Creating a Nationwide Network for RA Prediction and Prevention

By Vandana Suresh | May 9, 2025

With advancements in rheumatoid arthritis (RA) research, people with this autoimmune disease now have treatments that go beyond painkillers to disease-modifying medications. Despite considerable progress in the understanding of RA’s pathology, or how the disease develops and progresses, there remain gaps in predicting which individuals will develop RA with a high certainty.

To bridge this knowledge deficit, the Arthritis Foundation has awarded a RA Research Program award to Christopher Striebich, MD, PhD, associate professor of medicine at the University of Colorado Denver and Kevin Deane, MD, professor of medicine at the University of Colorado Anschutz Medical Campus and their team of research investigators.

They will use their funding to establish “StopRA: National,” which will be a USA-wide network to prospectively study individuals who are at-risk for RA. Specifically, this will serve as a repository of longitudinal clinical information from individuals who are positive for antibodies associated with RA but have not yet developed the disease.

“We know that certain blood markers like the autoantibody anti-cyclic citrullinated peptide (anti-CCP) can be predictive of future RA; however, a big challenge is finding who really will go on to get RA, and the other big challenge is these people are quite rare to encounter,” says Dr. Deane. “Getting people who are at-risk for RA together into one group and studying them as a group is a major challenge. That’s what this award is going to help us accomplish.”

The preclinical stage of RA is defined as the period that precedes the onset of joint inflammation that is diagnosed as “clinical RA.” During this time, the immune system is already dysregulated and is producing autoimmune antibodies such as rheumatoid factor and anti-CCP. Although an overwhelming majority of patients with RA are positive for anti-CCP antibodies, only 20% to 60% of individuals who are anti-CCP positive end up with full-blown RA. This uncertainty poses a significant hurdle in clinical interventions aimed at preventing RA.

Several clinical trials to prevent RA have been completed. However, in these trials, drugs including methotrexate, hydroxychloroquine and rituximab did not effectively prevent RA, although abatacept did help reduce progression to RA in some individuals. Further, the rates of development of RA in most of these studies were still between 18% and 57%.

“Certainly, it could be that the dose and/or duration of use of the pharmaceutical agents were related to their failure to prevent RA, but it is also highly likely that the drugs do not target the key pathways in preclinical RA,” says Dr. Striebich. “We need to identify those pathways to make the next interventions more effective and identify better models to predict who will go on to get RA”

The researchers noted that there is an immediate need to find and follow patients who are at risk for RA. The roughly 100 individuals who are at-risk for RA who will be participating in StopRA: National will be recruited from all over the United States by their local rheumatologists. Study participants will be anti-CCP positive without clinical RA at enrollment. Participants will be monitored remotely and longitudinally over a duration of three years for the development of clinical RA. In addition, StopRA: National investigators will collect biospecimens, including serum, plasma and DNA, to look for clinical and biomarker features that improve the prediction of RA.

“We’re quite excited about the award from the Foundation,” says Dr. Striebich. “It’s a great acknowledgment of the importance of what we’re doing, and of course, it’s the financial assistance needed to help us do the work.”