Dietary fiber supplementation for the prevention of rheumatoid arthritis

Rheumatoid arthritis (RA) is a common inflammatory disease for which there is no cure.

Observational studies in humans and interventional studies in animals imply that increased dietary fiber intake may prevent RA development.

Patients who seek health care because of joint pain and test positive for autoantibodies to citrullinated proteins, but lack clinical signs of arthritis, comprise an at-risk population where 20-50% develop RA within the next few years.

We aim to set up a clinical trial to test whether dietary fiber supplementation prevent RA onset among such at-risk individuals.

Subjects will be randomized to either one fiber bar daily or to an energy-equivalent control bar for 12 months, followed by a 12-month observational period to assess the duration of possible treatment effects. The primary outcome is the proportion of subjects fulfilling RA classification criteria after 12 months.

We will also assess changes in patient-reported outcomes, autoantibody levels, systemic inflammation (CRP), lipids, body weight, short chain fatty acids, intestinal permeability, and microbial diversity in fecal samples. Adverse events will be carefully monitored.

We have built a team of (i) experienced rheumatologists, (ii) experimental experts on gut-joint interplay, and (iii) frontline researchers on dietary intervention studies in RA and food sciences.

Together, we apply for funding to launch a unique trial with potential to open completely new avenues for the prevention of RA.