Juvenile idiopathic arthritis: personalising drug treatment
Published on 6 September 2018
Around 12,000 children in the UK are affected with juvenile idiopathic arthritis (JIA) – one in every 1,000 young people.1 These conditions can have a long-term impact on their health and well-being – causing joint pain, inflammation and stiffness. New biological drugs that fight disease are now an option, but they aren’t always effective and can cause serious side-effects. Professor Margaret Hall-Craggs at University College London is developing specialised magnetic resonance scans to help doctors measure joint inflammation more accurately and to choose the best drug treatment for each child. Their goal is to reduce pain and disability and to improve long-term quality of life for children with JIA.
How are children’s lives affected now?
JIA is an autoimmune condition, meaning the immune system attacks the body’s own joint tissues. To protect itself, the body creates inflammation, but this leads to stiffness and pain – and lasting damage. So many children with JIA will have life-long pain and disability that can seriously impact on their quality of life.
There are a variety of treatments available for children with JIA that aim to control their symptoms, enabling them to lead active, independent lives. These include new biological drugs that can reduce inflammation and joint damage.
“Although it’s good news that these powerful new drugs are now available, they aren’t effective for everyone and children can experience serious unwanted side-effects,” says Professor Hall-Craggs.
But currently, it’s difficult for doctors to identify who might benefit from these drugs as it is can be hard to assess if a child’s joints are inflamed, particularly if they are deeply seated in the body, and blood tests are often unhelpful.
How could this research help?
“Our aim is to develop tools that enable doctors to measure more accurately a child’s joint inflammation to help them decide when a biological drug treatment should start or change,” says Professor Hall-Craggs. “This will help ensure each child receives the best possible treatment – reducing long-term joint damage while lowering their risk of unnecessary side-effects.”
Professor Hall-Craggs’ team have developed specialised magnetic resonance imaging (MRI) scans that can show when joints are inflamed. The team now plan to improve their technique by analysing scan data using artificial intelligence, creating 3-D pictures that are colour-coded to provide a more accurate measurement of the degree of inflammation within a joint.
“We hope that these detailed images will make it much easier for doctors to interpret complex MRI data, helping to improve clinical decision-making,” says Professor Hall-Craggs. “And they will also help patients to see whether joints are improving or deteriorating over time – potentially encouraging them to keep taking an effective drug.”
- National Rheumatoid Arthritis Society: https://www.nras.org.uk/jia [website accessed 26 August 2018]
|Project Leader||Professor Margaret A Hall-Craggs, BA MBBS MRCP FRCR MD|
|Location||Centre for Medical Imaging, University College London|
|Grant awarded||25 July 2018|
|Start date||1 December 2018|
|End date||30 November 2021|
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