Results from the “Abatacept Reversing subclinical Inflammation as measured by MRI in ACPA positive Arthralgia” (ARIAA) trial showed that CTLA‐4 Ig treatment delayed disease onset for up to 18 months in and the “Arthritis Prevention In the Pre‐clinical Phase of Rheumatoid Arthritis with Abatacept” (APIPPRA) trial showed a delay for up to 24 months.34, 36. This evidence concerns the gene CTLA4 and arthritic joint disease.