A cohort of “at-risk” patients has been established over the past decade. Through a primary care initiative and partnerships with regional rheumatology clinics we have been able to recruit and follow a cohort of individuals at risk for development of inflammatory arthritis (anti-CCP positive with musculoskeletal symptoms but no synovitis). This cohort has permitted detailed phenotyping of anti-CCP+ at risk individuals and also their stratification according to risk of arthritis development. Through investigating a range of biomarkers, insights into the pathogenesis of the earliest phases of inflammatory arthritis are being obtained.
Over the past 15 years, Leeds has developed well defined patient inception cohorts in early inflammatory arthritis. Through support from Arthritis Research UK, the Yorkshire Early Arthritis Research Register (YEAR) has been established over the past 10 years. YEAR recruits patients with new onset inflammatory arthritis from a network of clinics covering the Yorkshire and Humber region. To date, YEAR has recruited over 1600 patients with rheumatoid arthritis. The inflammatory arthritis disease continuum longitudinal study (IACON) correlates clinical information obtained in inflammatory arthritis patients with immunological data obtained from the analysis of serum, blood and histological samples as well as therapeutic response clinical data. These cohorts have permitted unique experiments in the identification of non-responder subtypes and the pathophysiology of remission in patients with rheumatoid arthritis. This understanding allows targeting of clinical, imaging and immunological endpoints that have resulted in patients successfully ceasing medication.
Leeds also has inception cohorts in undifferentiated inflammatory arthritis, ankylosing spondylitis, psoriatic arthritis, resistant rheumatoid arthritis, early inflammatory back pain, scleroderma and lupus.
To date, there have been no MRI studies evaluating the development of hip osteoarthritis and examining features which predict the development and progression of clinical symptoms. We are therefore developing the Leeds Osteoarthritis Hip Cohort (LOHC) in order to study this. Determining the prognosis for hip OA will be invaluable for primary prevention and therapeutic planning.