All patients at present will be recruited from NHS Greater Glasgow & Clyde and must be referred by a Rheumatology specialist staff member. For further information, please contact Dr James Brock James.firstname.lastname@example.org
RA patients who are due to commence Adalimumab. A randomised placebo control study (Adalimumab vs Placebo). To explore the use of TNF antagonism on altering sickness behaviour in conjunction with brain connectivity/neurobiological mechanism pathways using 7T MRI, MRA and SPECT brain imaging.
RA patients who are inadequate responders to csDMARDs (SDAI >11) alongside additional patients with low disease activity (SDAI >3.3 <11). Investigation using vagal nerve stimulation and whether this affects the neurobiological pathways likely connected with pain in RA.
An observational study of RA patients who are due to commence Baricitinib. Reviewing the effects Baricitinib has in RA patients on their central pain pathways through brain connectivity pathways and markers using neuroimaging modalities.
RA patients with low disease activity (≥1 swollen joint count, CRP>6 and ESR>20) with additional ACR description of chronic pain. Using Transcranial Magnetic Stimulation vs placebo and exploring if this elucidates central pain pathways with the use of MRI brain scanning.