CompletedNot ApplicableInterventional

Can we predict which patients with psoriatic arthritis will respond to treatment using precision medicine?

Psoriatic arthritis causes painful, swollen, and stiff joints in people with the skin condition psoriasis. When standard treatments do not help, doctors often prescribe powerful medicines called biologics, such as TNF blockers or IL-17 blockers. Currently, both types work well for about half of patients, but doctors cannot predict who will respond best to which medicine. This study tests whether a simple blood test can predict which treatment will work best for each person. Researchers will measure specific immune cells in your blood before you start your medicine. You will be prescribed one of two standard biologic drugs and monitored for six months to see how your joints improve. If successful, this approach could help people get the right treatment straight away, avoiding trial and error. It aims to control joint pain more quickly, improve quality of life, and save valuable NHS resources.

At a glance

Status

Completed

Phase

Not Applicable

Sponsor

University of Oxford

Enrolment target

424

Start

01 Jan 2022

Estimated completion

31 Dec 2024

Arthritis that affects some people with the skin condition psoriasis

What is this study about?

Psoriatic arthritis is a long-term condition that causes joint pain, swelling, and stiffness in people who have psoriasis. For many people, everyday activities can become difficult and uncomfortable. While standard tablet medications help some people, others need stronger treatments known as biologics. These targeted medicines help calm the immune system and protect joints from further damage.

Today, doctors commonly use two different types of biologics to treat psoriatic arthritis: TNF blockers and IL-17 blockers. Both medicines work well, but they act on the body in slightly different ways. Around half of the people who try either drug get good relief. However, there is currently no way to know in advance which drug will work best for an individual. This often means trying one medication for months, and if it fails, switching to another.

This study aims to take the guesswork out of treatment. Researchers at the University of Oxford and other NHS centres are testing whether checking immune cells in a routine blood sample can reveal which drug will suit you best. By measuring these cells before treatment starts, doctors hope to predict your response with greater accuracy.

Finding the right drug the first time could transform care. It means people could feel better much sooner, avoid taking medicines that might not help them, and reduce unnecessary side effects. It could also help the NHS spend its funds more effectively by ensuring treatments are tailored to each patient.

Key takeaways

Researchers are testing if a blood test can pick the right arthritis drug first time.
Participants receive one of two standard NHS biologic treatments.
The study monitors your joint health and symptoms over six months.
Visits are scheduled alongside routine NHS appointments to minimise disruption.
Findings could help future patients avoid trial-and-error treatments.

Who may be eligible?

This study is open to adults aged 18 and over who have been diagnosed with psoriatic arthritis. To take part, you should have active joint swelling and tenderness, and your doctor must have already decided that you need to start your first biologic medicine because standard arthritis tablets have not worked well enough.

You will not be able to take part if you have ever used biologic drugs before, or if you have certain other health conditions. These include heart failure, multiple sclerosis, active bowel disease, recent cancer, or serious infections such as tuberculosis.

Women who are pregnant, breastfeeding, or planning to become pregnant over the coming year are also unable to join, as the study medicines may not be suitable during pregnancy.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am aged 18 or older.
I have a confirmed diagnosis of psoriatic arthritis.
Standard arthritis tablets have not controlled my joint pain and swelling.
My doctor has recommended that I start my first biologic medicine.
I have not taken biologic or targeted arthritis drugs in the past.
I am not pregnant, breastfeeding, or planning a pregnancy in the next 12 months.

Answer every question to see your result.

What does participation involve?

Taking part is designed to fit around your regular NHS appointments to keep things as easy as possible. You will be assigned to receive one of two standard biologic medicines (adalimumab or secukinumab) that are normally prescribed on the NHS. Before you start, you will give a blood sample so researchers can examine your immune cells. Over the next six months, you will attend hospital visits where doctors check your joints and ask you to fill in short surveys about your symptoms and daily life. If you attend clinics in Oxford, Glasgow, or Guy's and St Thomas' in London, you may be asked to attend one brief extra visit for an additional blood test, with travel costs paid back to you.

Potential risks and benefits

While taking part may not directly benefit you, you will receive an approved NHS treatment that should help ease your arthritis symptoms. The medicines carry the same standard side effects and risks as they would in normal care, and taking blood samples may cause slight bruising or soreness. You will be closely monitored by your care team throughout the study. Joining is completely voluntary, and you have the right to withdraw at any time without your regular NHS care or treatment choices being affected in any way.

Locations (19)

Oxford University Hospitals NHS Foundation Trust
City only
Oxford, England
Guy's and St Thomas' Hospitals
City only
London, England
Glasgow Royal Infirmary
Approximate
Glasgow, Scotland
Midlands Partnership University NHS Foundation Trust
City only
Stafford, England
University Hospitals Coventry and Warwickshire NHS Trust
City only
Coventry, England
Portsmouth Hospitals University NHS Trust
Unverified
Portsmouth, England
Royal Berkshire NHS Foundation Trust
Unverified
Reading, England
Royal United Hospitals Bath NHS Foundation Trust
Unverified
Bath, England
King's College Hospital NHS Foundation Trust
Unverified
London, England
University Hospitals Dorset NHS Foundation Trust
Unverified
Christchurch, England
Northampton General Hospital NHS Trust
Unverified
Northampton, England
South Warwickshire University NHS Foundation Trust
Unverified
Warwick, England

Common questions

Will I receive an unapproved or experimental drug?

No. Both medicines used in this study (adalimumab and secukinumab) are already approved and routinely prescribed on the NHS for psoriatic arthritis.

How long does the study last?

Your participation will last about six months, during which the medical team will track how well your joints respond to the medication.

Do I have to pay for anything?

No, your treatment is provided through the NHS. If you need to make an extra hospital visit at certain sites, your travel expenses will be reimbursed.

What happens if the medication does not work for me?

Your hospital team will monitor you closely. If your symptoms do not improve, your doctor can switch you to another treatment, just as they would in routine NHS care.

Can I leave the study early if I change my mind?

Yes, you can leave the study at any point. Deciding to withdraw will never affect your relationship with your medical team or your standard NHS care.

How to find out more

Laura Coates

laura.coates@ndorms.ox.ac.uk +44 (0)1865 737838 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.