# A precision medicine approach to assess progression from undifferentiated arthritis to rheumatoid arthritis

> **NIH NIH R21** · CHILDREN'S HOSPITAL & RES CTR AT OAKLAND · 2020 · $1

## Abstract

PROJECT SUMMARY
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that affects 1% of the adult world
population, including 1.5 million adults in the U.S. There is currently no cure for RA. In addition to joint
inflammation, the disease can lead to irreversible erosive damage to cartilage and bone, resulting in significant
disability and poor quality of life. Since early treatment of RA is beneficial and results in a less severe disease
course, it was hypothesized that very early stages of RA may represent a “therapeutic window of opportunity”
during which appropriate treatment may be able to alter the course of the disease, preventing further
progression, and possibly could switch off the disease process. It has also been shown that it would be more
beneficial to identify RA patients closer to the onset of symptoms for early therapy, i.e. when symptoms have
been present for less than 3 months. At that time, patients may not even satisfy the criteria for early RA
diagnosis but get a diagnosis of “undifferentiated arthritis” (UA), which is the most common diagnosis when
arthritis symptoms first appear and patients cannot be diagnosed with any specific disease. Hence, prediction
models are needed that can accurately predict who among all UA patients will (a) be among the 30% who
progress to RA, and hence, should be started on early aggressive treatment, and (b) will go into remission or
will develop other conditions, and hence, should not unnecessarily be given aggressive RA treatment as these
are associated with serious side effects. Currently available prediction models do not accurately predict which
UA patients will progress to RA. Since genomic markers associated with early RA have not been thoroughly
investigated and are not included among existing prediction models, we propose to first identify biomarkers of
progression from UA to RA at the levels of gene expression and genetic polymorphisms (expression
quantitative trait loci, eQTLs) in a cohort of early UA patients. The biomarkers identified will be included in a
prediction model with high specificity and sensitivity that can be applied to accurately predict progression from
UA to RA. The use of such a precision medicine approach for early RA treatment will provide significant health
and cost benefits. Second, we also propose to investigate biological changes associated with progression from
UA to RA over time to gain a better understanding of potential pathways that may be involved in RA
pathogenesis.

## Key facts

- **NIH application ID:** 10009272
- **Project number:** 5R21AR076026-02
- **Recipient organization:** CHILDREN'S HOSPITAL & RES CTR AT OAKLAND
- **Principal Investigator:** Damini Jawaheer
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1
- **Award type:** 5
- **Project period:** 2019-09-05 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10009272

## Citation

> US National Institutes of Health, RePORTER application 10009272, A precision medicine approach to assess progression from undifferentiated arthritis to rheumatoid arthritis (5R21AR076026-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10009272. Licensed CC0.

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