University news

Researchers across the UK are banding together to tackle one of the largest unmet
clinical needs in inflammatory arthritis, pain reduction, in a new £3m research programme funded by Arthritis UK.  

Inflammatory arthritis affects more than 1 in 100 people. It occurs when the immune system mistakenly attacks the joints, causing inflammation experienced as swelling, stiffness and pain.  

Current medical approaches for inflammatory arthritis largely focus on tackling inflammation, with pain not always being prioritised. This means that people with inflammatory arthritis do not always receive treatments that are appropriate for both their inflammation and their pain. 

The Arthritis UK TOPPIA (Targeting of Peripheral Pain in Inflammatory Arthritis) consortium, led by King’s College London researchers, will combine patients’ lived experience alongside multidisciplinary expertise, to achieve precision pain management that addresses individual needs. 
 
When patients are undergoing clinical care, inflammation and pain are often assumed to be interlinked. But for many people, medical tests can indicate reduced inflammation but fail to show whether pain symptoms persist.  

This means in some cases, someone’s arthritis is classed as in remission, but they continue to struggle with daily pain that impacts their quality of life. This oversight can discourage patients from raising their pain symptoms with healthcare professionals, due to a fear of being dismissed.  

Tom Esterine, 64, from Brixton, is a TOPPIA patient partner and helped shape the project by sharing his experience of living with rheumatoid arthritis. Tom said: “I’ve lived with arthritis pain for 14 years. The pain doesn’t stay the same; it shifts and changes as the condition develops. It comes and goes with new medications and can persist even when healthcare professionals tell me I’m in remission.

“Well, all I can say is that remission shouldn’t still hurt! This research is exciting because it treats pain as real, digging deeper into the joints to understand why we still experience it, and will finally find treatments to ease it.”

TOPPIA has already identified that pain is not always driven by traditional inflammation and instead can be caused by non-immune cells that remain in the joint. This may be present in around 1 in 4 patients, something the researchers call ‘nonclassical inflammation’.

Lead researchers on the project, Professor Leonie Taams, Faculty of Life Sciences & Medicine, King’s College London and Dr Franziska Denk, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said: “Pain is one of the most devastating symptoms for many people living with arthritis. It requires a large, united effort, where everyone is pulling in the same direction to improve drug development, patient stratification and advocacy. 

“Together, we will deepen our understanding of the drivers of pain, identify new therapeutic targets, improve treatment strategies, and champion the inclusion of pain as a core priority in both research and clinical care for inflammatory arthritis.

“This is what this Arthritis UK’s funding will allow us to do: working together across the UK towards a future free from arthritis pain.”

Professor Carl Goodyear, Professor of Translational Immunology and Assistant Vice-Principal at the University of Glasgow, said: “We are delighted that the University of Glasgow is part of the TOPPIA consortium, which represents an important step forward in the approach to inflammatory arthritis healthcare.

“Managing the pain associated with inflammatory arthritis largely remains an unmet need for patients. The TOPPIA consortium is the first research collaboration of its kind to prioritise finding new and effective therapies focused on pain reduction in inflammatory arthritis, as well as championing the voices of patients and prioritising their needs.”

Arthritis UK works to improve the lives of people living with arthritis through its advocacy work, provision of services and world-leading research. The charity is the largest dedicated funder of arthritis research. 

Professor Lucy Donaldson, Arthritis UK’s Director of Research, said: “We are delighted to be funding this foundational research which will address a critical yet often overlooked clinical need, chronic pain.  

“The pain of arthritis can severely impact both mental and physical health. Our recent lived experience survey showed that 6 in 10 people are living in pain most or all of the time due to their arthritis.

"By placing patient voices at the heart of the study, this research embodies all values that Arthritis UK stands for, as we are committed to making real, impactful improvements for all people living with arthritis, and this is a great step in that direction.”

The study, supported by lived experience experts, cutting edge technologies and unique resources, will take a four-stage approach. It will:  

• test new treatment targets for pain 
• create a biobank of joint samples to study clinical information on pain  
• improve tailored diagnosis and care 
• advocate for pain to be prioritised in care and research 

The TOPPIA consortium is comprised of researchers from King’s College
London, Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS
Foundation Trust, University College London, Great Ormond Street Hospital for
Children NHS Foundation Trust, Cardiff University, University of Oxford, University of
Birmingham, University of Glasgow, and The Rockefeller University in the USA.  
The consortium is united by a shared ambition to generate a step-change in how
pain is addressed across the entire arthritis life course. The 5-year study, funded by a
£3m grant from Arthritis UK, will start in Autumn 2026.  

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Enquiries: ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk

First published: 15 April 2026