Identifying the people most at risk of developing severe rheumatoid arthritis is vital as it means that they can then be treated quickly and early in the course of their disease. Meanwhile those people whose symptoms will remain mild or even go into remission will not needlessly be put on strong drugs.
Currently doctors have limited tools for predicting which of their patients with joint pain will go on to develop rheumatoid arthritis, and those who will not.
A team at the Leeds Institute for Molecular Medicine at the University of Leeds, led by Arthritis Research UK Professor of Rheumatology Paul Emery, has been at the forefront of research aiming to develop the concept of “personalised medicine” for the past decade. Targeting individual patients with the treatment that is best for them is regarded as the “Holy Grail” of medical research.
Now Dr Jane Freeston, NIHR Clinical Lecturer in Rheumatology, based at the rheumatology department at Chapel Allerton Hospital, has been awarded a Clinician Scientist Fellowship of more than £300,000 from Arthritis Research UK to develop this work further.
She plans to identify very small amounts of joint and tendon disease in a group of patients with the earliest signs of inflammatory arthritis, by combining cutting edge high resolution magnetic resonance imaging techniques and ACPA antibody testing (which can indicate the presence of rheumatoid arthritis).
She hopes her findings can ultimately be translated into a useful diagnostic and prognostic ultrasound tool that can be widely used by clinicians to make treatment more targeted and appropriate for the patient.
Rheumatoid arthritis is an inflammatory disease of the joints which leads to damage and destruction, and currently affects around 380,000 people in the UK.
“Early aggressive treatment can stop this damage so we need to identify and reduce inflammation as early as possible, but currently we can’t easily predict which patients with early signs of inflammation will go on to develop rheumatoid arthritis,” explained Dr Freeston.
“With the potential consequences of over-treating patients at a stage where many patients are often unwilling to accept aggressive treatments, doctors are increasingly looking for accurate tools to predict how the disease will progress so treatment can be tailored to the needs of individual patients. That is what we hope to achieve.”
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