Personalized medicine in RA by combining genomics, biomarkers, clinical and patient-derived data from the Nordic countries

Rheumatoid arthritis (RA, life-time risk around 2%) entails a considerable burden for affected individuals (pain, reduced life-span, reduced function, reduced quality of life), for health-care, and for society (reduced work ability, and treatment costs that currently accounts for almost 10% of the total drug expenditure). Delayed or ineffective treatment leads to joint destruction, co-morbidities, and increased mortality.

RA demonstrates a striking heterogeneity in terms of clinical presentation, response to treatment, and clinical outcomes. Emerging data suggest that RA is not one disease but comprised by subsets with distinct etiologies, which may explain the difficulties in predicting disease course, treatment response, and long-term outcomes. So far we treat by tradition and try different treatments in a rather random fashion and often too late, despite the increasing number of different, and still expensive, medicines that have become available in routine care.

The goal of this project is to develop a personalized medicine approach to the management of Rheumatoid Arthritis (RA), both by the development of new prediction tools and by digital tools to bring these now insights to patients and to health-care.

Our approach builds on our strong collaboration within Nordic Rheumatology including work with data sharing across the Nordic countries, and a complementary public-private partner constellation that spans all the necessary competences and infrastructures. The novelty in our approach includes the availability and analyses of data across different domains (genomics, biomarkers, clinical data, patient-reported data, register-linkage data) that so far have not been analyzed together, new biomarker assays, the inclusion of patient-centric outcomes (e.g., pain) rather than composite and insensitive outcome metrics. In addition, rather than a sole focus on generating scientific output, our constellation of partners will also develop, validate and disseminate these new insights into improvement of therapy directly to patients and health care via the development of digital tools.

The anticipated outcomes of our approach is better and earlier treatment of RA paired with the development of products (diagnostics and digital companion tools) that can be used for cost-efficient improvement of treatment results for patients, and thus become attractive commercial products as well.