Dr. Rae Yeung believes in collaboration and building networks to solve problems. Her current 3-year Arthritis Foundation-funded project, “Precision Decisions to STOP JIA”, is an example of that. The goal is to develop a tool that will predict treatment response to specific drugs. Dr. Yeung’s study focuses on a group of high-risk children with polyarthritis, one of the most severe forms of childhood arthritis that affects many joints and is difficult to treat.
The aim of the study is to identify unique patterns of patient symptoms and biomarkers that, when considered together, will predict how a child with arthritis may react to different drugs and accurately predict when treatment will result in disease remission. This will result in a tool that will create personalized treatment guidelines to improve outcomes and, ultimately, the quality of life for patients and their families.
Dr. Yeung likes to work in collaboration with other researchers and rheumatologists. This project uses the clinical data (such as how many joints are affected, how severe is the disease) collected from 400 children with polyarthritis during the STOP JIA project. The STOP JIA study is led by researchers from the Childhood Arthritis and Rheumatology Research Alliance (CARRA)and funded by the Patient Centered Outcomes Research Institute (PCORI).
In addition, this project collects additional blood from the children to look for biological data (such as genes, proteins and other biomarkers found in blood) that predict drug response.
“My patients are very receptive to this research,” Dr. Yeung said. “When patients first come to us, we can’t answer a lot of the questions that parents and patients ask because clinical measures alone are limited. We need to look for biological answers. We need to look at the whole person and use things like biomarkers, in conjunction with clinical observations, to make personalized predictions based on the individual patient.”
By looking at the combined clinical and biological data, Dr. Yeung’s team may see things that might not otherwise be seen by looking at the data separately. In December, the team began the collection of blood from STOP JIA children with polyarthritis at 53 sites across the U.S. and Canada. After the samples are collected, they are sent to one of two sites (one in the U.S. and one in Canada) for processing, storage and analysis.
The team will look at the clinical and biological data that are present at different times and stages of the disease to see if a treatment is working effectively at those same time points in individual patients. This will create a tool that will help create the predictive model for personalized treatment guidelines.
Dr. Yeung is excited to be working with other scientists on her current project. “Through collaboration, we can analyze data from a much larger population and find more reliable answers,” she explained.
“More than 95% of all pediatric rheumatologists in North America are actively involved in CARRA. Thus, the results from our study and the decision-making tool we are creating have the potential to usher in an era of personalized medicine that may be rapidly adopted by clinicians to impact care and improve outcomes in the children we care for.”
Dr. Yeung is the senior scientist in cell biology research at the Hospital for Sick Children in Toronto and Professor of Pediatrics, Immunology and Medical Science at the University of Toronto.