Precision Medicine for Psoriatic Arthritis Using miRNA Sequencing

Principal Investigator: Dafna Gladman, M.D.
Institution: University Health Network

Grant Mechanism: Discovery Grant
Funding Amount: $74,979
Project Start Date: August 1, 2023
Project End Date: July 31, 2024
Status: Active
Keywords: Psoriatic Arthritis, Biomarkers, Drug Therapy, Clinical Research, Basic Science

Project Summary:

One-third of psoriatic arthritis (PsA) patients exhibit moderate to severe disease and are managed by biological medications such as tumour necrosis factor inhibitors (TNFi) or interleukin-17A inhibitors (IL-17i). Although biologics are effective in some patients, ~40% of patients are unresponsive to these therapies. At present, the trial-and-error approach is used which might prove to be disadvantageous to the patient. Thus, there is pressing need for predictive biomarkers of treatment response.

Our aim is to identify levels of small molecules in the blood called microRNAs (miRNAs) that can predict response of PsA patients to biologic treatment. The results of this study could help develop precision medicine test that can guide selection of therapy for better management of the disease, reduce healthcare costs, and help in reducing patient's time and suffering.

How will your project help improve the lives of the 125 million affected by psoriatic disease?

The proposed project will be important in improving the lives of patients with psoriatic arthritis by developing a blood test for clinicians to more precisely tailor drug therapy leading to improved outcomes and avoiding loss of time during which permanent joint damage can occur.

Why is psoriatic disease research important to you, personally? What role will this award play in your research efforts or career development?

Psoriatic disease has been a major focus of my research career. I established the Toronto Psoriatic Disease Research Program and the International Psoriasis and Arthritis Research Team (!PART) and was a founding member of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Early in my Rheumatology career I identified that psoriatic arthritis was a more serious disease than was initially thought leading to significant damage and impact on patient quality of life. Since that time my research has been dedicated to improving the health outcomes for patients with psoriatic disease and to foster international collaborative research in this field.

Researcher Profile:

Dafna D. Gladman, MD, FRCPC is Professor of Medicine, University ofToronto. She trained in both Internal Medicine and Rheumatology at the University of Toronto. Dr. Gladman has been Senior Staff Physician at the Toronto Western Hospital since 1995. She is Director of the Centre for Prognosis Studies in the Rheumatic Diseases, Director of the Psoriatic Arthritis Program, and Co-Director of the University of Toronto Lupus Clinic. She is a Senior Scientist at the Krembil Research Institute.

Dr. Gladman's research program includes clinical and laboratory research. The clinical research program began with the establishment of the psoriatic arthritis (PsA) clinic in 1978, the largest PsA longitudinal observation cohort in the world. Observations on clinical features, assessment tools outcome measures, and prognosis have changed the approach to patients with PsA. The laboratory research program initially included genetic studies, mainly HLA markers in the rheumatic diseases, and other biomarkers, particularly in psoriatic disease. The research has been supported by the Arthritis Society, the Canadian Institutes of Health Research, the Krembil Foundation, National Institutes of Health (US), and the National Psoriasis Foundation (US). Dr. Gladman helped establish the Group for the Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

In 2007, Dr. Gladman established the International Psoriasis and Arthritis Research Team (!PART). IPART includes dermatology and rheumatology researchers who are working together to investigate the biology of psoriasis and PsA. Dr. Gladman is a Co-Principal Investigator and Executive Committee member as Treasurer of the Spondyloarthritis Research Consortium of Canada (SPARCC), a research program on spondyloarthritis (SpA). The dominant goal of the SPARCC program is to achieve significant improvement in outcomes for Canadians with SpA, and evaluating the significance of early diagnosis and treatment.

Dr. Gladman received the Women Who Lead Award from the National Psoriasis Foundation of America and was ranked 3rd in Canada by Research.com in their 2022 ranking of Top 10,000 female scientists in the world. Dr. Gladman was awarded the Carol Nachman Prize for innovative research in inflammatory arthritis and the Distinguished Investigator Award from the American College of Rheumatology.