THE BLOG

Rheumatoid Arthritis - Great Progress Made But We Need to Do More

26/06/2013 09:38 BST | Updated 25/08/2013 10:12 BST

One of the biggest success stories in modern medicine of the past 20 years or so has been the development of a new class of drugs for severe rheumatoid arthritis called anti-tumour-necrosis (TNF) therapy.

Rheumatoid arthritis is a serious, inflammatory disease in which the body's immune system

attacks itself, leading to severe joint pain, affecting the internal organs and causing chronic fatigue.

It's not an exaggeration to say that anti-TNF therapy, developed and pioneered by Arthritis Research UK scientists, has revolutionised the treatment of not just rheumatoid arthritis, but more widely inflammatory arthritis around the world. It reduces symptoms and in some cases induces remission in large numbers of patients, for whom the outlook had previously been bleak; the wheelchair beckoning.

And anti-TNF therapy spawned a number of new, ever-more effective biologic drugs, which continue to keep around two-thirds of people with severe disease well and able to lead near-normal lives.

But, and it's a big but, we know that these drugs don't work in at least a third of patients with severe disease. It's little consolation to those people to hear about the fantastic success of biologic therapies on others when they are still wracked with joint pain, struggling with fatigue, and unable to work.

Recognition that there remains a considerable unmet need was the driving force behind our decision to launch a new £2.5m rheumatoid arthritis research centre, looking into the causes (pathogenesis) of the disease.

Researchers at the new centre, headed by my colleague Professor Iain McInnes at the University of Glasgow, will investigate the underlying causes of rheumatoid arthritis. They will focus on the mechanisms of auto-immunity that cause rheumatoid arthritis to start, and why it doesn't stop.

Although much of the research will be laboratory-based basic science, the ultimate aim of the centre will be to develop new therapies that will provide patients with specific treatment that will work best for them early in the course of their disease, without the need to try an array of different drugs.

The centre will be driven by collaborative partnerships by bringing together three world-class institutes; the Universities of Glasgow, Newcastle and Birmingham who have a track record of joint working, with each university bringing expertise in different fields and access to large groups of patients.

The centre, which will start its important work later in the year, has ambitious aims but we think the research teams have a realistic chance of taking our knowledge of this complex disease forward in a practical way. There are several possible paths that researchers need to follow to fully understand the underlying nature of the problem and hence direct the development of new treatments. Without having a complete understanding of why rheumatoid arthritis develops, we have no chance of finding the elusive cure.

The new centre forms just one part of our research activities. With other funding partners, we're looking to develop further the concept of 'stratified' or personalised medicine. That means treating each patient as an individual, giving them the drugs we know will work best for them, at the right time, and at the right dose. This concept remains something of a 'Holy Grail' of researchers, and would make a huge difference to rheumatoid arthritis patients.

In the meantime we're heading in the right direction. The future has never looked brighter for people with this painful, chronic condition.

For more information about rheumatoid arthritis visit www.arthritisresearchuk.org

Follow Alan Silman on Twitter: www.twitter.com/ArthritisRUK