors, including age, biological sex, genes, specifically genetic markers, and shared epitopes.

Environmental factors such as infections such as Epstein-Barr virus, E. coli, and hepatitis C can increase your risk. Toxins such as second-hand smoke, asbestos, silica dust, and pesticides. and childhood trauma. Lifestyle factors such as smoking, obesity, periodontal disease, diet, and changes in your microbiome can also increase your risk.

Intervening before arthritis can have a huge impact, potentially preventing or at least delaying the onset of the disease and reducing its severity.¹ While receiving an intervention may seem like an obvious choice for some people, others may be hesitant to receive it. They may think, “What’s the point of taking precautions when I have so few symptoms?”

However, preventive interventions can not only modulate the immune response but also target other risk factors such as smoking, elevated body mass index (BMI), and dyslipidemia. Prevention measures range from taking medications to lifestyle changes such as eating a healthy diet, increasing physical activity, and quitting smoking.

This study aimed to explore the perspectives of individuals at risk of developing rheumatoid arthritis, and we wanted to know what they think about the risk of rheumatoid arthritis and their opinions about preventive interventions. I did. As a secondary endpoint, the researchers also aimed to understand and compare different health-related behaviors related to the prevention of rheumatoid arthritis.

The study included 19 anti-CCP positive individuals aged 35 to 70 years with musculoskeletal symptoms but no synovitis who participated in a semi-structured interview. More than half of the participants were female (n = 10).

The researchers found three themes: being at risk of being anti-Chinese, wanting to prevent rheumatoid arthritis, and “who influences engagement.”

Although some participants talked about distress related to symptoms, anxiety about disease progression, and adverse effects of drugs, many participants had positive opinions about the intervention and said that they were able to improve their lives to prevent rheumatoid arthritis. I was willing to adopt the habit.

Certain factors influenced willingness to take preventive interventions, including symptom severity, personal risk level, comorbidities, and experience with other medications or supplements. Additionally, if you are knowledgeable about rheumatoid arthritis, risk factors, and medications, you are more likely to take preventive measures.

Ultimately, three types of participants were identified from this study. Those who actively prevent (n = 8), those who consider change (n = 9). This type of person is more likely to become upset if their doctor advises them to change their lifestyle or change their habits. on medication and fear avoiders (n = 2). People with healthier lifestyles tended to have more positive attitudes towards rheumatoid arthritis prevention.

People were also more likely to take preventive measures if they heard how painful rheumatoid arthritis was. One participant said, “Progress can always happen. It could be tomorrow, it could be in 10 years, it could be in five years…I don’t know. It’s…unstable, because you can’t predict it. Because, and even if it happens, when it happens, it’s life-changing, right? So for me, it becomes a much more dangerous situation to ignore.”

Active preventionists understood that increased CCP in the blood meant they were at higher risk of developing rheumatoid arthritis and were more likely to seek more knowledge about that risk. Change believes that people tend to be less knowledgeable about what it means to be exposed to risk and less likely to seek out information about risk themselves.

In contrast, fear avoiders often have less knowledge about rheumatoid arthritis risks and do not practice a healthy lifestyle, which may explain why they are less likely to take preventive measures. there is. Fear avoiders said they needed further justification because they were more likely to receive treatment to prevent rheumatoid arthritis if their symptoms worsened or if they were at high risk of developing rheumatoid arthritis. They were also hesitant to take drug precautions if they had experienced negative adverse events with other drugs.

The researchers noted that the sample size was small, that despite the ideal type of analysis, they did not explicitly explore typology during data collection, and that the questions asked were directed toward oral health. They highlighted multiple limitations, including that the participants were recruited from a previous study cohort and were therefore likely to be active preventers. .

“Understanding the specific barriers and facilitators for different ideal patient types will be beneficial to increase engagement in preventive interventions for at-risk individuals, and will help clinicians increase patient participation in preventive intervention studies.” “This will help recruit and retain participants,” the researchers concluded.

^References

1. ^{Chapman LS, Siddle HJ, Selvan S, et al. “What is my risk really?”: A qualitative investigation of preventive interventions for individuals at risk for rheumatoid arthritis. Rheumatol Advanced Practice. 2024;8(2):rkae023. Published February 29, 2024. doi:10.1093/rap/rkae023}
2. ^{11 risk factors for rheumatoid arthritis and what you can do about them. Arthritis Foundation. December 14, 2022. https://www.arthritis.org/health-wellness/about-arthritis/undering-arthritis/11-risk-factors-rheumatoid-arthritis-reduce-risk. Accessed March 22, 2024.}