Rheumatoid Arthritis (RA) is the commonest cause of inflammatory joint disease and affects 1% of the population: over half a million people in the UK alone. Untreated, RA causes profound disability, with the potential for permanent joint damage in the majority of patients; direct NHS costs of treatment are estimated at over £500m, while indirect societal costs top £2b annually. A more aggressive approach to early therapy coupled with developments in biologic therapies and more recent small molecule inhibitors have had a significant impact on our ability to control disease over the last decade. However, pragmatic studies of real world efficacy of biologic therapies reveal poor response rates of around 60% and frequent loss of efficacy that do not fulfil the promise of initial clinical trials, revealing widespread refractory disease with persisting disability, and a frustrating inability to induce true remission.
A-TAP investigators are harnessing the common features of inflammation shared across diseases to understand mechanisms of refractory disease at the tissue level, using cutting edge technologies such as single cell sequencing and multi-parameter digital tissue imaging to define cellular populations that drive persistent disease. Uniquely, A-TAP provides the infrastructure to translate these findings rapidly into clinical trials that are run across diseases, interrogating the effects of therapy at the tissue level in order to both generate new science and inform Go:No Go decisions for both academic investigators and industry.
Lead Dr Andrew Filer, University of Birmingham