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Our work aims to address unmet needs relating to pathogenesis, timely diagnosis and optimal management throughout the journey of a patient with psoriatic arthritis (PsA). We focus on the role of the immune system in disease pathogenesis by studying immune cells from the blood and synovial fluid of patients with PsA. Work around accelerating the appropriate referral and earlier diagnosis of PsA investigates screening questionnaires and we aim to establish optimal referral algorithms for use in both primary and secondary care.  

 

Following a diagnosis, research focuses on clinical and patient reported outcomes that accurately reflect the disease burden of individual patients and can be used to guide therapy.  Following our successful trial of a treat-to-target strategy in PsA (the Tight Control of PsA – TICOPA trial), we are addressing psychological and logistical factors that can aid implemention into routine practice nationally.

 

Laura Coates leads the MONITOR study (Multicentre ObservatioNal Initiative in Treat to target Outcomes in PsA), a multicentre NIHR funded prospective cohort of newly diagnosed PsA patients.  This utilises a Trials Within Cohorts (TWiCs) design enabling embedded trials comparing new therapeutic strategies with standard care in the cohort to establish optimal care pathways in the disease.  Clinical research in this cohort covers disease assessment, imaging (potentially MRI and US), disease impact and patient satisfaction with therapies. This cohort includes an embedded laboratory study aiming to identify biomarkers of treatment response and clinical phenotype led by Dr Hussein Al-Mossawi. We use a multi-modal big data approach to study blood and synovial fluid immune cells using flow cytometry, mass cytometry (CyTOF) and RNA sequencing investigating immunophenotype in PsA and predictors of response to therapy.

 

We have strong collaborative links across the University and beyond. Dr Laura Coates is the chair of the British PsA Consortium (BritPACT) and is a steering committee member of the international Group for Research and Assessment of Psoriasis and Psoriatic Arthritis.  Dr Al-Mossawi is a fellow/lecturer at St Edmunds Hall and a member of the PsA Genetics Consortium. 

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