Finding the Rheumatoid Arthritis Holy Grail

Researchers are working to better predict which patients with signs of joint pain and inflammation will develop rheumatoid arthritis.

It is no secret that early detection and treatment of a disease is vital for the patient’s wellbeing. Recently, University of Leeds researchers have been working on a way to better predict which patients with early signs of joint pain and inflammation will develop rheumatoid arthritis later in life.

Rheumatoid arthritis is an inflammatory disease of the joints which leads to damage and destruction, and currently affects around 380,000 people in the United Kingdom. Presently, doctors possess restricted tools for predicting which of their patients with joint pain will go on to develop rheumatoid arthritis, and those who will not.

The prospect of early detection is not only imperative for patients who will develop rheumatoid arthritis but also for patients whose symptoms will remain mild or even go into remission; these people, if they are found to not be at risk for the disease, will not have to take very strong medication unnecessarily.

In the United Kingdom, Arthritis Research Professor of Rheumatology, Paul Emery, leads a team at the Leeds Institute for Molecular Medicine at the University of Leeds. His team has been at the head of cutting edge research aspiring to expand upon the concept of "personalized medicine" for the past decade.

Recently, Dr Jane Freeston, NIHR Clinical Lecturer in Rheumatology, rooted in the rheumatology department at Chapel Allerton Hospital, has been granted a Clinician Scientist Fellowship of more than £300,000 from Arthritis Research UK to develop this work further.

Her goal is to identify very small amounts of joint and tendon disease in a group of patients with initial signs of inflammatory arthritis through a combination of ACPA antibody testing, which can indicate the presence of rheumatoid arthritis, and revolutionary high resolution magnetic resonance imaging techniques.

"Early aggressive treatment can stop this damage, so we need to identify and reduce inflammation as early as possible," explained Dr Freeston, which, she goes on to say, is not possible at this juncture. "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."

Freeston anticipates that her findings will ultimately be rendered into a useful diagnostic and prognostic ultrasound tool that can be used extensively by professionals in the medical field in an effort to make treatment better targeted and appropriate for the patient.