Researchers at King's College London are leading a national research consortium to tackle one of the largest unmet clinical needs in inflammatory arthritis, pain reduction, funded by a £3m grant from Arthritis UK.
The Arthritis UK TOPPIA (Targeting of Peripheral Pain in Inflammatory Arthritis) consortium, led by Professor Leonie Taams (Faculty of Life Sciences & Medicine) and Dr Franziska Denk (Institute of Psychiatry, Psychology & Neuroscience) at King's, will combine patients' lived experience alongside multidisciplinary expertise, to achieve precision pain management for inflammatory arthritis that addresses individual needs.
Prioritising pain in arthritis care and research
Inflammatory arthritis affects more than 1 in 100 people. It occurs when the immune system mistakenly attacks the joints, causing inflammation experienced as swelling, stiffness and pain.
Current medical approaches for inflammatory arthritis largely focus on tackling inflammation. This means that people with inflammatory arthritis do not always receive treatments that are appropriate for both their inflammation and their pain.
Pain is one of the most devastating symptoms for many people living with arthritis. Tackling it requires a large, united effort, where everyone is pulling in the same direction to improve drug development, patient stratification and advocacy.
Dr Franziska Denk, Reader in Neuroscience
Together, we will deepen our understanding of the drivers of pain, identify new therapeutic targets, improve treatment strategies, and champion the inclusion of pain as a core priority in both research and clinical care for inflammatory arthritis.
Professor Leonie Taams, Professor of Immune Regulation & Inflammation
"This is what the Arthritis UK funding will allow us to do: working together across the UK towards a future free from arthritis pain," Dr Denk added.
When people with inflammatory arthritis are undergoing clinical care, inflammation and pain are often assumed to be interlinked. But for many people, medical tests can indicate reduced inflammation but fail to show whether pain symptoms persist.
This means in some cases, someone's arthritis could be classed as in remission, but they could continue to struggle with daily pain that impacts their quality of life.
The TOPPIA consortium is united by a shared ambition to generate a step-change in how pain is addressed across the entire arthritis life course.
The research approach
Researchers in the consortium have already identified that pain is not always driven by traditional inflammation and instead can be caused by non-immune cells that remain in the joint. This 'non-classical inflammation' may be present in around 1 in 4 patients.
With the new funding, the consortium members will build on this work to gain a better understanding of the drivers of pain, identify new therapeutic targets and improve treatment strategies.
The five-year study will be supported by lived experience experts, cutting edge technologies and unique resources. It will take a four-stage approach, including:
- testing new treatment targets for pain
- creating a biobank of joint samples to study clinical information on pain
- improving tailored diagnosis and care
- advocating for pain to be prioritised in care and research.
Tom Esterine, 64, from Brixton, is a TOPPIA patient partner and helped shape the project by sharing his experience of living with rheumatoid arthritis. Tom said: "I've lived with arthritis pain for 14 years. The pain doesn't stay the same; it shifts and changes as the condition develops. It comes and goes with new medications and can persist even when healthcare professionals tell me I'm in remission.
"Well, all I can say is that remission shouldn't still hurt!
"This research is exciting because it treats pain as real, digging deeper into the joints to understand why we still experience it, and will finally find treatments to ease it."
Professor Lucy Donaldson, Arthritis UK's Director of Research, said: "We are delighted to be funding this foundational research which will address a critical yet often overlooked clinical need, chronic pain.
"The pain of arthritis can severely impact both mental and physical health. Our recent lived experience survey showed that 6 in 10 people are living in pain most or all of the time due to their arthritis.
"By placing patient voices at the heart of the study, this research embodies all values that Arthritis UK stands for, as we are committed to making real, impactful improvements for all people living with arthritis, and this is a great step in that direction."
The TOPPIA consortium is comprised of researchers from King's College London, Guy's and St Thomas' NHS Foundation Trust, King's College Hospital NHS Foundation Trust, University College London, Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiff University, University of Oxford, University of Birmingham, University of Glasgow, and The Rockefeller University in the USA.
