Rheumatology at Leeds Teaching Hospitals NHS Trust

Rheumatology at Leeds Teaching Hospitals NHS Trust
-translating research excellence into world class care
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Dr Jacqueline Andrews
Consultant Rheumatologist and Clinical Director for Chapel Allerton CSU
Leeds Teaching Hospitals NHS Trust
Honorary Clinical Associate Professor
University of Leeds
March 16th 2015
What is Rheumatology? What do Rheumatologists do?
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Rheumatologists deal mainly with clinical problems caused by disorders of the immune
system “autoimmune conditions”. More common in females.
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Can affect any organ, but mainly joints, soft tissues such as tendons and muscle, skin,
lungs , nervous system and kidneys
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Previously also looked after people with mechanical joint problems such as
osteoarthritis, but increasingly this is managed in primary care/orthopaedic surgery
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One of the major changes in modern rheumatology is the development of new drugs
called biologics, which can control severe disease more effectively (but costly…)
Rheumatology at Leeds Teaching Hospitals NHS Trust
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EULAR (European Rheumatology Society) Centre of Excellence in Rheumatology since 2005
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Chapel Allerton Hospital facilities
– Ward C2
- 20 bed ward shared with Dermatology
– Day Care Unit C5
- 5,00 patient visits per year
– Outpatient Suite
- 25,000 patient visits per year
– Others
- Physiotherapy (hydrotherapy), Occupational Therapy
Podiatry, Research Facilities
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St James’s University Hospital:
– Inpatient beds
– Outpatient Clinics
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Wharfedale Hospital:
– Outpatient Clinics
Rheumatology at Leeds Teaching Hospitals NHS Trust- who’s who
Management Team:
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Clinical Director - Dr Jacqueline Andrews
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Head of Nursing - Zoe Kirk
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Lead Clinician
- Dr Jane Freeston
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Business Manager- Rob Guest
Consultants:
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Dr Sarah Bingham
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Dr Shouvik Dass
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Dr Helena Marzo-Ortega
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Dr Colin Pease
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Dr Maya Buch
Professor Philip Conaghan
Dr Francesco del Galdo
Professor Paul Emery
Dr Sarah Mackie
Professor Dennis McGonagle
Professor Ann Morgan
Dr Ai-Lyn Tan
Dr Ed Vital
Dr Richard Wakefield
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Also- Rheumatology Nurse Specialists, Rheumatologists in Training, Allied Health Professionals, Specialist Pharmacist, Research Team
Conditions managed by Rheumatologists
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There are over 100 rheumatic diseases – including arthritis, certain autoimmune diseases,
musculoskeletal disorders and osteoporosis:
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Degenerative Arthritis and musculoskeletal disorders
– Osteoarthritis
– Tendonitis
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Inflammatory Arthritis
– Rheumatoid arthritis
– Psoriatic arthritis
– Ankylosing spondylitis
– Gout
Conditions managed by Rheumatologists
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Connective Tissue Diseases:
– Systemic lupus erythematosis (Lupus)
– Sjogren’s Syndrome
– Scleroderma
– Inflammatory Myositis
– Anti-phospholipid syndrome
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Vasculitis:
– Polymyalgia Rheumatica
– Large vessel Vasculitis (Giant Cell Arteritis or Temporal Arteritis)
– Wegener’s and Churg Strauss Vasculitis
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Osteoporosis:
– Often with colleagues in metabolic bone units (Endocrinologists)
Treatments….
Treatment of Rheumatic Conditions
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Musculoskeletal or degenerative arthritis:
– Painkillers or anti-inflammatories
– Steroid injections
– Physiotherapy, Occupational therapy, Podiatry, Orthotics
– Orthopaedic surgery
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Inflammatory and auto-immune conditions:
– Steroids
– Disease modifying drugs (Methotrexate, Azathioprine, Mycophenolate)
– Biological therapies (target specific molecules)
• Anti-TNF drugs (infliximab, etanercept, adalimumab), Rituximab, Tocilizumab, Abatacept
– Small doses of chemotherapy
• Cyclophosphamide
Rheumatology Research at Leeds
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The Leeds Musculoskeletal Biomedical Research Unit (LMBRU) is an NIHR funded centre of
excellence for translational musculoskeletal research, established in 2008
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A partnership collaboration between the Leeds Teaching Hospital Trust and the University of
Leeds, the LMBRU strives to deliver excellence in patient based research in the following areas:
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Experimental Rheumatology & Inflammatory Mechanisms
Musculoskeletal Imaging & Tissue Characterisation
Biomaterials & Regenerative Interventions
Rheumatology Clinical Research
Bioengineering and Technological Interventions
also:
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NIHR Clinical Research Facility-
Musculoskeletal Hub
(Leeds also has a Oncology and Cardiovascular Hub)
Research Facilities
Imaging Centre Facilities
• MRI Scanner
• High field
• Wide bore
•World leading Radiologists
•Ultrasound
• High resolution
• 4D fusion scanner
Research developments- what we are known for in Leeds
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Developing and trialling new treatments (especially Biologic agents) for Inflammatory Arthritis
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Blood tests to aid the early diagnosis of Rheumatoid Arthritis
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New Imaging methods to diagnose arthritic conditions earlier and more accurately
More recently:
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New treatments for connective tissue diseases and vasculitis
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Specialist Centre for Yorkshire for these conditions
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Some examples of what we do….
Once upon a time…
The first MRI in human – the finger
Mansfield P, B J Radiology 1977
3D quantitative MRI- courtesy of Prof Philip Conaghan
Bowes et al, OARSI 2014
Normal Joint
Rheumatoid
Arthritis
MRI Images courtesy of Dr Ai-Lyn Tan Leeds 2015
Nano-PET scanner
Professor Dennis McGonagle
Hand Osteoarthritis
hrPET
hrMRI
Research –why it’s important- how you can get involved!
1. 95% of volunteers would recommend taking part in a research study
2. Organisations that are research active have better patient outcomes
3. Wealth creation for the Yorkshire region- links with industry
LMBRU Patient and Public Involvement Group
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Established in 2009
More than 120 active members
Subgroup of 25 specialists
Patients as partners
LMBRU Patient & Public Involvement Group- next meeting:
Wednesday 18th March 2015 - 1 pm LMBRU Meeting Room Chapel Allerton Hospital
“Novel Hip Research” – an interactive meeting by Research Team based at Chapel Allerton Hospital.
For further details contact Sue Smith susan.smith4@nhs.net Tel 0113 39 24474
Thank You
Any questions?