RhEumatoid Arthritis SynOvial tissue Network (REASON)

 描述(由申请人提供)：我们在理解导致类风湿性关节炎(RA)发病的免疫学和遗传学机制方面取得了实质性进展。虽然传统的抗风湿药物(DMARDS)是有效的，但超过65%-75%的患者对这些疗法没有反应。即使联合抗肿瘤坏死因子治疗，缓解率也不超过50%。多达50%的抗肿瘤坏死因子难治患者对二线疗法的反应也不充分。更引人注目的是，24%的RA患者甚至对任何治疗都没有表现出最低水平的反应。因此，确定可能对抗肿瘤坏死因子治疗或其他生物治疗有反应的患者将在医学和经济上极大地受益于患者。然而，由于以下事实，在RA中缺乏生物标记物来确定对给定患者最有效的治疗 在美国，很少有医学实践检查滑膜组织，因为这需要活检，而活组织检查在医学上可能并不必要。在过去的几年里，超声波技术已经成为美国风湿病实践中的重要工具。最近，微创超声引导的滑膜活检显示了巨大的前景，因为与该程序相关的并发症很少，甚至没有。虽然这种手术在整个欧洲都被广泛接受，但它并没有成为美国风湿病医生的常见做法。为了解决美国这一未得到满足的需求，我们召集了一个由领先的学术风湿学团体组成的联盟，其中包括阿拉巴马大学伯明翰分校、哥伦比亚大学、梅奥诊所、华盛顿大学、密歇根大学和西北大学，成立了类风湿性关节炎滑膜组织网络(REASON)。因此，我们将在美国培养新一代风湿病专家，他们将进行微创超声引导的滑膜活检，这对于从RA患者的所有阶段(早期、确诊、DMARD或生物反应不充分)获取滑膜组织至关重要。这些组织将由Reason技术网站的研究人员分析，他们将使用这些材料进行翻译研究，以确定可能预测治疗反应的新途径和潜在的生物标记物。

 DESCRIPTION (provided by applicant): Substantial advances have been made in our understanding of the immunologic and genetic mechanisms that contribute to the pathogenesis of rheumatoid arthritis (RA). Although traditional disease modifying anti- rheumatic drugs (DMARDS) are effective, over 65-75% of patients do not respond to these therapies. Even with combination with anti-TNF therapy, no more than 50% of patients achieve remission. As many as 50% of anti-TNF refractory patients are also inadequate responders to second-line therapies. More strikingly, 24% of RA patients do not even demonstrate a minimal level of response to any therapy. Thus, identifying patients that may respond to anti-TNF therapy or other biologic therapies would greatly benefit the patient medically and economically. However, there is a lack of biomarkers in RA to identify the most effective therapy for a given patient due to the fact that few medical practices in the United States examine synovial tissue, as this requires a biopsy, which may not be medically necessary. Over the past several years ultrasound technology has become an important tool in the practice of rheumatology in the United States. Recently, minimally invasive ultrasound guided synovial biopsies have shown great promise, as there are minimal to no complications associated with the procedure. While this procedure is widely accepted throughout Europe, it has not become a common practice for rheumatologists in the United States. To address this unmet need in the United States, we have assembled a consortium of leading academic rheumatology groups which include the University of Alabama Birmingham, Columbia University, Mayo Clinic, Washington University, University of Michigan, and Northwestern University to form the RhEumatoid Arthritis SynOvial tissue Network (REASON). Thus, we will be creating a new generation of rheumatologists in the United States who will perform minimally invasive ultrasound guided synovial biopsies that is critical for obtaining of synovial tissue from patients at all phases of RA (early, established, DMARD or biologic inadequate response). These tissues will be analyzed by researchers at REASON technology sites who will use this material for translational studies to identify novel pathways and potential biomarkers that might predict therapeutic response.