Researchers from many disciplines are working together to ease the pain of rheumatoid arthritis patients and potentially save the NHS millions of pounds on ineffective drugs.
Doctors can waste a long time prescribing different therapies to patients while trying to find one which provides effective relief but there is currently no short cut, no way of telling which person will respond to which medicine. Until the correct drug is discovered by trial and error the patient goes on suffering and the NHS spends money on drugs which don’t work and handles increased numbers of appointments. Last year researchers from various institutions came together under the umbrella of the MATURA Consortium to try to shed light on this problem. With £5 million funding from the Medical Research Council and Arthritis Research UK eleven academic groups and nine commercial concerns will be looking at two approaches to the issue – better tests and techniques to improve diagnosis, and ways to predict which patient will respond to which treatment.
One of the treatments which has unpredictable results in patients is anti-TNF therapy, an approach which blocks the effects of a protein called tumour necrosis factor which, when overproduced by the body, can damage bones and cartilage. Forty percent of patients do not respond to anti-TNF therapy. A similar number fail to respond to methotrexate, one of a group of medicines known as disease-modifying anti-rheumatic drugs (DMARDs) Four drugs will form the focus of the research, which will attempt to discover precisely how each affects the body because it is known they each use different mechanisms. They are methotrexate, etanercept, rituximab and tocilizumab. Two main projects will run alongside one another. The first will examine knee biopsies of rheumatoid asrthritis patients to test whether biomarkers can predict response to biological therapies. This research will include a year-long clinical trial involving 200 patients. A second research programme will look at blood-based biomarkers in patients under treatment to predict response to methotrexate and biological therapies.
The MATURA Consortium is headed by Prof. Constantino Pizalis of Queen Mary University in London and Prof. Anne Barton from the University of Manchester. Each will head up one of the research streams. Prof. Pizalis told Arthritis Research UK: “We can’t continue to use biological therapy on a trial-and-error basis. We need to find biological markers to identify patients who are likely to respond to the first drug they are given. As well as improving diagnostics and finding better outcome measures, we can accelerate the discovery of new targets and develop new drugs. “This is the beginning of a new journey to improve treatment for people with rheumatoid arthritis and to make an enormous difference to people’s lives.” Prof. Constantino Pizalis from the Queen Mary University in London said: “We can’t continue to use biological therapy on a trial-and-error basis. We need to find biological markers to identify patients who are likely to respond to the first drug they are given.”