Can we personalise treatment for rheumatoid arthritis by looking at a patient’s immune cells in the blood?

Disease - Rheumatoid arthritis

Lead applicant - Dr Sebastien Viatte

Organisation - University of Manchester

Type of grant - Invited Research Award

Status of grant - Active

Amount of the original award - £253,210

Start date - 18 June 2018

Reference - 21818

Public Summary

What are the aims of the research?

Rheumatoid arthritis is a complex disease in which many different types of white blood cells from the immune system are involved. There are now a variety of biologic drugs available to treat rheumatoid arthritis which are very effective. However, not all biologic drugs work equally well in all people with rheumatoid arthritis and there is currently no way of predicting which biologic treatment will be best to treat each person.

The aim of this work is to see whether each person with rheumatoid arthritis has a particular profile or combination of white blood cells, which can be tested using a simple blood test, that can predict which biologic drug they will respond to best.

Why is this research important?

The researchers aim to include 300 people with rheumatoid arthritis in this study. They will take blood from each individual before they start treatment with a biologic drug. The choice of biologic drug to be used will follow current guidelines that doctors follow when prescribing these treatments.

White blood cells will be extracted from the blood and will be analysed in the laboratory according to which proteins they have both on the surface and inside the cell. Based on this information, the white blood cells will be categorised into several already known groups of cells. These groups will be compared between people who respond well and those not responding well to a particular biologic drug. This could provide a “signature” of treatment response which could be used in future to guide doctors on the best treatment choice for each individual with rheumatoid arthritis.

How will the findings benefit patients?

Although biologic drugs have been a major breakthrough in the treatment of people with rheumatoid arthritis, not all individuals respond equally well to each drug and there is no way of predicting which drug will be most effective for each individual. If this research is successful, it could allow doctors to predict each individual patient’s response to different biologic drugs, based on a simple blood test. This could mean that patients will be treated earlier with the best treatment option available, avoiding pain and joint damage due to a delay in effective treatment.