Title: NIHR Leeds BRC
Funder: Department of Health and Social Care

Abstract: Musculoskeletal conditions (MSK) conditions are the single most common cause of chronic disability and one of the most expensive to treat. The global burden of MSK diseases has increased by 25 percent over the past decade. The two musculoskeletal conditions that have the largest economic and personal burden are immune mediated inflammatory diseases (IMIDs) and osteoarthritis (OA). IMIDs affect the immune response of the body and include a number of inflammatory arthritic conditions, (such as rheumatoid arthritis, spondylarthropathies and polymyalgia rheumatica), inflammatory connective tissue conditions (such as scleroderma and systemic lupus erythematosus) and the vasculitides (such as giant cell arteritis and Beh&ccedil;et s Syndrome). IMIDs affect over 5% of the population and result in joint damage, physical disability and reduced life expectancy. Effective treatments exist and some are expensive: it is crucial that we ensure that people with IMIDs receive the right treatment at the right time. While not as aggressive, OA presents a wider challenge: worldwide estimates of OA indicate that one in ten men and one in five women aged over 60 have symptomatic OA and treatment options remain poor. The prevalence of OA will increase with changing ageing and obesity rates, with an expected increase in joint replacement surgery in younger people who will subsequently be living longer with their replacements. The vision for the Leeds Musculoskeletal Biomedical Research Centre (BRC) is that through accurate detection and early diagnosis, we can identify individually targeted, cost-effective therapies for musculoskeletal patients for both IMIDs and OA. This personalised approach will be driven by two clinical challenges To identify people who are at risk of developing inflammatory arthritis in order to prevent development of inflammatory complications and develop targeted, safe treatments To improve the treatment of OA to provide fifty active years after fifty in the ageing population Capitalising on our internationally recognised strengths in musculoskeletal medicine, medical engineering and imaging, our research will build on existing research capability to improve patient care. We will Establish a national referral network for people who are at risk of developing rheumatoid arthritis (RA) with the aim of developing regional treatment centres across England. We know that people who have a specific protein (or antibody) in their blood are more likely to develop RA: this network will identify such individuals and allow them to have rapid access to treatment if required (Yr 1-2) Identify why these antibodies, which are first present in the mouth, lung and gut, move into the blood stream and increase the risk of developing RA (Yr 3-4) Extend these approaches to other IMIDs (Yr1-4) Improve the treatment of IMIDs by conducting studies where the drug is targeted to the individual characteristics of the patient and thereby reducing drug toxicity from existing treatments (Yr 3-5) Develop longer lasting joint replacements to improve patient function and outcomes (Yr 3-5) Using new tissue regeneration and stem cell therapies, improve the repair of ligaments, bone and cartilage in people with OA (Yr 4-5)

Lay abstract: Musculoskeletal conditions (MSK) conditions are the single most common cause of chronic disability and one of the most expensive to treat. The global burden of MSK diseases has increased by 25 percent over the past decade. The two musculoskeletal conditions that have the largest economic and personal burden are immune mediated inflammatory diseases (IMIDs) and osteoarthritis (OA). IMIDs affect the immune response of the body and include a number of inflammatory arthritic conditions, (such as rheumatoid arthritis, spondylarthropathies and polymyalgia rheumatica), inflammatory connective tissue conditions (such as scleroderma and systemic lupus erythematosus) and the vasculitides (such as giant cell arteritis and Beh&ccedil;et s Syndrome). IMIDs affect over 5% of the population and result in joint damage, physical disability and reduced life expectancy. Effective treatments exist and some are expensive: it is crucial that we ensure that people with IMIDs receive the right treatment at the right time. While not as aggressive, OA presents a wider challenge: worldwide estimates of OA indicate that one in ten men and one in five women aged over 60 have symptomatic OA and treatment options remain poor. The prevalence of OA will increase with changing ageing and obesity rates, with an expected increase in joint replacement surgery in younger people who will subsequently be living longer with their replacements. The vision for the Leeds Musculoskeletal Biomedical Research Centre (BRC) is that through accurate detection and early diagnosis, we can identify individually targeted, cost-effective therapies for musculoskeletal patients for both IMIDs and OA. This personalised approach will be driven by two clinical challenges To identify people who are at risk of developing inflammatory arthritis in order to prevent development of inflammatory complications and develop targeted, safe treatments To improve the treatment of OA to provide fifty active years after fifty in the ageing population Capitalising on our internationally recognised strengths in musculoskeletal medicine, medical engineering and imaging, our research will build on existing research capability to improve patient care. We will Establish a national referral network for people who are at risk of developing rheumatoid arthritis (RA) with the aim of developing regional treatment centres across England. We know that people who have a specific protein (or antibody) in their blood are more likely to develop RA: this network will identify such individuals and allow them to have rapid access to treatment if required (Yr 1-2) Identify why these antibodies, which are first present in the mouth, lung and gut, move into the blood stream and increase the risk of developing RA (Yr 3-4) Extend these approaches to other IMIDs (Yr1-4) Improve the treatment of IMIDs by conducting studies where the drug is targeted to the individual characteristics of the patient and thereby reducing drug toxicity from existing treatments (Yr 3-5) Develop longer lasting joint replacements to improve patient function and outcomes (Yr 3-5) Using new tissue regeneration and stem cell therapies, improve the repair of ligaments, bone and cartilage in people with OA (Yr 4-5)

Research activity codes: 6.9 RESOURCES AND INFRASTRUCTURE (TREATMENT EVALUATION)
Health categories: RESPIRATORY;INFECTION