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  • Intake: OxKEN

PROJECT OVERVIEW

Psoriatic arthritis (PsA) is a type of arthritis that develops in around 30% of people with the skin condition psoriasis.  In addition to PsA related inflammation in the joints and skin, other non-inflammatory processes contribute to pain and disability experienced, with some preliminary information that this may be different in women and men. This DPhil project will the first in-depth study to investigate both inflammatory (patterns of psoriasis/arthritis) and non-inflammatory processes (including underlying causes of pain, mood, sleep disturbance, and coping strategies) that prevent patients achieving treatment targets and minimal impact of disease.

Funding is already secured for a 300 patient cross-sectional study, across 10-15 UK centres, with measures of psoriasis and arthritis disease activity alongside a comprehensive assessment of non-inflammatory factors including: fatigue, self-efficacy, fibromyalgia, neuropathic pain, pain catastrophizing, anxiety, depression, and sleep disturbance.

This will be complemented by analysis in existing longitudinal data from the Dutch Early PsA Registry (DEPAR), for over 700 early PsA patients. There will be the opportunity for an exchange to visit or exchange with another PhD student with supervision from Professor Marijn Vis in Rotterdam.  Logistic regression modelling will be used to identify predictors of good disease control and low patient impact. This will also be combined with a data driven approach, using cluster and principle component analyses, to identify novel patient subgroups and predictors of response.

We believe that this study will help to find a new way of grouping patients who have not achieved well-controlled disease, due to different combinations of inflammatory and non-inflammatory processes. This could be used to improve their outcome using specific tailored treatments for non-inflammatory factors (for example painkillers targeting nerve-related pain) alongside current psoriasis and arthritis treatments aimed at controlling inflammation.

KEYWORDS

Disease burden, psoriatic arthritis, pain, clinical study, 

TRAINING OPPORTUNITIES

Biostatistics, big data, epidemiology, specialist psoriatic arthritis and combined rheum/derm clinics, presentations at national and international meetings, link into large European PsA consortium investigating predictors of PsA development.

KEY PUBLICATIONS

  1. Soni A, Wanigasekera V, Mezue M, Cooper C, Javaid MK, Price AJ, Tracey I. Central sensitisation in knee osteoarthritis: Relating pre-surgical brainstem neuroimaging and PainDETECT based patient stratification to arthroplasty outcome. Arthritis Rheumatol 2018.
  2. Soni A, Santos-Paulo S, Segerdahl A, Javaid MK, Pinedo-Villanueva R, Tracey I. Hospitalization in fibromyalgia: a cohort-level observational study of in-patient procedures, costs and geographical variation in England. Rheumatology (Oxford) 2020;59(8):2074-2084.
  3. Coates Laura C, Moverley Anna R, McParland Lucy, Brown Sarah, Navarro-Coy Nuria, O’Dwyer John L, Meads David M, Emery Paul, Conaghan Philip G, Helliwell Philip S. (2015) Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet; 386(10012):2489-98.
  4. van Mens Leonieke JJ, van de Sande Marleen GH, van Kuijk Arno WR, Baeten Dominique, Coates Laura C. (2018) Ideal target for psoriatic arthritis? Comparison of remission and low disease activity states in a real-life cohort. Ann Rheum Dis;77(2):251-257.
  5. Coates LC, FitzGerald O, Merola JF, Smolen J, van Mens LJJ, Bertheussen H, Boehncke WH, Callis Duffin K, Campbell W, de Wit M, Gladman D, Gottlieb A, James J, Kavanaugh A, Kristensen LE, Kvien TK, Luger T, McHugh N, Mease P, Nash P, Ogdie A, Rosen CF, Strand V, Tillett W, Veale DJ, Helliwell PS. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis/Outcome Measures in Rheumatology Consensus-Based Recommendations and Research Agenda for Use of Composite Measures and Treatment Targets in Psoriatic Arthritis. Arthritis Rheumatol. 2018 Mar;70(3):345-355.

CONTACT INFORMATION OF ALL SUPERVISORS

Laura Coates

Anushka Soni

Irene Tracey