Humanitas University coordinates a European project on multi-drug resistant rheumatoid arthritis

The MDR-RA (Multi-Drug Resistance in Rheumatoid Arthritis) project has officially started: it’s an international research initiative, with a total budget of €8.4 million, funded by the European Union under the Horizon Europe program and the Swiss State Secretariat for Education, Research, and Innovation. Coordinated by Humanitas University, the project involves 23 partners from 12 European countries, including prestigious academic institutions, leading companies, healthcare organizations, and patient associations.

The MDR-RA project aims to identify the molecular mechanisms underlying drug resistance in difficult-to-treat rheumatoid arthritis and integrate them with clinical risk factors. Its objective is to develop personalised predictive models and optimise patient treatments while simultaneously reducing the socioeconomic impact of the disease.

“This project represents a fundamental step forward in understanding the molecular basis of multi-drug resistance in rheumatoid arthritis. Through a precision medicine approach, we aim to transform patient care with more targeted and effective therapies,” stated Prof. Costantino Pitzalis, project coordinator, Full Professor of Rheumatology at Humanitas University, where he also leads the Residency School in Rheumatology, and at Queen Mary University of London, where he conducts his clinical and scientific activities.

An innovative approach to managing a complex disease

Rheumatoid arthritis is the most common chronic inflammatory joint disease, affecting approximately 1% of the adult population, with about 3 million people impacted in the European Union alone. The condition, which significantly affects the lives of patients, is potentially disabling and responsible for considerable economic and social costs, estimated at €55 billion annually in Europe, and represents a particularly complex clinical challenge when patients develop resistance to existing therapies.

The mission of the MDR-RA project is to provide new, personalized, and more effective solutions for these patients by integrating clinical and molecular data, particularly through the study of the synovial membrane, the disease’s target tissue. Synovial biopsy, a minimally invasive procedure still underutilized in routine clinical practice, allows for the analysis of joint tissues with highly advanced technologies to detect significant molecular biomarkers, not only of the inflammatory type, that can guide therapy selection.

These data, combined with patients’ clinical information, will be processed using artificial intelligence to create a comprehensive predictive algorithm called iCare-RA. This tool will be central to personalising treatments and improving clinical outcomes.

The key role of IRCCS Istituto Clinico Humanitas in the project’s clinical and translational studies

“A fundamental objective of the project will be the creation and validation of the predictive algorithm iCare-RA in real-world clinical settings,” explains Prof. Elisa Gremese, Associate Professor of Rheumatology at Humanitas University and Principal Investigator of the MDR-RA project’s clinical trials. “The data collected from existing cohorts and new MDR-RA patients will contribute to building the algorithm. Subsequently, its effectiveness will be tested in a prospective study to evaluate whether it can predict the best therapy for each patient, compared to clinicians’ standard practice decisions.”

In both these clinical studies and the molecular analysis of synovial biopsies, IRCCS Istituto Clinico Humanitas and Humanitas University will play a pivotal role. “The ultimate goal of the project is to go beyond rheumatoid arthritis, providing a replicable model for other complex chronic conditions, even non-rheumatologic ones, promoting precision medicine and enhancing the effectiveness of European healthcare systems,” adds Gremese.

Prof. Carlo Selmi, Head of Rheumatology and Clinical Immunology at IRCCS Istituto Clinico Humanitas and Full Professor of Internal Medicine at Humanitas University, highlights the importance of the initiative: “We are thrilled about the project, which will allow our patients with difficult-to-treat rheumatoid arthritis to access innovative care pathways and help the entire international community find more targeted and effective solutions.”

“In the end, this project brings us one step closer to the precision future of rheumatology,” concludes Pitzalis, outlining a promising vision for the treatment of complex chronic diseases.