BRC researcher’s new scientific test could improve the health of rheumatoid arthritis sufferers

Methotrexate is the most commonly prescribed drug for the 400,000 people in the UK suffering from this autoimmune disease.  However, around 40% of rheumatoid arthritis (RA) patients do not take the drug as prescribed and, currently, clinical staff have no way of knowing whether a patient is taking their medication as advised.

Thirty eight year old, Dr Bluett practises at the borough’s Pennine MSK Partnership which provides care for patients in orthopaedics, rheumatology and chronic pain.

He is also a Manchester BRC researcher and a Clinical Senior Lecturer at The University of Manchester.

The new test, developed, refined and assessed over 4 years, measures the methotrexate levels in a patient’s blood over the previous seven days.  The final research results from 138 RA patients showed that the test has a 95% sensitivity in detecting whether someone took their methotrexate in the preceding week.

The initial evaluation of the blood test’s effectiveness was carried out in the NIHR Manchester Clinical Research Facility with 20 patients from the North West.

“Patients may not take their methotrexate as prescribed for several reasons” said Dr Bluett, who splits his time equally between clinical practice and academic research at The University of Manchester. “Methotrexate is a weekly treatment, taken over a long period and can have side effects.   Non-adherence means the drug won’t work as effectively and risks a patient’s condition worsening.

“Our new marker will enable doctors to start supportive conversations with patients about the difficulties they may be experiencing with the medication and how to resolve them.”

Dr Bluett was appointed as a consultant at the specialist musculoskeletal service, on New Radcliffe Street, in April 2018.  The service, commissioned by NHS Oldham Clinical Commissioning Group, receives nearly 15,000 new referrals a year, mainly from local GPs and provides long term support for nearly 1,500 people with rheumatoid arthritis.

Dr Bluett’s research paper was published this month in the world’s leading rheumatology journal: the Annals of the Rheumatic Diseases.

“We need to see whether RA patients’ adherence improves when they receive feedback on their methotrexate levels. So, the next step will be a feasibility study to assess how we can gauge this in a clinical trial.

“I hope this further work validates our approach which could then, after appropriate regulatory approval, be incorporated into routine clinical practice.  I want to ensure the best outcomes for RA patients” concluded Dr Bluett.