Arthritect: Advancing Precision Medicine of Inflammatory Arthritides through inflammatory biomarker sensing technology

**背景：**类风湿性关节炎(RA)和牛皮癣关节炎(PSA)是使人衰弱的疾病，影响1-2%的人。不可逆的关节损害形成的时间越长，这些情况就越不能得到有效的管理或治疗。有这些症状的人中，超过三分之一的人必须在症状开始两年内停止工作。然而，从症状开始到看风湿病医生需要6个多月的时间。即使这样，40%的患者对可以阻止疾病进展的专家治疗的第一次试验没有反应。患者必须尝试这些药物的另一种和另一种变体，直到他们找到一种有效的治疗方法。到有效的治疗开始时，数十万人(仅在英国)不幸地失业，生活质量不可挽回地下降。目前，诊断RA/PSA需要血液测试、关节检查和成像(如超声波或MRI)。这些测试费用高昂，因此执行起来很少。目前还没有现有的方法可以由患者自己用来定期检测活动性炎症(RA/PSA的损害原因)。但是-如果这样的方法确实存在，那么患有这些疾病的人将被更快地诊断出来，并且成本更低(避免昂贵的方法，如MRI)，并且可以被远程监测。如果我们可以测量新药对关节炎症的影响，我们就可以更快地确定何时更换新药。**创新：**Senti-Tech已经完成了确定这种方法的可行性工作。这笔拨款将使我们能够开发进入阿尔斯里特系统的方法。该系统使用生物阻抗传感器(测量身体区域的导电性；炎症中的某些变化)以及一个创新的系统来在传感器和患者之间进行良好的接触。该系统将是首个用于检测手中活动炎症的患者使用系统。我们将把日常读数与人工智能决策支持系统结合起来，提供有针对性的治疗见解。**结果：**在这个赠款项目中，我们将改进我们的技术方法，并在患者中进行测试。我们将纳入他们的反馈，以提高系统的可用性。最后，我们将把这个精炼版本的Arritect应用到临床试验中，以研究Arritect是否可以检测到患者是否对新的治疗有反应。Arritect将启用虚拟风湿科病房，减轻患者和医院的负担。我们将通过更快地诊断RA/PSA来提高生活质量，并减少有效治疗的时间。

**Background:** Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are debilitating conditions that affect 1-2% of people. Irreversible joint damage builds up the longer these conditions remain ineffectively managed or untreated. Over 1-in-3 people with these conditions have to stop work within two years of symptoms starting.Yet, it takes over 6 months from the start of symptoms to seeing a rheumatology doctor. Even then, 40% of patients do not respond to a first trial of specialist treatment that can halt the progression of the disease. Patients must instead try another and another variation of these medications until they find one which works.By the time effective treatment has started, hundreds of thousands of people (in the UK alone) are sadly out of work with irreparably reduced quality-of-life.Currently, diagnosing RA/PsA requires blood tests, joint examination, and imaging (such as Ultrasound or MRI). These tests are expensive and are therefore performed sparingly. There are no existing approaches which could be used by patients themselves to detect active inflammation (the cause of damage in RA/PsA) regularly.However - if such an approach did exist, then people with these conditions would be diagnosed faster and at lower cost (avoiding expensive approaches like MRI) and could be monitored remotely. If we could measure how inflammation in the joints is affected by new medications, we could work out faster when to change to a new drug.**Innovation:** Senti-Tech has completed feasibility work to determine just such an approach. This grant will enable use to develop our approach into the Arthritect system. This system uses bioimpedance sensors (which measure conduciveness of areas of the body; something which changes in inflammation) together with an innovative system to make good contact between the sensors and the patient.This system will be a first-of-its-kind patient-use system to detect active inflammation in the hands, We'll combine daily readings with an artificially intelligent decision support system to provide targeted treatment insights.**Outcomes:** In this grant project, we will refine our technological approach and test this with patients. We will incorporate their feedback improving system usability. Finally, we will take this refined version of Arthritect into a clinical trial to investigate whether or not Arthritect can detect if a patient is responding to a new treatment.Arthritect will enable virtual rheumatology wards, reducing the burden on patients and hospitals. We'll improve quality-of-life through faster diagnosis of RA/PsA and reduce the time-to-effective treatment.