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    CPMC Launches New Arthritis Study

    January 14, 2015

    Rheumatoid arthritis—an inflammatory condition that costs the U.S. healthcare system billions of dollars each year—is among the most common conditions treated by specialists at California Pacific Medical Center (CPMC). A key priority for rheumatologists at CPMC and among investigators at Sutter Health is to better understand the molecular and genetic events underlying early arthritis, so that patients can be diagnosed and treated more effectively, and to even predict which patients are at higher risk of the illness.

    Recognizing this unmet medical need, CPMC and its Research Institute (CPMCRI) have launched a registry and biorepository to follow patients with early, undifferentiated arthritis. Led by Pedro Ruiz, M.D., Ph.D., Neal Birnbaum, M.D., and Greg Tranah, Ph.D., the registry will set a new precedent for arthritis research at Sutter Health.

    “We anticipate this novel initiative will create the foundation to study early developments in a person affected with inflammatory arthritis,” said Dr. Ruiz, a rheumatologist at CPMC. “We’ll be well positioned to obtain more precise information about the biomarkers and genetic factors predisposing patients to early arthritis. With this information, we can assess how patients will respond to treatment, and predict which therapies will be best matched to manage the course of their illness, and their symptoms.”

    Dr. Ruiz and colleagues are recruiting consenting patients from those undergoing evaluation for arthritis in the offices of participating physicians at CPMC. Patients enrolled in the registry will be tracked for one year to monitor their symptom onset, progression and severity. Information will be collected about their medical history, lifestyle factors such as diet, exercise habits and sleep patterns, symptoms, gene expression profiles, and blood-based biomarkers.

    The data will be used to help Sutter Health clinicians and researchers understand the interplay between genetic and environmental factors contributing to the development of undifferentiated early arthritis and patient outcomes.

    Gregory Tranah, Ph.D., is a scientist who leads research studies in aging and age-related illnesses at CPMCRI. He and other investigators at the Institute will collaborate with Dr. Ruiz in assessing data from the registry, looking at biomarkers including rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP), and conducting DNA sequencing analyses.

    “Identifying genetic mechanisms that precede arthritis onset may lead to the development of new interventions or clinical strategies that prevent or delay the onset of disease,“ said Dr. Tranah. “These specific cellular and molecular mechanisms that are shown to change early in disease may present more desirable therapeutic targets than the reversal of the individual pathologies that occur later in the disease process.”

    Once launched at CPMC, the registry—which will represent the only early arthritis cohort of its kind on the U.S. West Coast—is expected to be adopted by the rheumatology community at Sutter centers across Northern California.

    Dr. Birnbaum, Director of the CPMC Division of Rheumatology and a past president of the American College of Rheumatology stated, “I applaud Dr. Ruiz's efforts to revitalize the rheumatology research at CPMC and throughout the Sutter system. His early arthritis registry presents a unique opportunity to study this important cohort of patients.”

    Early undifferentiated arthritis (UA)
    UA patients are those with inflammatory arthritis that, by the American College of Rheumatology criteria, cannot be classified into specific diagnoses. The clinical outcome of a patient with UA is difficult to predict. Over time, patients may meet the criteria of a specific diagnosis, and/or overlap into more than one diagnosis, and some will have disease that persists as a partial form of a defined arthritis.