Rheumatiod arthritis: Preventative treatment

Rheumatoid arthritis (sometimes called “RA”) is a common chronic inflammatory disease that affects around 1% of the population. It is 2-3 times more common in women. In most cases, patients begin having symptoms between 40 to 60 years of age, but it can begin earlier, or later in life.

RA affects the joints and causes pain, swelling, and stiffness, but also fatigue. If patients are not treated, the joints can suffer permanent damage, which subsequently can lead to disability. To date, there is no cure, which means that for the vast majority of patients treatments are long term, with the aim of controlling the inflammatory disease activity and reducing symptoms.

There is increasing research interest in the idea of treating individuals who are at an increased risk of developing RA to assess whether a relatively short course of therapy will prevent or delay the onset of RA. One such ‘at risk’ group are the siblings and children of patients with RA, who are four times more likely to develop the disease. The presence of RA-related autoantibodies in the blood increases the risk of developing the disease further.

This PREFER case study will ask siblings, children and members of the general public about their preferences for preventive treatments for RA. The case study will further look at how participant characteristics, country (UK vs Germany), population (siblings and children vs. general population), knowledge/experience with RA will impact on these treatment preferences. In addition, this case study will evaluate the similarity of two different methods to measure treatment preferences.


G Simons, K Schölin Bywall, M Englbrecht, EC Johansson, RL DiSantostefano, C Radawski, J Veldwijk, K Raza & M Falahee (2022) Exploring preferences of at-risk individuals for preventive treatments for rheumatoid arthritis, Scandinavian Journal of Rheumatology, DOI: 10.1080/03009742.2022.2116805

Simons G, Veldwijk J, DiSantostefano R, Englbrecht M, et al., Preferences for preventive treatments for rheumatoid arthritis: discrete choice survey in the UK, Germany and Romania, Rheumatology, 2022, DOI: 10.1093/rheumatology/keac397

Simons G, Caplan J, DiSantostefano R, Veldwijk J, et al., Systematic review of quantitative preference studies of treatments for rheumatoid arthritis among patients and at-risk populations, Arthritis Research & Therapy, 2022, DOI: 10.1186/s13075-021-02707-4

Falahee M, Simons G, DiSantostefano R, Valor Méndez L et al., Treatment preferences for preventive interventions for rheumatoid arthritis: protocol of a mixed methods case study for the Innovative Medicines Initiative PREFER project, BMJ Open, 2021;11:e045851 DOI: 10.1136/bmjopen-2020-045851

Fact sheet

Therapeutic area: Rheumatoid arthritis

Study led by: University of Birmingham, University of Erlangen

PREFER leads team: Karim Raza, Marie Falahee, Larissa Vaylor-Mendez, Jorien Veldwijk, Rachael DiSantostefano

MPLC decision points of interest: Early-development and post-marketing

PREFER case study acronym: RA

Clinical objectives: Assessing the preferences of people at risk of RA for preventive treatments, Evaluating the maximum acceptable risk (MAR)/Minimum acceptable benefit (MAB), Characterising preference heterogeneity and characteristics that may explain heterogeneity

Patients from: United Kingdom, Germany

Methods in Qualitative study: Focus group discussion, Nominal group technique

Methods in Quantitative study: DCE, Probabilistic Threshold Technique

End-date qualitative data collection: December 2019

End-date quantitative data collection: Q3 2020


  • Karim Raza, University of Birmingham, Lead for rheumatoid arthrits case study
  • Jorien Veldwijk, Erasmus Medical Center, public co-lead for case studies


Rheumatoid arthritis, often referred to as RA, is a long-term condition that mainly affects the joints. RA causes pain, swelling, stiffness and often fatigue. If patients are not treated, their joints can suffer permanent damage, which can lead to disability. Preventative treatment can help. In this study, 350 first degree relatives of RA patients and 3000 members of the general public were asked to imagine that they had a 60% risk of developing RA in the next 2 years before being asked to make treatment choices. We have produced a plain language summary to describe the results from our case study that is now available for download.

Preventing rheumatoid arthritis

Simons, G et al. Preventing RA: What treatments do people at risk of rheumatoid
arthritis prefer?
. Zenodo. 2021. DOI: 10.5281/zenodo.5607650






  • Disclaimer: This website and its contents reflects the PREFER project's view and not the view of IMI, the European Union or EFPIA.


The Patient Preferences in Benefit-Risk Assessments during the Drug Life Cycle (PREFER) project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115966. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA).