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Dr Ken Baker

Predicting drug-free remission in rheumatoid arthritis

In this blog, Dr Ken Baker tells us about his project, aimed at identifying predictors to reduce drug prescription in rheumatoid arthritis, including its key achievements.

About the study

The Biomarkers of Remission in Rheumatoid Arthritis (BioRRA) Study formed the basis of a PhD Fellowship jointly supported by the NIHR Newcastle BRC and the Wellcome Trust. In the study, patients with rheumatoid arthritis (RA) in remission were invited to stop their arthritis drugs and were monitored for 6 months. 23/44 patients experienced an arthritis flare, which could be accurately predicted by a 5-variable composite biomarker score.

Data and samples from this study have gone on to support:

  • An international patent application by Newcastle University
  • An industrial collaboration with an international pharmaceutical company
  • Two original research articles
  • Three further research projects
  • Two PhD Studentships
  • One NIHR Clinical Lectureship
Successful collaboration between BRCs and industry

If these biomarkers are successfully validated in an external cohort (a focus of my ongoing research), then they hold promise to be developed towards a future commercial assay to guide arthritis drug tapering and cessation in the clinic.

Following completion of the BioRRA study, I successfully negotiated with a major international pharmaceutical company to collaborate on analysis of BioRRA study plasma samples. This has allowed me to access high-sensitivity cytokine/chemokine assays not available to me within the University, and use this data to further analyse the changes in circulating cytokines at the point of arthritis flare (which will ultimately lead to further publication(s)).

This study has also been instrumental in paving the way for further studies of this kind. Data and/or biological samples from the BioRRA study have directly supported the following research activity:

  • Biological Factors that Limit Sustained Remission in Rheumatoid Arthritis (BIO-FLARE) study – MRC Experimental Challenge Grant (£3.5 million)
  • Understanding Remission and Flare in Rheumatoid Arthritis – JGW Patterson Foundation PhD Studentship (£134,000)
  • Cellular Markers of Relapse in Rheumatoid Arthritis (CeMaRRA) study – British Society of Rheumatology Research Fellowship (£37,000)
  • Academy of Medical Sciences Starter Grant for Clinical Lecturers (£29,942)
  • Somatic mutations in RA: NIHR Newcastle BRC PhD Studentship
Working with patients and the public

The participation of patients in this study was instrumental in its success. Without people willing to give their time, we could not have identified the biomarkers of drug-free remission in RA; the benefit of which is laying the foundations for translation of these biomarkers to clinical practice, potentially within the next 10 years, helping clinicians and patients decide when it is appropriate to taper or stop arthritis medication altogether.

Supporting the training and development of the research workforce

I was very pleased to have been a trainee with the NIHR Newcastle BRC. This opportunity provided frequent training on topics such as research governance, clinical trial design and grant application, which were invaluable in helping me develop these essential and transferable research skills. The BRC also nominated me to attend the NIHR Infrastructure Doctoral Research Training Camp in both 2015 & 2017; at the latter of which I was awarded first place poster prize. My career development has been further augmented by external research prizes arising from BioRRA, including:

  • 2019 Royal College of Physicians Turner-Warwick Lecturer (Northern Region)
  • 2019 Association of North of England Physicians Dewar Research Worker’s Prize
  • 2018 European League Against Rheumatism (EULAR) Abstract Award in Clinical Science
  • 2017 First place clinical presentation prize. 23rd Annual Northern and Yorkshire Rheumatology Meeting

I am currently preparing pilot data to support an externally funded Intermediate Fellowship application. Ultimately, I aim to be an international leader in rheumatology research, leading a team of clinical and laboratory researchers to deliver a programme of translational research for patient benefit.