Significant funding to ensure personalised treatments that work for rheumatoid arthritis

In recent years treatment with powerful biologic and targeted synthetic therapies has changed the landscape for arthritis, but currently finding the right treatment for each person is a matter of trial and error.

Only a proportion of patients with inflammatory arthritis respond to each expensive therapy, which results in unnecessary treatment and a long and often frustrating journey for patients, not to mention significant cost to the NHS.

University of Birmingham researchers working with the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC) have just been awarded £3.5 million funding from Johnson & Johnson to investigate mechanisms of response and non-response to biologic and targeted synthetic therapies in rheumatoid arthritis.

In this new study, researchers will take biopsies from patients both before and during treatment during their routine care, to understand why some patients respond better than others, and importantly what goes wrong when a patient doesn’t respond to treatment. This is the first study of its kind systematically analysing tissue samples taken over time and will recruit 100 patients over the next three years.

“We hope that by the end of this study, we …. will be able to recommend effective ways of matching the right treatments to the right patients sooner”.

Professor Andrew Filer

Professor Andrew Filer, Professor of Translational Rheumatology at the University of Birmingham and co-lead of the NIHR Birmingham BRC Inflammatory Arthritis research theme, said:

“Different patients respond to different drugs; so whilst it is good news for patients that there are many to try, it can be a long road until they find something that works. During this time their condition continues to progress and cause pain and discomfort.

“We hope that by the end of this study, we will understand much more about how different treatments work for different patients and will be able to recommend effective ways of matching the right treatments to the right patients sooner.”

Helping clinical decision making

The findings should help clinical decision making for rheumatoid arthritis patients not responding to first line therapies for rheumatoid arthritis. It is important to understand what is happening in each patient’s joints at the tissue level, so that if they are not responding, clinicians can decide whether to switch or add an additional drug to help suppress the disease.

Rheumatoid arthritis is a chronic condition that causes joint inflammation, leading to pain and swelling most commonly affecting the hands wrists and feet. The condition affects over 600,000 patients in England, costing an estimated £4.8 billion per year to the UK economy due to health costs and work-related disability.

The study will use tissue rather than blood samples to help researchers to better understand what is happening at a cellular level in the joint in the joint itself when different patients are given different treatments. Researchers will make use of single cell and spatial technologies available through Birmingham Tissue Analytics to study the tissue biopsies taken.

Birmingham Tissue Analytics is a facility based in the Institute of Translational Medicine and provides a high level digital spatial tissue imaging service for academic-led research and industry collaborators.