She gained her MRCP in 2008, started on the rheumatology rotation the following year- during which she attained an MSc in clinical rheumatology with merit and obtained her specialty certificate in rheumatology. Prior to commencing the North West England MRC Clinical Research Fellowship, she undertook a number of research projects throughout her clinical years as well as during her MSc, investigating shared genetic risk factors in myositis with other autoimmune diseases, at the Arthritis Research UK Epidemiology Unit University of Manchester. During her time in clinical training and research, increasing experience of patients with inflammatory disorders on biologics and variation in their clinical response/ development of serious side effects, lead to an avid interest in their potential in personalised medicine. The aim of her current study is to assess factors that may be able to predict response to biologics in rheumatoid arthritis, psoriatic arthritis and
Investigation of immunogenicity in response to biological therapy for autoimmune disease
‘Biologic agents’ introduced in the last decade, have revolutionised the treatment of rheumatoid arthritis, psoriasis and psoriatic arthritis. They are expensive, costing approximately £10,000 per patient per year. However, in about one in five patients where biologics work initially, the treatment stops working a few months later, or patients may develop a bad reaction and the drugs have to be stopped. At present, we do not know which patients are likely to fail on treatment and/or get side-effects.
The body’s immune system can react against the biologic drug by producing antibodies. There is emerging evidence that drug antibodies stop biologics from working and lead to certain side-effects. We will study a large number of rheumatoid arthritis patients receiving biologics and see whether antibodies affect how the drugs work. We will also study patients with psoriasis and psoriatic arthritis, and assess whether prescribing other treatments such as methotrexate at the same time lowers the chances of antibody production. The ability to predict a lack of response at an early stage of treatment, might save patients months of futile treatment, encourage an earlier shift to effective therapy and ensure that these expensive drugs can be given to patients responding well in a cost-effective manner.