Rheumatology
We are a group of highly collaborative clinical and non-clinical scientists advancing understanding of the causes and developing new ways of treating rheumatological conditions.
Our aim is to deliver excellent science and clinical research together with people with lived experience of rheumatological conditions. We are delivering novel insights and pragmatic treatment for conditions across the life course and in diverse populations, including osteoarthritis, gout, CPPD disease, immune-mediated inflammatory diseases such as rheumatoid arthritis, and musculoskeletal pain. These conditions represent the most common reasons for healthcare utilization in the NHS. Our studies range from preclinical modelling to randomised controlled mechanistic and efficacy trials. We link findings from real-world data (big-data research), research cohorts and biorepositories with deeply phenotyped cases. We embrace collaboration with patients, international academics and pharmaceutical industry.
Our research has informed national and international guidelines on osteoarthritis, gout, CPPD disease, and vaccination. We have combined multi-omics with deep clinical characterisation, linked gut microbiome to musculoskeletal disease, and defined how rheumatological and non-rheumatological conditions interact to define disease and disease management.
Our research has also informed the development of the teaching modules both for undergraduate (e.g. Evidence-based Medicine and Clinical Study Design), as well as postgraduate students (e.g. Quantitative Evidence Synthesis). We also provide excellent PhD training programs spanning from preclinical to clinical, and from epidemiology to development of a complex intervention, clinical trial and systematic review.
Our research
Our research themes include:
Chronic Pain
Rheumatology leads Pain Centre Versus Arthritis at the University of Nottingham, and the national Advanced Pain Discovery Platform. The Pain Centre develops new and improved treatments through a translational research programme into the mechanisms by which changes within the joint and in the nervous system interact with psychosocial factors to produce arthritis pain. Targeted treatment approaches are based on mechanistic pain phenotypes in order to improve the lives of people with chronic pain.
Mechanistic and multi-omic studies
We investigate molecular mechanisms underlying chronic pain and pain relief in people with osteoarthritis or trauma through observational studies, experimental medicine and lifestyle interventions
Lifestyle interventions
targeting metabolism and inflammation in musculoskeletal conditions are becoming increasingly important particularly in the context of multimorbidities during the ageing process. This type of intervention can reduce pain from arthritis, reduce cardiometabolic risk, improve outcomes following surgery, reduce chronic inflammation, have survival benefits and even have cognitive benefits. the lack of understanding of the mechanisms of action it is impossible to undertake efficacy studies in any meaningful manner. Development of a measurable biomarker based on efficacy pathways would allow modifying, readapting, or optimising these interventions thereby improving adherence and adoption by the general population.
This work has resulted in papers in Cell, Nature Metabolism, Cell Reports Medicine and Nature Medicine among many others.
Digital Health
This includes categories such as mobile health wearable devices, telehealth and telemedicine, and personalised medicine. We have pioneered the delivery of app delivered physiotherapy to reduce osteoarthritis pain with high effectiveness as featured in our work in JAMA Open Network.
Longitudinal cohorts
We have established longitudinal cohorts to investigate musculoskeletal health and wellbeing (IMH&W), knee pain and related health in the community (KPIC), foot/ankle osteoarthritis and cognitive impairment in the UK soccer players (FOCUS). We also developed cohorts of healthcare workers (patherstudy.org.uk) which enabled us to during the COVID-19 pandemic to answer several key research questions and to establish national and international collaborations which resulted in papers in Lancet, Lancet Infectious Diseases, Nature and Science among others.
Biorepositories
We host unrivalled biorepositories of human joint tissues from living and post mortem donors, matched spinal tissues, and blood and synovial fluid samples linked to our clinical cohorts
Inflammatory Diseases
We undertake large multi-centre primary-care and secondary-care clinical trials that have implications for patient management globally. Our clinical trial research is funded by NIHR-HTA and NIHR-MRC EME programs and is geared towards answering key clinical uncertainties in the management of gout (T2T), rheumatoid arthritis (MOOSE), perioperative biologic management (PERISCOPE), and optimising immune-response to COVID-19 boosters in people with inflammatory conditions (VROOM) and chronic lymphocytic leukaemia (IMPROVE). We collaborate with trial units throughout England and with other leading institutions such as Southampton, Imperial, Oxford, Leeds, QMUL, Keele and Sheffield. Our interventional studies have been published in Lancet, and Lancet Respiratory Medicine
We undertake big-data research using UK electronic health records datasets and UK Biobank studying epidemiology of inflammatory conditions, gout, and safety and effectiveness of vaccination in people with inflammatory conditions in collaboration with colleagues in Nottingham and Birmingham. Using a multi-specialty and multi-disciplinary approach we study rheumatic, dermatologic and gastrointestinal inflammatory conditions. This workstream has been funded by NIHR (RfPB, HTA/EME) FOREUM, AstraZeneca, Versus Arthritis, and several other funders. We have obtained over £8 million in external research grants (over £5 million with Professor Abhishek as Chief Investigator). Our observational studies have been published in JAMA and the BMJ.
We lead on the development of the first validated classification criteria for CPPD disease, leading a multinational collaborative of investigators from three continents. We collaborate with qualitative researchers, basic scientists with interest in inflammatory conditions and methodologists nationally to deliver patient centred research with our main research strengths in observational studies and clinical trials.
Evidence based Medicine
Comorbidity and multimorbidity
Our research in this area started with gout, SLE and rheumatoid arthritis. We are currently leading a European project on “Comorbidities in osteoarthritis (ComOA)” in UK, Netherlands, Sweden and Spain, aiming to examine the temporal association, clusters, analgesics contribution, causality and variation between populations. We are revealing how pain, multimorbidity and frailty interact to impair quality of life in elderly populations.