Strategy Overview

Immune-mediated inflammatory diseases (IMIDs) are a wide group of common and rare autoimmune conditions with overlapping immune mechanisms affecting over 1 million people in the UK. Modern management and treatments have revolutionised outcomes of common IMIDs, such as Rheumatoid arthritis (RA) and Spondyloarthritis (e.g. psoriatic arthritis, ankylosing spondylitis), but mortality is still high, largely due to premature cardiovascular (CV) disease (CVD); and significant unmet needs remain in less common conditions such as systemic lupus erythematosus (SLE) and related conditions and rare diseases such as systemic sclerosis (SSc), idiopathic inflammatory myopathies (IIM) and vasculitides. Heightened inflammation and disrupted immune pathways contribute to the increased risk of cardiovascular involvement in such IMIDs, but the exact processes need elucidating. Established treatment targets in IMIDs have been associated with the basis for general population CVD such that IMID-associated cardiovascular involvement (and the effect of immune-targeted therapies) provides an excellent model for identification of key biological pathways and common targets. The field of medical science that addresses CVD in IMIDs is termed ‘cardio-rheumatology’. The principal aims of this UK network are to establish a core infrastructure, diagnostic and imaging methodology and experimental capability to deliver future research studies of cardiovascular involvement of IMIDs. Sensitive cardiovascular imaging is informing our understanding greatly and forms a large part of activity of this Partnership (see workstream 3).  The core objectives of the Partnership are to:

1. Establish an active network of cardio-rheumatology clinicians and researchers with patient public involvement and engagement (PPIE) to improve education, and build basic, experimental, and translational research expertise in cardiovascular involvement of IMIDs.
2. Establish a national register of people with IMIDs across a spectrum of cardiovascular involvement, supported by a data storage and analytical platform to facilitate multi-centre research.
3. Enhance UK cardiovascular imaging infrastructure in the diagnosis and assessment of cardiovascular involvement in IMIDs, including of cardiovascular magnetic resonance (CMR), Positron Emission Tomography (PET)-Computed tomography (CT) (PET-CT) and CT Coronary Angiography (CTCA).
4. Support discovery and validation of mechanistic, prognostic and predictive biomarkers of cardiovascular involvement of IMIDs and multi-omic/multi-modal analysis techniques.
5. Establish strong industry collaboration and Partnership sustainability.

The programme is separated into 4 complementary workstreams, each headed by workstream leads who are experts in their fields. The workstreams will have individual targets and goals which will synergise to satisfy the core aims of the project. The workstreams, focus and workstream leads are detailed under the ‘workstream’ tab.