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05 April 2018

UH Bristol part of ground-breaking study of over 5,000 children and young people with childhood arthritis


Researchers from University Hospitals Bristol NHS Foundation Trust, led by Professor A. V. Ramanan, will join Medical Research Council-funded scientists from across the UK to begin a five year study of childhood arthritis and its linked eye inflammation, called uveitis.

With nearly £5million in funding, the CLUSTER childhood arthritis study, led by the UCL Great Ormond Street Institute of Child Health, will follow the health trajectories of 5,000 children with the condition.

Juvenile Idiopathic Arthritis (JIA) and uveitis affects one in 1,000 16 year olds in the UK. This study aims to better understand how to treat the complex condition.  This initiative hopes to move away from the one-size-fits-all approach and take into consideration a patients' genes, environment and lifestyle to create tailored therapies.

Childhood arthritis can cause long-term disability and poor quality of life, sometimes well into adulthood. If it isn't diagnosed and treated early, patients may require hip and knee replacements, are significantly shorter than their peers, and some end up in wheelchairs.

For those patients who also have uveitis, a condition where the inside of the eyes become inflamed, there is also a significant risk of vision loss and blindness.

Currently, young people diagnosed with arthritis in the UK are given a single drug therapy, but it only works in about 50% of cases. The remaining half must try other treatments, one after the other, to find a therapy which works for them. Along the way, they may experience painful side effects, time out of school and even a worsening of their symptoms.

Professor A. V. Ramanan, consultant paediatric rheumatologist at Bristol Royal Hospital for Children, will be co-leading two workstreams, looking specifically at uveitis as well as working in partnership with industry to develop new effective treatments for children with JIA and uveitis.

Professor Ramanan, funded by NIHR and Arthritis Research UK, led the Sycamore Study, results of which have led to access to novel therapy across 35 countries globally.  Blood samples of patients from the Sycamore study and the APTITUDE study (funded by Arthritis Research UK) will be looked at to screen for predictors of response to treatment.

Professor Ramanan said:

"Sight threatening uveitis in children is major cause of avoidable visual loss.

"Identifying patients with arthritis at greatest risk of developing uveitis and delivering targeted therapy early is crucial in preventing this.

"This Medical Research Council funded project will enable us to make significant strides in our efforts to diagnose and treat uveitis in children more effectively."