Precision medicine in RA via improved aetiological insights and clinical predictions

AIMSTo enable a precision medicine approach to the management of rheumatoid arthritis (RA) we aim to i) improve our understanding of aetiological heterogeneity of RA, and use that along with patient- and drug-specific factors to ii) explain clinical heterogeneity, iii) predict treatment response and (iv) drug safety, and to v) weigh treatment benefits to their risks in the short- and long-term, for individual drugs, and for the individual patient.WORK PLANMy research programme takes a clinical-epidemiological “eco-system” approach and rests on capture of RA data from clinical practice that together with new biomarkers and enrichment with data from national registers and other sources will be integrated and analysed using hypothesis-based as well as data-driven analytic approaches, in (inter-)national collaboration, to address specific questions related to i) through v) above, and thereby transform clinical practice.

We will employ definitions of RA phenotypes that preserve their multidimensional nature, and parse out effects of RA-specific factors, non-RA related patient characteristics, and contextual factors.SIGNIFICANCEFor the individual, an aetiology-based individualised approach to RA would open for targeted primary prevention, for more precise choice of effective and safe interventions, and reduced risks of irreversible damage and comorbidities.

For society, this will mean considerable savings through increased workability and reduced costs for ineffectively used drugs.