PT  - JOURNAL ARTICLE
AU  - Kevin L Winthrop
AU  - John D Isaacs
AU  - Philip J Mease
AU  - Dimitrios T Boumpas
AU  - Xenofon Baraliakos
AU  - Jacques-Eric Gottenberg
AU  - Stefan Siebert
AU  - Marta Mosca
AU  - Neil Basu
AU  - Dana Orange
AU  - R Lories
AU  - Daniel Aletaha
AU  - Iain B McInnes
AU  - Tom W J Huizinga
AU  - Reinhard E Voll
AU  - Ellen M Gravallese
AU  - Ferry C Breedveld
AU  - Josef S Smolen
TI  - Unmet need in rheumatology: reports from the Advances in Targeted Therapies meeting, 2022
AID  - 10.1136/ard-2022-223528
DP  - 2023 May 01
TA  - Annals of the Rheumatic Diseases
PG  - 594--598
VI  - 82
IP  - 5
4099  - http://ard.bmj.com/content/82/5/594.short
4100  - http://ard.bmj.com/content/82/5/594.full
SO  - Ann Rheum Dis2023 May 01; 82
AB  - 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.