Psoriatic arthritis (PsA) affects around 150,000 people in the UK and is a type of arthritis that develops in around 15% of people with the skin condition psoriasis, causing swollen and painful joints. Currently, there is little research on the best way to treat these patients.
A new NHS consultant with over 10 years experience in PsA research, Dr Coates will explore the 'Treat to Target' approach to care in detail. In Dr Coates's previous TICOPA trial with this strategy, patients are reviewed every four weeks and their treatment increased until a target is achieved. Whilst patients report improved arthritis, psoriasis, quality of life, pain and function, the approach is not widely used due to worries about increased hospital visits and costs.
Crucially, Dr Coates's project will evaluate if a more practical version of the 'treat to target' approach can be run successfully in a routine NHS Clinic that is both beneficial to patients and sustainable.
"My research is clinical and focuses on improving everyday care for patients with PsA.", says Dr Coates. "I want to take successful treatment approaches like treat to target from clinical trials and integrate them into routine clinical practice to improve care for everyone."
In the next step, she will test different drug choices within the treat to target approach to try and personalise therapy for individual patients. The project will also investigate if patients with severe PsA do better if they start on stronger arthritis drugs, rather than having to start on weaker ones and step up from that over time.
The research is also focused on personalisation, looking to assess whether a trial is feasible for patients with mild disease to go without standard arthritis drugs as it is possible these patients may not need any of these treatments, suffering unnecessary side effects.
"We have many drugs available to treat PsA but very little research to tell us how to use them. This study will help us understand the best way to use the therapies we already have for patients with mild and severe disease", adds Dr Coates.
The project is funded by the National Institute for Health Research.