Predicting drug-free remission in rheumatoid arthritis
In a Newcastle BRC-funded study, Dr Ken Baker aimed to predict which patients with rheumatoid arthritis could safely stop taking arthritis drugs.
How does medication affect people living with rheumatoid arthritis?
Around a third of patients with rheumatoid arthritis can now achieve remission thanks to modern arthritis drugs. However, these powerful drugs carry a potential risk of severe side-effects. They also require regular blood test monitoring. Arthritis drugs are usually prescribed as long-term treatments, often life-long.
However, recent studies show that up to half of patients with rheumatoid arthritis in remission can stop their arthritis drugs, without a flare-up. Stopping arthritis drugs for these individuals could avoid side-effects, improve quality of life, and offer huge savings for the NHS. However, there is currently no reliable way of predicting which patients can achieve this.
Led by Dr Ken Baker, the ‘Biomarkers of Remission in Rheumatoid Arthritis’ (BioRRA) Study worked with patients with rheumatoid arthritis in remission. They were invited to stop their arthritis drugs and then monitored for six months. By measuring clinical and bloodstream markers before the drugs were stopped, we aimed to identify markers that could predict which patients could achieve drug-free remission. The study found that half (21/44) of patients stayed in remission for six months after stopping their arthritis drugs, which could be accurately predicted by a combination of five markers.
Ongoing and future research aims to validate these biomarkers. For example, the BIO-FLARE study is a follow-on £3.5m MRC-funded projects into the study of drug cessation in rheumatoid arthritis. If successful, this ongoing work will lay the foundations for translation of these biomarkers to clinical practice potentially within the next 5-10 years, helping clinicians and patients decide when it is appropriate to taper or stop arthritis drugs.
Key outputs from this study
- a 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