Precision prevention and early therapy for RA; Combining patient reported information, epidemiology, genetics and immunology

Purpose and aims: To enable prevention of RA, both by providing information for public health based prevention and for precision prevention directed towards individuals at high risk for RA, and to improve outcomes for people who develop RA despite efforts towards prevention.More specific aims are to:better understand the role of environmental, genetic and immune determinants behind development of RAdevelop better diagnostic and surveillance tools to enable identification of individuals at high risk for RA (pre-RA)obtain new understanding of determinants and mechanisms for the protection against arthritis that is observed in some pre-RA individualsdevelop and evaluate digital tools that can provide patients and health care with information and capacity to test and implement precision prevention and early precision-based therapies for RA.Work planUse our large case-control and cohort studies to describe combinations of environment/life styles and genes that predict development vs protection of RAUse insights from (1) to determine which biomarkers that predict onset vs protection of RAUse novel digital tools to extend prospective cohorts of individuals at risk for RA, where prediction tools can be validated and mechanisms behind protection investigatedDevelop systems where precision prevention strategies can be tested and implemented.The long term clinical significance should be a shift in the care of RA from the present care of established disease to personalized prevention.