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Research in Leeds led by Professor Paul Emery pioneered early diagnosis and treatment for patients with rheumatoid arthritis (RA), with the aim of disease remission rather than reduction of symptoms. This approach has transformed management of RA and is now standard practice for patients worldwide. It has led to greatly improved disease control, increased quality of life and reduced disability as well as direct productivity gains of an estimated £4 million per year to the UK economy.
Rheumatoid arthritis (RA) is a costly and debilitating autoimmune disorder that is characterized by joint pain, stiffness, and impaired functionality. Work at Imperial College identified tumour necrosis factor (TNF) as a key therapeutic target in the abnormal joint lining in RA. This discovery revolutionised the treatment of Rheumatoid Arthritis and other inflammatory conditions. Since 2008 the anti-TNF inhibitor infliximab (Remicade®) has been used to treat more than 1.3 million patients worldwide who have inflammatory conditions such as plaque psoriasis, rheumatoid arthritis, psoriatic arthritis, adult and paediatric Crohn's disease, ulcerative colitis, and ankylosing spondylitis. The work has had ongoing impact across the globe for the treatment of inflammatory diseases. It established the concept of biological therapy demonstrating the use of an antibody to block a cytokine and treat chronic inflammatory disease. In 2012 Remicade® was the 4th best-selling worldwide drug with total global sales of $7.67 Billion.
An estimated 1% of UK adults suffer from rheumatoid arthritis and the long-term pain and disability associated with it, Historically, however, treatments focused on relieving symptoms and did not control the arthritis itself or prevent disability. An extensive series of clinical trials and associated research programmes at King's College London (KCL) over 20 years has now significantly improved treatment recommendations and thus quality of life for thousands of rheumatoid arthritis patients in the UK, Europe and other countries. Multicentre trials of intensive treatments using conventional drugs have extended the range of drugs available, established the effectiveness of early intensive treatment, and shown that early combination therapies are safe.
Rheumatoid arthritis (RA) is a common destructive joint disease, causing pain and swelling, affecting 1 in 100 people. Work conducted by the University of Birmingham's Rheumatology Research Group has shown that early diagnosis is important, as the first few months represent a critical therapeutic window during which treatment can significantly improve health outcomes, increasing the chances of achieving disease remission and reducing the rate of progressive joint damage. The group have demonstrated that there are significant delays in patients making initial contact with their GP, which leads to delays in referral to a Rheumatologist and starting treatment; this situation has been shown to be worse in patients of South Asian origin. The outcome of the work has been incorporated into national policy documents and clinical guidance material and has underpinned a patient focused campaign to raise awareness of the disease and the need for early diagnosis.
University of Salford researchers have transferred knowledge from research in the foot health devices sector into products and services in commercial and clinical settings, supporting a £100 billion global healthcare equipment and supplies industry, contributing to economies and to quality of life on a daily basis for those with foot and lower limb health problems, world-wide. The benefiting partners are part of global businesses and public and private sector clinical services and researchers have pioneered the connection of research to commercial foot health contexts on a unique scale:
When anti-TNF therapies (which block tumour necrosis factor) were first licensed in 1999 only a few hundred patients with rheumatoid arthritis had received them, most for relatively short periods of time. Although the drugs represented a major breakthrough, `real-world' effectiveness and safety were unproven. Research at the University of Manchester (UoM) has addressed this knowledge gap and has successfully refined the ways in which anti-TNF drugs are used around the world, leading directly to more effective prescribing and improved patient outcomes. The research has also provided strong evidence that women do not need to discontinue anti-TNF treatment prior to conception.
Glasgow Caledonian University researchers have dramatically changed the manufacture of custom ankle-foot and foot orthoses through additive manufacturing (3D printing) combined with improved design personalisation. The research has beneficially impacted on health and well-being as new 3D printed orthoses have been designed and trialled with patients with positive outcomes reported. Moreover, European SME companies in the orthotic design and manufacture sector have benefitted through the commercialisation of new orthotic products and computer-based design optimisation software. The research has also led to raised global awareness of the capabilities of additive manufacturing for the orthotic sector and beneficially influenced manufacturing research and development funding at the European policy level.
Eculizumab has transformed quality of life and life expectancy for patients with PNH and led to major economic impacts with global drug sales of $1,134 million in 2012 and to Alexion Pharmaceuticals being worth over $19 billion. PNH is a disabling blood disorder that was previously fatal in 50% of patients but with eculizumab survival is comparable to the normal population as well as returning patients to having a normal quality of life. Research in Leeds led to the introduction of eculizumab in 2007. Eculizumab is now approved for clinical use in over 40 countries and for another life threatening disease, atypical haemolytic uraemic syndrome.
With one in five of the adult population in the UK living with arthritis, self-management education is a key approach used by occupational therapists (OTs) to support people with arthritis. University of Salford research has improved the tools available to OTs to deliver more effective self-management education, demonstrating the following impact:
Rheumatoid arthritis is a debilitating inflammatory condition, affecting around 500,000 people in the UK and around 0.5-1% of the adult population worldwide. Using novel techniques to study human synovium, Professor Sir Marc Feldmann and Professor Sir Ravinder Maini from the Kennedy Institute of Rheumatology identified a therapeutic target, TNFα, for treatment of rheumatoid arthritis. Following successful clinical trials, showing the safety and effectiveness of this new target, anti-TNFα antibodies have now become the gold standard treatment for severe rheumatoid arthritis worldwide. In addition to dramatically impacting patient care, anti-TNFα antibodies represent the largest group of therapies against rheumatoid arthritis on the market, with annual sales currently exceeding US$24.4 billion.