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First Patients Enrolled: 3TR Clinical Study Investigating Precision Therapy in Patients with Rheumatoid Arthritis Has Begun

Rheumatoid Arthritis (RA) is one of seven chronic diseases being investigated within the 3TR project. It is a chronic inflammatory disease that affects 0.5-1% of adults in developed countries. Uncontrolled active RA can cause joint damage, disability, decreased quality of life and cardiovascular problems along with other comorbidities. There are a number of therapeutic interventions available to treat RA and this has immensely expanded over the past 30 years, and although biologic disease-modifying antirheumatic drugs (so-called) DMARDS have shown clinical and radiological benefits, patients are still treated with a “trial and error” approach with approximately 40% of patients not responding sufficiently to treatment.

In recent years, thanks to the development of minimally invasive ultrasound-guided biopsy, synovial tissue analysis has been proposed as a tool for patient stratification with potential use in clinical practice. Following on from previous studies (e.g., PEAC, R4RA, and STRAP), the new 3TR-Precis-The-RA trial aims to identify biomarkers in the synovial tissue of patients with RA in order to give a more informed choice of treatment. We hope that the treatment of RA patients according to their biomarker will provide better care (avert delay starting a more effective drug), prevent unnecessary exposure to potentially toxic drugs, and additionally be cost saving.

Enrolment in the 3TR-Precis-The-RA trial started in February 2023 with the first patient recruited at Mile End Hospital, Barts Health NHS Trust (UK). The target is to include 200 patients from sites across six European countries. Patients will undergo a synovial biopsy before being randomised to either a “control” or “biomarker treated” group. The 3TR studies are proposed to understand the underlying mechanism of non-response to treatment with a view to provide a more effective and personalised therapy.

In an online talk on 20 March 2023, 2 to 3.30 (UK time), Costantino Pitzalis, Professor of Rheumatology at Queen Mary University of London/Centre for Experimental Medicine and Rheumatology (EMR) and leader of the RA working group within 3TR, will provide further insights into the study's set-up and speak about recent findings and medical advances in RA treatment with a particular focus on the promise of new, more personalised therapy options for RA patients. Further information on the event and the registration link can be found here.

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