Researchers at the University of Glasgow will play a key role in the major new EU research project, HIPPOCRATES, which will promote the early identification of and improve outcomes for patients with psoriatic arthritis.

HIPPOCRATES is a collaboration between European research partners, pharmaceutical companies, SME’s and patient organisations, who have all joined forces as partners to develop innovative, personalised treatment options for people affected by psoriatic arthritis. It is hoped the project will revolutionise treatment and deliver profound patient benefits.

By looking into psoriatic arthritis disease mechanisms, the 26 European partners aim to improve diagnostic and therapeutic options for patients living with this condition. The project aims to gain a better understanding of the complex interplay between clinical and environmental factors, as well as genotype and molecular pathways, to enable earlier diagnosis and a more accurate prediction of disease progression.

One of the aims of HIPPOCRATES is to identify biomarkers that help predict response to treatment. Professor Stefan Siebert and Professor Carl Goodyear from the University of Glasgow’s Institute of Infection, Immunity and Inflammation, are co-leading the project arm addressing this important area. Their team will use state of the art technologies to identify biomarkers that will help inform a move to a more targeted approach for the treatment of this condition.

Professor Siebert, who also runs a specialist psoriatic arthritis clinic in Glasgow, said: “Having biomarkers to predict which therapy is most likely to work in a patient with psoriatic arthritis would avoid the current largely trial-and-error approach and would lead to significant improvements in patients’ quality of life.”

HIPPOCRATES also aims to promote early diagnosis and improve the management of people with psoriatic arthritis.  Professor Frances Mair, from the University of Glasgow’s Institute of Health and Wellbeing, who leads the project arm promoting communication, dissemination & sustainability, said: “Our project aims to ensure that any biomarkers found to help identify patients developing psoriatic arthritis – and any algorithms that may be produced to support clinicians to make appropriate diagnoses earlier – are implementable in practice, so that they can transform the management of psoriatic arthritis.”

The project will run for a period of five years, with a total budget of €21million provided by the Innovative Medicines Initiative (IMI 2), a Joint Undertaking of the European Union and the European Federation of Pharmaceutical Industries and Associations (EFPIA). Of the total budget, 50% are contributed by the EFPIA partners (Novartis [EFPIA lead], UCB [EFPIA Co-lead], Pfizer and BMS) and 50% by the EU.

Psoriatic arthritis is a chronic immune-mediated inflammatory disease that affects joints and other components of the musculoskeletal system, together with skin involvement, in an estimated 5-10 million individuals in the EU.  The symptoms of the disease, including pain, joint stiffness and fatigue, can impact on many aspects of life including function and productivity.

Overall, it is increasingly recognised that Psoriatic arthritis is associated with multiple comorbidities, particularly those affecting mental health such as depression and those which promote the development of accelerated atherosclerosis and contribute to the observed increase in cardiovascular morbidity and mortality. Psoriatic arthritis most commonly develops on a background of established skin and/or nail psoriasis, however it can be difficult to diagnose as there are no diagnostic criteria or laboratory tests available. This can contribute to diagnostic delay and poor outcomes.

Psoriatic arthritis is characterised by considerable heterogeneity with regards to clinical features, disease progression and response to targeted therapies. Future treatments will need to focus on earlier disease stages and be selected on the basis of detailed patient molecular profiling so as to limit poor long-term outcomes and possibly prevent the development of Psoriatic arthritis altogether.   

“We anticipate that the advances provided by HIPPOCRATES will result in significant new developments that improve patients’ quality of life” says Prof. Oliver FitzGerald, Newman Clinical Research Professor at University College Dublin, Conway Institute for Biomedical and Biomolecular Research, Ireland coordinator of the HIPPOCRATES consortium.

Co-coordinator, Prof. Stephen Pennington, Professor of Proteomics at University College Dublin and also in the Conway Institute notes: “The advances will include the identification of sub-populations and endotypes, the validation of existing and identification of new biomarkers, improved imaging options and the development of a sustainable infrastructure for future PsA research.

“HIPPOCRATES offers the great promise of powerful new tools to advance both early diagnosis and treatment of patients with PsA. Additionally, and to further its effectiveness, HIPPOCRATES retains the focus on the patient, involving Patient Research Partner’s within all aspects of the project,” adds Denis O’Sullivan (Patient Representative Arm of GRAPPA-EU).

“This public-private partnership is a great opportunity to decipher this highly heterogenous disease, and to enable the development of novel PsA therapies and treatment strategies including precision medicine approaches” adds Dr. Christine Huppertz, Senior Principal Scientist in the Disease Area Autoimmunity, Transplantation and Inflammation at Novartis, and EFPIA lead of the consortium.

In order to achieve its goals, the HIPPOCRATES project will set up a single integrated database combining the cohorts and datasets of the most important European PsA studies and establish a Europe-wide library of relevant clinical biosamples. HIPPOCRATES will also establish a large, prospective, observational study of 25,000 patients with psoriasis who will be recruited and followed on-line for development of PsA, with patient-centric blood sampling at defined intervals.

Furthermore, the team of experts will evaluate and validate newly discovered biomarker signatures for the early diagnosis of PsA, for the identification of psoriasis patients at risk of developing PsA, for the identification of PsA patients at highest risk of damage progression and for personalised or stratified treatment strategies so as to maximise treatment response. Overall, HIPPOCRATES places particular emphasis on the involvement of patients, clinicians, primary care practitioners, regulators, SMEs (ATTUROS Limited, Oxford Biodynamics Limited and NEOTERYX Limited) and relevant large industry to meet the needs of all stakeholders and to maximise the project’s impact.

Formed as a transdisciplinary consortium, the project team comprises 26 partner institutions from Belgium, Denmark, Germany, Ireland, Italy, Spain, Sweden, Switzerland, the Netherlands, the United Kingdom and the United States of America. Led by University College Dublin, the partners contribute a diverse range of backgrounds including clinical, scientific, data analytics, ethics, patient participation as well as SME and pharmaceutical industry expertise in pursuit of the ambitious goals set for the HIPPPOCRATES project.