Biomedical Research Centre

Biomedical Research Centre

The TARGET (Treatment According to Response in Giant cEll arteritis) Partnership

Giant cell arteritis (GCA) is an autoimmune vasculitis occurring exclusively after the age of 50, which is difficult to diagnose and, due to a risk of blindness, commonly treated with high-dose glucocorticoids (steroids) which cause serious side effects in the majority of patients.

Established in 2017, TARGET is a multi-speciality partnership between clinicians, scientists, industry and patients aiming to tackle issues concerning the causes, diagnosis and treatment of GCA and complications arising from glucocorticoid therapy. Through the partnership we have been able to compile a wide variety of datasets which allow modelling of pathogenesis and epidemiology of GCA, glucocorticoid toxicity and the most appropriate diagnostic and treatment pathways aiming towards rational patient stratification and reducing the overall glucocorticoid burden.

Since its inception, TARGET has shown that, for rare diseases especially, strong national and international partnerships are highly beneficial. Our collective expertise, for example, helped influence NHS England policy on tocilizumab use for GCA during the COVID-19 pandemic, resulting in patients having their funded treatment extended beyond the stipulated 12-month limit. Other recent achievements by TARGET partners include developing and updating guidelines for the management of GCA both nationally (British Society for Rheumatology) and internationally (European League Against Rheumatism); defining the magnitude of common glucocorticoid toxicities across the immune-mediated inflammatory diseases; improving and reducing variation in clinical pathways and treatments for GCA in England as the Joint National Clinical Lead for the Getting It Right First Time (GIRFT) rheumatology work stream within NHS England and NHS Improvement; securing industry funding to develop and validate a patient reported outcome measure for glucocorticoids (the Steroid PRO); establishing an atlas of histopathology education to advance diagnostics of GCA in the patient cohort that undergoes a temporal artery biopsy; using Target Product Profiles (TPP) to define unmet clinical needs in the diagnosis of GCA; obtaining accreditation to become an Olink Proteomics Facility, one of only two in the UK.

2021-22 has seen TARGET build on established collaborations. The NIHR Rare Diseases BioResource for GCA and autoimmune vasculitis, led by PI Prof Ann Morgan, extended its successful recruitment strategy to new RNA Phenotyping projects which aims to look at the expression of genes in selected cells of GCA and vasculitis patients. The TARGET partnership also supports an international network of 8 PhD students, and numerous early career and intermediate fellows around the UK working to a common goal of reducing the glucocorticoid toxicity burden and improving health related quality of life in GCA.

 

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