Associate Clinical Professor in Vascular Rheumatology at the University of Leeds, and Honorary Consultant Rheumatologist at Leeds Teaching Hospitals NHS Trust
CCT in Rheumatology; PhD, University of Leeds; MRCP (UK), Royal College of Physicians, London; BM BCh, University of Oxford Medical School; BA (Hons) Physiological Sciences, University of Oxford (First Class)
I am a rheumatologist with an interest in the related diseases, giant cell arteritis (GCA) and polymyalgia rheumatica (PMR), both of which affect people aged 50 years and over. GCA is a form of vasculitis, which if untreated, can cause permanent blindness or stroke. PMR causes widespread inflammation of the periarticular soft tissues (tissues around the joints), which if untreated causes severe pain and stiffness. Currently, the treatment for these two diseases is restricted to long-term oral glucocorticoid (steroid) therapy. Steroids are usually very effective in the short-term, but in the long-term the cumulative toxicity can be significant. For example, long-term steroid treatment can increase the risk of diabetes, fractures, skin thinning and muscle weakness. It can also be difficult to stop long-term steroids, partly because the longer steroid treatment continues, the more likely it will be that the body’s ability to produce its own natural steroids (cortisol) is impaired. There remains a real unmet need amongst patients with GCA and PMR, as for most patients, steroid therapy remains the only option.
During my PhD, I initiated the first UK cohort of patients with GCA for genetics studies, the UK GCA Consortium. I subsequently conducted an in-depth phenotyping study using whole-body MRI to evaluate patients with PMR (Mackie et al). This showed the burden of inflammation in patients with PMR and confirmed that this is distinct from the pattern of inflammation seen in rheumatoid arthritis. I was then awarded a NIHR Clinician Scientist Fellowship to determine whether ultrasound imaging might help improve the diagnosis of patients with suspected PMR. This work (ADDRESS-PMR) is nearing completion.
I am co-author on the latest version of the international clinical guidelines for the management of PMR and am involved with the revision of the British Society for Rheumatology guidelines for GCA. I am co-chair of the OMERACT PMR Working Group. OMERACT recently endorsed our Core Domain Set for PMR Clinical Trials (Mackie et al). I am a Trustee for the national charity PMRGCAuk.
My aim is to improve outcomes for patients with PMR and GCA. These conditions have historically not received much research attention but this is changing. We now have the opportunity to help patients receive a more rapid, accurate diagnosis and we are reaching a better understanding of the effects of long-term steroid treatment in these diseases. Advances in our knowledge, including the underlying basic science, are informing design of clinical trials of better treatment strategies in these diseases. Well-designed clinical trials will produce the evidence needed to change treatment pathways for the better.
I have over 70 publications in the leading peer-reviewed journals in my field. I have an H-index of 14 and 701 citations (according to Scopus, 2017). For a comprehensive list of these publications, please follow this link.
- I am currently lead supervisor for three PhD students: Amy Graham (year 3), Charikleia (Hara) Chatzigeorgiou (year 3), and Lana Lai Lin Hui (year 2).
- Completed students: Daniel Drayton, MRes project (2014 – 2015, Distinction).
Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, Leeds, LS7 4SA, UK