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Unmet need in rheumatology: reports from the Advances in Targeted Therapies meeting, 2022
  1. Kevin L Winthrop1,
  2. John D Isaacs2,
  3. Philip J Mease3,
  4. Dimitrios T Boumpas4,
  5. Xenofon Baraliakos5,
  6. Jacques-Eric Gottenberg6,
  7. Stefan Siebert7,
  8. Marta Mosca8,
  9. Neil Basu7,
  10. Dana Orange8,
  11. R Lories9,
  12. Daniel Aletaha10,
  13. Iain B McInnes7,
  14. Tom W J Huizinga11,
  15. Reinhard E Voll12,
  16. Ellen M Gravallese13,
  17. Ferry C Breedveld14,
  18. Josef S Smolen10
  1. 1Department of Medicine, Oregon Health and Sciences University (OHSU), Portland, Oregon, USA
  2. 2Department of Clinical Rheumatology, Newcastle University, Newcastle upon Tyne, UK
  3. 3Swedish Medical Center; University of Washington, Seattle, Washington, USA
  4. 44th Department of Internal Medicine, Rheumatology and Clinical Immunology Unit, National and Kapodistrian University of Athens, Athens, Greece
  5. 5Ruhr-University Bochum, Rheumazentrum Ruhrgebiet Herne, Herne, Germany
  6. 6Centre National de Référence des Maladies AutoImmunes Systémiques Rares CHU Strasbourg-Hautepierre, Strasbourg, France
  7. 7College of Medical, Veterinary & Life Sciences; University of Glasgow, Glasgow, UK
  8. 8Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
  9. 9Division of Rheumatology Hospital for Special Surgery, New York, NY, USA
  10. 10Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Wien, Austria
  11. 11Division of Rheumatology, University of Leuven, Leuven, The Netherlands
  12. 12Department of Rheumatology and Clinical Immunology, University of Freiburg, Freiburg, Germany
  13. 13Brigham and Women‟s Hospital, Harvard University, Boston, Massachusetts, USA
  14. 14Department of Rheumatology, University of Leiden, Leiden, The Netherlands
  1. Correspondence to Dr Kevin L Winthrop, OHSU, Portland, Oregon, USA; winthrop{at}


To detail the unmet clinical and scientific needs in the field of rheumatology. After a 2-year hiatus due to the SARS-CoV-2 pandemic, the 22nd annual international Advances in Targeted Therapies meeting brought together more than 100 leading basic scientists and clinical researchers in rheumatology, immunology, epidemiology, molecular biology and other specialties. Breakout sessions were convened with experts in five rheumatological disease-specific groups including: rheumatoid arthritis (RA), psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus and connective tissue diseases (CTDs). In each group, experts were asked to identify and prioritise current unmet needs in clinical and translational research, as well as highlight recent progress in meeting formerly identified unmet needs. Clinical trial design innovation was emphasised across all disease states. Within RA, developing therapies and trials for refractory disease patients remained among the most important identified unmet needs and within lupus and spondyloarthritis the need to account for disease endotypes was highlighted. The RA group also identified the need to better understand the natural history of RA, pre-RA states and the need ultimately for precision medicine. In CTD generally, experts focused on the need to better identify molecular, cellular and clinical signals of early and undifferentiated disease in order to identify novel drug targets. There remains a strong need to develop therapies and therapeutic strategies for those with treatment-refractory disease. Increasingly it is clear that we need to better understand the natural history of these diseases, including their ‘predisease’ states, and identify molecular signatures, including at a tissue level, which can facilitate disease diagnosis and treatment. As these unmet needs in the field of rheumatic diseases have been identified based on consensus of expert clinicians and scientists in the field, this document may serve individual researchers, institutions and industry to help prioritise their scientific activities.

  • rheumatoid arthritis
  • psoriatic arthritis
  • ankylosing spondylitis
  • spondyloarthritis
  • systemic lupus erythematosus

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  • Handling editor David S Pisetsky

  • Twitter @ProfJohnIsaacs, @none, @StefanSiebert1

  • Correction notice This article has been corrected since it published Online First. Author affiliations have been corrected.

  • Contributors All authors contributed to the study design, data collection, discussion and critical revision of the manuscript.

  • Funding Funding for this meeting was provided by AbbVie, Chugai Pharmaceutical, Eli Lilly, Galapagos, Mitsubishi Tanabe, Novartis, Pfizer, BMS

  • Competing interests KLW has received research grants and/or consulting honoraria from Janssen Pfizer, AbbVie, Union Chimique Belge (UCB), Eli Lilly & Company, Galapagos, GlaxoSmithKline (GSK), Roche, Gilead, BMS, Regeneron, Sanofi, AstraZeneca, Novartis; JDI has received grants and/or consulting honoraria from Janssen, Pfizer, AbbVie, BMS, Gilead, Roche, UCB, Eli Lilly; PJM has received grants and/or consulting honoraria from AbbVie, Acelyrin, Aclaris, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Inmagene, Janssen, Moonlake, Novartis, Pfizer, Sun Pharma, UCB; DTB has received grants/or consulting honoraria from AstraZeneca, Abbvie, Pfiser, GSK and Lilly; XB has received grants and/or consulting honoraria from AbbVie, BMS, MSD, Celgene, Chugai, Merck, Novartis, Pfizer, Sandoz, and UCB; J-EG has received grants and/or consulting honoraria from Abbvie, BMS, Gilead, Galapagos, Lilly, MSD, Novartis, Pfizer, Roche Chugai, Sanofi; SS has received grants and/or consulting honoraria from Amgen, AbbVie, Biogen, Eli Lilly, GSK, Janssen, UCB, Pfizer, Boehringer Ingelheim and Novartis; MM has received grants and/or consulting honoraria from Lilly, GSK, Astra Zeneca, UCB, Janssen, Abbvie and Pfizer; NB has received grants and/or consulting honoraria from Roche, MSD, Pfizer, GSK, Galapagos, Vifor and Lilly; RL has received grants and/or consulting honoraria from Abbvie, Boehringer-Ingelheim, Celgene, Eli-Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Sandoz, Kabi-Fresenius, Biosplice (formerly Samumed) and UCB; DA has received grants and/or consulting honoraria from Abbvie, Amgen, Galapagos, Lilly, Janssen, Merck, Novartis, Pfizer, Sandoz and Sanofi; IBM has received grants and/or consulting honoraria from AbbVie, Amgen, BMS, Causeway Therapeutics, Cabaletta, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Sanofi, UCB, Evelo, Compugen, AstraZeneca, Moonlake and serves as a NHS GGC board member, Evelo Board of Directors, Versus Arthritis Trustee Status; REV has received grants and/or consulting honoraria from AbbVie, Amgen, Boehringer Ingelheim, BMS, Janssen-Cilag, GSK, Hexal, Neutrolis, Novartis and Pfizer; EMG: serves as an associate editor at the New England Journal of Medicine; JSS has received research grants and/or consulting honoraria from AbbVie, Amgen, AstraZeneca, Astro, Bristol-Myers Squibb, Chugai, Janssen, Lilly, Merck Sharp & Dohme, Novartis-Sandoz, Pfizer, R-Pharma, Roche, Samsung and UCB serves as the editor of Annals of Rheumatic Diseases but was not involved in the handling or review of this manuscript.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.