Predicting outcomes in patients with inflammatory arthritis: BEACON

Status: Ongoing

Many individuals develop a new onset of inflammatory arthritis with painful and swollen joints. In some cases, this arthritis settles spontaneously within a few weeks or months; other times, the arthritis persists and the patient goes on to develop either rheumatoid arthritis (RA) or another form of arthritis. These patients with persistent disease can have a variety of outcomes, with some experiencing mild disease and others very severe disease, with problems affecting not only the joints but other organ systems, such as the heart.

It is important to be able to predict from the start which patients with early arthritis will develop RA, to allow targeted early treatment. Furthermore, while a wide range of medications are available for the treatment of RA, there are considerable differences in responses to treatment amongst patients. Being able to predict treatment response in each patient would support more personalised and effective care.

The Birmingham Arthritis Early Cohort (BEACON) cohort, established in 2000, is designed to address these questions by carefully tracking the progress of patients with new onset arthritis over time, and linking their progress to the results of scientific analyses of the samples they donate.

Our work with BEACON includes the study of autoantibodies, cytokines, ultrasound imaging, metabolomics and tissue taken directly from the joint using ultrasound imaging guidance.

Project aims

By studying the BEACON cohort, we aim to:

1. assess predictors of outcome (development of persistent disease vs. resolving disease; development of severe disease vs. mild disease) in patients with a new onset of inflammatory arthritis, or symptoms suggestive of arthritis in the absence of synovitis
2. understand mechanisms operating in the joints of patients with inflammatory arthritis that drive the persistence of inflammation and the destruction of the joints
3. understand mechanisms underlying the development of systemic problems in other organ systems in patients with persistent arthritis