Despite significant advances in understanding of the pathogenesis of inflammatory arthritis and the corresponding development of targeted therapies with proven efficacy in a number of these chronic inflammatory conditions, numerous areas of unmet need remain. Most prominent among these are the low proportion of patients who do not attain sustained remission with currently available treatments and patients who consistently cite debilitating pain and fatigue as their major symptoms despite access to contemporary treatments. New, cost-effective interventions are required to address these issues. The Taylor team has two parallel and overarching goals set within the context of practice-changing clinical trials and experimental medicine studies. Firstly, to advance our understanding of the aetiopathogenesis of rheumatic disease using targeted therapies as probes of pathogenesis. Second, to develop novel, sensitive and robust outcome measures that will inform an early go/no-go decision for further clinical development, thus enriching for the success of clinical studies that advance to phase III testing.
We are running clinical trials in rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. These include early phase studies to test novel therapeutic approaches in musculoskeletal disease in areas of unmet clinical need and experimental medicine studies that will permit investigation of the biological role of the drug target in vivo. In addition, in parallel, we will test the sensitivity of novel measures of outcome linked to the pathobiology of the disease. This system may provide an early, reliable and sensitive indication that will inform a rational decision as to whether to progress a potential pharmacotherapeutic to later phase clinical studies - for which the primary endpoint is designed to meet the regulatory criteria required for licensing for clinical use. Such an approach is predicted to greatly enrich for likely success in phase 3 studies, and thus to considerably cut research and development costs.