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

**背景：**类风湿关节炎（RA）和银屑病关节炎（PsA）是影响1-2%人群的衰弱性疾病。这些情况得不到有效管理或治疗的时间越长，不可逆转的关节损伤就越严重。超过三分之一的患者必须在症状出现后两年内停止工作。然而，从出现症状到看风湿病医生需要6个多月的时间。即便如此，40%的患者对可以阻止疾病进展的专科治疗的首次试验没有反应。患者必须不断尝试这些药物的变体，直到找到一种有效的药物。当有效的治疗开始时，成千上万的人（仅在英国）不幸地失去了工作，生活质量无可挽回地下降。目前，诊断RA/PsA需要血液检查、关节检查和成像（如超声或MRI）。这些测试很昂贵，因此很少进行。目前还没有可以由患者自己定期检测活动性炎症（RA/PsA损伤的原因）的方法。然而，如果这种方法确实存在，那么患有这些疾病的人将得到更快、更低成本的诊断（避免昂贵的MRI方法），并可以远程监控。如果我们能测量出新药物对关节炎症的影响，我们就能更快地知道什么时候该换一种新药。**创新：** sentii - tech已完成可行性工作，以确定这种方法。这笔拨款将使我们能够将我们的方法发展到艺术家系统中。该系统使用生物阻抗传感器（测量身体各部位的电导率；炎症时的变化）和一个创新系统，使传感器和病人之间保持良好的接触。该系统将是首个用于检测手部活动性炎症的患者使用系统，我们将把每日读数与人工智能决策支持系统相结合，以提供有针对性的治疗见解。**结果：**在这个资助项目中，我们将改进我们的技术方法并在患者身上进行测试。我们将纳入他们的反馈，以改善系统的可用性。最后，我们将把这个改良版的Arthritect应用于临床试验，以研究Arthritect是否能检测出患者对新疗法的反应。关节炎将启用虚拟风湿病病房，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，缩短有效治疗的时间。

**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.