Musculoskeletal conditions are the single most common cause of chronic pain and disability and one of the most expensive to treat, estimated to affect 1 in 6 people in the UK with a high cost to the NHS, in addition to social care costs and lost productivity. Musculoskeletal conditions include immune-mediated inflammatory disease (inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis) and connective tissue diseases such as scleroderma and lupus), and osteoarthritis (degenerative / mechanical arthritis).
Inflammatory arthritis affects almost 4% of the population and if untreated results in joint destruction, functional impairment and increased mortality, with cardiovascular disease the most common cause of premature mortality. Connective tissue diseases, whilst not as common, carry a higher morbidity and mortality, resulting in considerable patient burden. Developments in biologic therapies have improved the outcomes for immune-mediated inflammatory disease, but there remains scope to improve the prevention of disease and disability. Worldwide estimates are that 10% of men and 20% of women over 60 have symptomatic osteoarthritis. Treatment options for osteoarthritis are limited to joint replacement and there is a need for improved outcomes in particular for the younger population.
Estimates of the global burden of musculoskeletal diseases have increased 25% over the past decade. International studies indicate a five-fold increase in the surgical treatment of patients with osteoarthritis by 2030. With the ageing population, increased levels of obesity and reduced physical activity, this trend will continue, necessitating a global research strategy.
The vision for the NIHR Leeds Biomedical Research Centre is that through accurate phenotyping (biomarker and imaging based) and early intervention, we can develop and evaluate individually targeted, cost-effective therapies and therefore improve outcomes for musculoskeletal patients. A longer term goal is the early diagnosis and prevention of musculoskeletal disease and modulation of risk factors to improve outcome.
Since the commencement in 2008 we have been successful in securing more than £100 million in external funding, instigating more than 140 translational projects and publishing over 1000 peer reviewed papers. We have had considerable global impact on patient care through our joint replacement technologies and our work in establishing the importance of early intervention in rheumatoid arthritis has changed the treatment paradigm, with remission now the agreed target for new patients with inflammatory arthritis. Our work has also led to imaging being standard practice in assessment of rheumatoid arthritis patients.