Using core genes and pathways to stratify rheumatoid arthritis and predict outcomes in Rheumatoid Arthritis

Rheumatoid arthritis is a long-term condition in which the immune system attacks the joints. It affects 1 in 100 people in the United Kingdom. This inflammation causes pain and, if uncontrolled, can lead to joint damage and disability. The earlier we can control the inflammation, the better the long-term outcomes. The development of biologic therapies means that we now have more options than ever before to treat rheumatoid arthritis. There are a number of types of these drugs, all affecting different immune pathways to try and reduce inflammation. We have no reliable way of predicting which type of biologic treatment will be most effective for an individual. Currently, selection is done by a process of trial and error with each new drug trialled for a period of time. During this time, if the drug does not work, a person may develop irreversible joint damage which could lead to permanent disability.

The aim of this study is to see whether genetic and protein markers, identified using a blood sample, can be used to predict whether a person with rheumatoid arthritis is likely to respond to a certain treatment and inform us about the likely severity of their disease. These are known as biomarkers. This project will analyse data collected in MATURA (Maximising Therapeutic Utility in Rheumatoid Arthritis), a nationwide consortium of academics, doctors and industry groups developing personalised approaches to treatment of rheumatoid arthritis.

When researching biomarkers of treatment response, it is really important to first establish what we consider a good response to be. One of the methods health professionals use in clinical practice is a scoring system known as the DAS-28 score. This score is made up of four components: number of tender joints, number of swollen joints, the patient global visual analogue score (a self-reported score from 0-100 of a patient's overall health) and CRP (C-reactive protein, a blood test which measures inflammation). Lots of factors can...