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Birmingham researchers lead novel review of heart disease in chronic kidney disease

Written by Louise Stanley on . Posted in Inflammation and chronic disease.

Researchers at BHP member organisations have carried out a state-of-the-art commissioned review on heart disease in chronic kidney disease (CKD), recently published in leading cardiovascular journal Nature Reviews Cardiology. Bringing together decades of clinical, imaging and experimental evidence the review provides a robust and authoritative overview of heart disease in patients with CKD.

Based on existing research, conducted at the University of Birmingham and elsewhere, the review highlights that structural and functional abnormalities of the heart often begin early in CKD, long before patients reach kidney failure, and that heart disease in CKD is not primarily driven by blocked coronary arteries, but by a combination of long-term stresses on the heart. Such stresses include high blood pressure, fluid overload, metabolic and hormonal disturbances, inflammation, anaemia, and abnormalities in calcium and phosphate metabolism – which, together, can lead to heart muscle thickening, stiffness and scarring, increasing patients’ risk of heart failure, arrhythmias and sudden cardiac death.

Birmingham researchers also propose that the term “chronic kidney disease-associated cardiomyopathy”, should be used in place of the traditionally used “uraemic cardiomyopathy”, to more accurately reflect current evidence.

Professor Jonathan Townend, Director of Clinical Research and honorary Professor of Cardiology at the University of Birmingham, said: “Being invited to write this review recognises the strength of cardiovascular and cardio-renal research at Birmingham. The evidence shows clearly that heart damage in chronic kidney disease starts early, progresses silently, and needs to be identified and addressed well before patients reach kidney failure.”

The review concludes that a shift in clinical focus is needed, away from treating heart disease only at the stage of kidney failure, and towards earlier detection and prevention of cardiac damage in people with chronic kidney disease.

Birmingham’s leadership in clinical cardio-renal research

The review draws heavily on evidence generated by the Birmingham cardiovascular and cardio-renal research community, which has delivered multiple influential clinical studies and trials over the past two decades. This body of work has been central to defining how CKD affects heart structure, function and clinical outcomes, and Birmingham-led and associated studies have helped demonstrate that cardiac abnormalities are present in early-stage CKD, often before overt symptoms develop.

Professor Charles Ferro, Consultant Nephrologist at University Hospitals Birmingham and Honorary Professor of Cardiovascular Sciences at the University of Birmingham said: “For years the Birmingham Cardio-Renal Research Group has been advocating that the excess cardiovascular disease observed in patients with kidney disease has much more to do with structural changes to the heart rather than coronary artery disease. It is really gratifying that our ideas are getting increasing recognition, becoming more accepted, influencing research strategies worldwide, and most importantly, benefitting patients.”

Collectively, these trials and cohort studies have shaped international understanding of cardiovascular risk in CKD and directly underpin many of the concepts brought together in the review.

Birmingham researchers are now leading a programme of well-funded mechanistic research, supported by the British Heart Foundation, aimed at increasing our understanding of the cellular and molecular drivers of heart disease in early CKD.

Dr Davor Pavlovic, Associate Professor in Cardiovascular Sciences at the University of Birmingham, said: “Heart damage in chronic kidney disease starts early. Our focus at Birmingham is to understand the mechanisms behind these early changes and use that knowledge to prevent disease progression.”

By consolidating existing evidence and setting out future research priorities, the review highlights the importance of a focus on earlier detection and prevention of cardiac damage for CKD patients in the future.

National childhood type 1 diabetes screening could prevent thousands of emergency diagnoses, Birmingham study shows

Written by Louise Stanley on . Posted in Birmingham Health Partners, Early diagnosis and detection, Inflammation and chronic disease.

A landmark UK study led by researchers at BHP founder members the University of Birmingham – which involved tens of thousands of families – has shown that childhood screening for type 1 diabetes is effective, laying the groundwork for a UK-wide childhood screening programme.

Results from the first phase of the ELSA (EarLy Surveillance for Autoimmune diabetes) study, co-funded by charities Diabetes UK and Breakthrough T1D, are published today in The Lancet. 

The findings mark a major step towards a future in which type 1 diabetes can be detected in children before symptoms appear. Currently, over a quarter of children with type 1 diabetes don’t receive a diagnosis until they are already in diabetic ketoacidosis (DKA), a potentially fatal condition that requires urgent hospital treatment. Early detection can dramatically reduce emergency diagnoses and could give children access to new immunotherapy treatments that can delay the need for insulin for years.

Launched in 2022, ELSA is the first UK study of its kind, and tested childrens’ blood samples for autoantibodies – markers of type 1 diabetes that can appear years before symptoms.  

We know that risk rises sharply with the number of autoantibodies. Children without autoantibodies are unlikely to develop type 1 diabetes, while those with one autoantibody have a 15% chance of developing the condition within 10 years. Having two or more autoantibodies indicates the immune system has already started attacking the insulin-producing cells in the pancreas and it is therefore almost certain these children will eventually need insulin therapy. This is known as early-stage type 1 diabetes.

Among the 17,283 children aged 3-13 years who were screened for type 1 diabetes risk at the time of analysis: 

  • 75 had one autoantibody, signalling increased future risk. 
  • 160 had two or more autoantibodies but did not yet require insulin therapy, indicating early-stage type 1 diabetes. 
  • 7 were found to have undiagnosed type 1 diabetes with all needing to start insulin immediately.  

Families of children found to have early-stage type 1 diabetes received tailored education and ongoing support to prepare for the eventual onset of type 1 diabetes symptoms and to ensure insulin therapy can begin promptly when needed, reducing the chances of needing emergency treatment. Those with one autoantibody also received ongoing support and monitoring.

Some families were also offered teplizumab, the first ever immunotherapy for type 1 diabetes, which can delay the need for insulin by around three years  in people with early-stage type 1 diabetes. The first patient was treated at Birmingham Children’s Hospital, demonstrating the hive of cutting-edge diabetes activity in and around Birmingham Health Partners and the Birmingham health and life sciences district. Teplizumab was licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK in August 2025, and is currently being assessed by the National Institute for Health and Care Excellence (NICE) to determine whether it should be available through the NHS.

As of November 2025, more than 37,000 families had signed up to the ELSA programme and, building on this strong foundation, the second phase of the research launches today. ELSA 2 will expand screening to all children in the UK aged 2-17 years, with a focus on younger children (2-3 years) and older teenagers (14-17 years). The research team aims to recruit 30,000 additional children across these new age groups.

ELSA 2 will also establish new NHS Early-Stage Type 1 Diabetes Clinics, providing families taking part in the study with clinical and psychological support and creating a clear pathway from screening to diagnosis, monitoring and treatment.

Amy Norman, 44, from the West Midlands, was diagnosed with type 1 diabetes at the age of 13. She recently discovered via the ELSA study that her 11-year-old daughter, Imogen, is in the early stages of type 1 diabetes but has been able to slow its progression as the second child in the UK to access a breakthrough immunotherapy drug – teplizumab. She said: “Being part of the ELSA study has helped us as a family to prepare for the future in a way we never expected. Knowing what’s coming – rather than being taken by surprise – has made an enormous difference to our confidence and peace of mind.

“When I was diagnosed, I had no warning and ended up quite poorly in hospital with diabetic ketoacidosis (DKA). When Imogen’s diagnosis arrives, we hope that having this awareness will reduce her chances of experiencing DKA and the added trauma that comes from a sudden illness.

“Imogen took part in the study to further research and help others, but it has helped her too – being forewarned is being forearmed. She was always going to develop type 1 diabetes, but through ELSA we’ve been able to slow down the process and prepare – we know what is coming, but we’re not scared.” 

Lead researcher, Parth Narendran, Professor of Diabetes Medicine at the University of Birmingham, said: “We are extremely grateful to all the families who have participated in the study and generously given their time to help understand how a UK-wide screening programme could be developed. Together with Diabetes UK, Breakthrough T1D and NICE, we are working towards a future where type 1 diabetes can be detected in a timely manner, and families appropriately supported and treated with medicines to delay the need for insulin.

“We are also grateful to partners across the Birmingham health and life sciences district and beyond as well as the NIHR for the support they have provided in getting us to where we are.”

Dr Elizabeth Robertson, Director of Research and Clinical at Diabetes UK, said: “For too many families, a child’s type 1 diabetes diagnosis still comes as a frightening emergency. But that doesn’t have to be the case. Thanks to scientific breakthroughs, we now have the tools to identify children in the very earliest stages of type 1 diabetes – giving families precious time to prepare, avoid emergency hospital admissions, and access treatments that can delay the need for insulin for years.

“The ELSA study, co-funded by Diabetes UK, is generating the evidence needed to make type 1 diabetes screening a reality for every family in the UK. We’re incredibly grateful to the 37,000 families who’ve already signed up and urge others to get involved. Together, we can transform type 1 diabetes care for future generations.”

Rachel Connor, Director of Research Partnerships at Breakthrough T1D, said: “This is about rewriting the story of type 1 diabetes for thousands of families. Instead of a devastating emergency, we can offer time, choices, and hope. By finding children in the earliest stages, we’re not just preparing families, we’re opening the door to treatments that can delay the need for insulin by years. That extra time means childhoods with fewer injections, fewer hospital visits and more normality. Thanks to research like ELSA, what once struck as an unexpected crisis can become an actively managed healthcare process, changing the course of T1D for the better.”

The Research FIRST team at Birmingham Health Partners has played a pivotal role in the successful delivery of the ELSA study. Drawing on extensive specialist expertise, the team developed and implemented a robust, resilient database to support high-quality data capture and long-term study integrity.

Beyond technical delivery, the team also provided dedicated data management support throughout the project, ensuring rigorous standards, regulatory compliance and operational efficiency. They also offered oversight across key project activities, working closely with participating sites to support recruitment and ensure timely follow-up.

The team’s co-ordination and proactive problem-solving were instrumental in keeping the study on track. A further major achievement was the end-to-end management of dry blood spot testing kit dispatch, enabling sites to begin screening as quickly as possible after families signed up. This comprehensive project management has been critical in maintaining momentum and supporting the continued success of the study, enabling researchers to continue their work with confidence.

The findings from ELSA’s first phase signal a major step towards a future in which type 1 diabetes can be detected early, managed proactively, and potentially delayed through immunotherapy. ELSA demonstrates that childhood screening in the UK is feasible, acceptable to families, and capable of preventing emergency diagnoses. Continued research through ELSA 2 will assess how screening can be scaled across the NHS and evaluate its cost-effectiveness.

Type 1 diabetes is a serious and lifelong autoimmune condition affecting up to 400,000 people in the UK. It is caused by an immune system attack on the insulin-producing cells in the pancreas, meaning they can no longer make enough insulin. Rapid diagnosis of type 1 diabetes is essential to avoid life-threatening complications. 

For more information about ELSA or ELSA 2, visit elsadiabetes.nhs.uk/taking-part/. 

Simple tool predicts mental health and treatment needs for new inflammatory bowel disease patients

Written by Louise Stanley on . Posted in Early diagnosis and detection, Inflammation and chronic disease, Mental health.

Researchers at BHP founding-members the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), have shown how early use of the IBD Disk questionnaire can help forecast which patients are likely to experience more severe physical and mental health outcomes over the following year.

More than half a million patients in the UK have inflammatory bowel disease (IBD), and research suggests that up to 30% experience mental ill health as a result. Now, a new study outlines how many of the 25,000 new patients diagnosed each year could receive more tailored mental health support thanks to a simple tool that identifies psychological distress and predicts disease severity.

The paper published in Frontiers in Gastroenterology shows how a patient-reported questionnaire called IBD Disk – currently used to track impact of disease on daily life – can also be powerful prediction tool, detecting anxiety and depression symptoms from the outset of a patient’s diagnosis for the inflammatory condition.

The Birmingham study is the first to show that the tool can be used at the point of diagnosis to identify patients at risk of mental health challenges and predict who may need more intensive treatment.

This dual-purpose use – both as a mental health screener and a predictor of disease trajectory – could help clinicians intervene earlier and personalise care for patients more effectively.

Dr Peter Rimmer, lead author of the study, researcher at the University of Birmingham and Consultant Gastroenterologist at University Hospitals Birmingham NHS Foundation Trust said: “This is the first time we’ve shown that the IBD Disk can act as both a mental health screener and a predictive tool for clinical outcomes at the very start of a patient’s journey.

“The findings support the use of the IBD Disk not only as a disability tracker, but as a proactive tool to guide early treatment decisions and mental health support. It’s a simple intervention that could help personalise care and reduce long-term burden on the NHS.”

Mental health conditions more common for IBD patients

Mental health conditions including anxiety and depression are more common in people with established IBD than in the general population, with some studies suggesting that 20-30% of patients are affected by mood disorders.

However, very few studies have been undertaken among patients when they are first diagnosed – at a time when their new IBD symptoms and uncertainty around diagnosis can contribute to psychological distress.

This study found that patients with higher levels of disease-associated physical disability and psychological distress at diagnosis were more likely to need escalating treatments such as stronger medication or surgical interventions, or require an emergency admission to hospital later on – adding to growing evidence that early identification of these symptoms could play a key role in improving long-term outcomes for people with IBD.

The study followed 188 patients attending a rapid-access clinic for suspected IBD who were subsequently diagnosed with either Crohn’s Disease or Ulcerative Colitis. At their first visit – before diagnosis – patients completed the IBD Disk, and a subgroup also completed the Hospital Anxiety and Depression Scale (HADS) to assess mental health. After diagnosis, patients were treated according to standard clinical guidelines and followed for 12 months.

Researchers analysed whether scores on the IBD Disk, particularly in the “Emotions” domain, could identify patients with moderate to severe anxiety or depression symptoms, and whether those scores predicted the need for advanced therapies, hospitalisation, and persistent disease activity.

Statistical analysis showed that an “Emotions” score of 7 or higher was highly correlated with moderate to severe depression symptoms. Patients with higher IBD Disk scores at diagnosis were significantly more likely to experience poor clinical outcomes, especially those with ulcerative colitis. Where medical treatments were not effective and their IBD remained active, patients were more likely to experience ongoing symptoms of psychological distress.

The study involved collaborators from Hoffmann-La Roche, Beaumont Hospital Dublin, and Royal Wolverhampton NHS Trust. Hoffmann-La Roche provided funding for the study and the Roche author participated in manuscript writing, review and editing.

International initiative to tackle heart health inequalities in cities to be led from Birmingham

Written by Louise Stanley on . Posted in Health inequalities, Inflammation and chronic disease.

Researchers from BHP founder the University of Birmingham will collaborate with international partners on an ambitious project aiming to help reduce the burden of cardiovascular disease in urban environments, as well as reducing the health inequality gap.

Cardiovascular disease is the leading cause of death globally, accounting for over 20 million deaths per year and costing the EU an estimated €282bn annually. To tackle this, the European Union Innovative Health Initiative has funded the new Cities@Heart consortium which will design, pilot and evaluate a series of city-level strategies to improve cardiovascular health for all.

Addressing cardiovascular disease in urban environments is challenging due to factors like poor access to healthcare and healthy food, exposure to pollution, and lack of safe spaces for physical activity. Urban infrastructure, food systems, and socio-economic disparities also contribute to adverse cardiometabolic outcomes.

While there are many interventions for cardiovascular disease, a lack of effective implementation means these often fail to reach individuals who would benefit most. This is particularly evident in underserved city populations such as those experiencing poverty, and in certain ethnic groups, disabled people, and women.

Addressing these complex issues requires a whole-city, integrated approach that changes health policy through co-production of suitable interventions with communities and community leaders.

The Cities@Heart project, starting in January 2026 and coordinated by the University of Birmingham, the University Medical Center Utrecht (Netherlands) and Novartis (Switzerland), will combine medical, technical, social and policy innovations to achieve a transformation in outcomes for communities experiencing health inequality.

Led by Professor Dipak Kotecha, the project will utilise existing infrastructure from seven city councils across Europe, embedding new health innovations and technologies from industry partners to tackle the challenge of urban cardiovascular disease on a significant scale.

The strategies will target obesity, hypertension, dyslipidaemia and diabetes, key drives of common and high-cost cardiovascular disease, such as heart attacks, stroke, heart failure, atrial fibrillation and vascular dementia. These disproportionately impact underserved and disadvantaged communities in urban areas.

Professor Dipak Kotecha, Professor of Cardiology at the University of Birmingham, researcher at the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, through which this project will be delivered, Honorary Professor at the University Medical Center Utrecht and Global Director of Cities@Heart said: “Huge strides have been made to better manage disease of the heart and circulation, but they still remain the world’s biggest killers. We will jointly develop approaches with affected citizens, community leaders, city councils, clinicians, health policy leaders and industry partners to achieve long-term change.”

Collaboration across Europe

The project consortium involves 34 international partners, including the World Health Organization (WHO) European Healthy Cities Network, World Heart Federation, European Heart Network, European Society of Cardiology, European Public Health Association and multiple European universities.

Birmingham joins another six cities committed to city-wide improvement that will test and implement strategies that can be scaled across the WHO’s network of more than 1,800 cities: Belfast (Northern Ireland), Cork (Republic of Ireland), Łódź (Poland), Izmir (Turkey), Udine (Italy) and Utrecht (Netherlands).

The vision of the consortium is that evidence-based prevention, early detection, and management of cardiovascular disease is universally accessible in urban areas, supported by new health technology developments. The Cities@Heart project aims to reduce the economic burden of cardiovascular disease on society and improve quality-of-life and life expectancy for millions.

Birmingham researchers lead world-first treatment trial for rare liver disease

Written by Louise Stanley on . Posted in Clinical trials, Experimental medicine, Inflammation and chronic disease.

The first participant has been treated in an early-phase clinical trial investigating whether a new medical device, Carbalive, can slow disease progression and improve outcomes for patients with a rare liver disease called primary sclerosing cholangitis (PSC). The trial, known as the CATCH trial, marks the first time this device will be studied in humans with PSC-IBD.

The new clinical trial involves several BHP partners – it’s being coordinated by researchers from the University of Birmingham and the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, and clinicians at University Hospitals Birmingham (UHB) NHS Foundation Trust. 

PSC affects around 3500-4000 people in the UK, including both adults and children. In PSC, the body’s immune system attacks itself, causing inflammation and scarring of the bile ducts – the small tubes that carry bile (a digestive fluid produced by the liver) to the gallbladder and small intestine. This leads to reduced or blocked bile flow, and over time, liver damage.

In around 80% of people with PSC, the body also attacks the bowel, which can lead to inflammatory bowel disease (IBD), a devastating disease that affects the lining of the gut, leading to severe gut inflammation, bleeding and diarrhoea.

There is currently no cure or medication to improve survival, and liver transplantation remains the only life-saving option for PSC.

The exact cause of PSC is not known, but research has shown that gut inflammation, that is also a key component of IBD, is a key trigger for the disease. Removing harmful substances and restoring the disturbed gut microbiome reduces gut inflammation, which may help slow its progression.

Carbalive (also called YAQ001) is a medical device created by Yaqrit – a company that develops life-saving treatments for patients with advanced liver disease. This device is made up of tiny carbon beads with lots of different sized pores to absorb toxins that would otherwise return to the liver.

In pre-clinical studies, animals with cholestatic disease (a condition where bile flow from the liver is impaired) showed improvements in liver function and signs of disease activity after treatment with Carbalive. Early studies in people with cirrhosis have also shown the device to be safe and effective in restoring the gut microbiome and reducing inflammation.

Palak Trivedi, Principal Investigator of the study, Consultant Hepatologist and Clinician Scientist at UHB, and Professor of Cholestatic and Immune-mediated Liver Disease at the University of Birmingham, said: “PSC-IBD is a progressive condition, and with no approved treatments, it can ultimately lead to liver failure.

“This trial is an important step in exploring the potential of Carbalive to slow the progression of this disease and improve patient outcomes. By funding this trial, and this innovation, LifeArc offers hope to patients and their families through a promising new approach.”

First participant in the trial

Nick Haynes, from Nottingham, is the first participant to take part in the trial and began his treatment this week.

Nick said: “I was diagnosed with PSC a couple of years ago, and as there aren’t many treatment options available currently, that really attracted me to taking part in this trial. I think it comes with many benefits – you hope the medicine will lead to some kind of improvement, but it’s also very reassuring to be part of enhanced screening. It’s about looking to the future too, and being part of something that could advance medicine and treatment options for people with PSC feels really positive. I really hope it becomes a viable treatment for patients in the future.”

Twelve patients with PSC-IBD will receive Carbalive orally for twelve weeks, and the data collected will assess whether the treatment improves bile flow and reduces inflammation.

The trial has been made possible through funding from LifeArc, a not-for-profit organisation supporting research into rare diseases.

Troels Jordansen, Yaqrit’s Chief Executive Officer said: “This is a great opportunity for Yaqrit to help patients with PSC-IBD while remaining highly focused on the treatment of late-stage liver disease.

“In YAQ001, the company has developed a treatment that addresses toxicities and inflammation that are common in advanced liver disease but also apparent in a broader spectrum of conditions.”

Sam Barrell, CEO of LifeArc, said: “For the 3.5 million people in the UK living with rare diseases, access to treatment is a huge challenge – 95% of conditions have none. That must change. World-first trials, like the CATCH Trial, are part of the solution, which is why LifeArc funded it through our Pathfinder Programme. We have an opportunity to make the UK the go-to place for innovative trials like this, but to realise this ambition we need to transform how we support rare disease research, making a difference for rare disease patients much faster.”

CATCH is the latest clinical trial delivered through the NIHR Birmingham Biomedical Research Centre, a partnership between the University of Birmingham and University Hospitals Birmingham NHS Trust, which focuses on inflammatory disease research. Collaborative research from the NIHR Birmingham BRC has already seen nearly 1,000 clinical trials initiated and has informed UK clinical guidelines.

Professor Andrew Filer appointed Director of NIHR Birmingham Biomedical Research Centre

Written by Louise Stanley on . Posted in Birmingham Health Partners, Inflammation and chronic disease.

The National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC) has announced the appointment of Professor Andrew Filer as its new Director. Professor Filer takes over from Professor Paul Moss, who has served as Interim Director since June 2024.

Professor Filer is already co-lead of the BRC’s Inflammatory Arthritis research theme and brings a wealth of clinical and translational research experience to the role. His leadership will further guide the BRC in delivering cutting-edge research that transforms patient care across the region and beyond.

Professor Filer said: “I’m honoured to take on the role of Director at such an exciting time for the Birmingham BRC. Our BRC is built on a foundation of collaboration, innovation and clinical excellence. I look forward to working with our partners to ensure our research continues to make a real difference to patients’ lives.”

The NIHR Birmingham BRC is a cross-BHP collaboration, hosted by University Hospitals Birmingham NHS Foundation Trust (UHB) and delivered in partnership with the University of Birmingham and six associate academic and NHS partners across the region. It brings together clinicians, scientists and healthcare professionals to drive translational research improving outcomes for people with inflammatory diseases.

Professor Kiran Patel, Chief Medical Officer at UHB, said: “Professor Filer is passionate about integrating patient-centred approaches and high-quality discovery science to drive innovation. I am delighted he has taken on this role, and I am sure he will provide effective leadership to our incredibly successful NIHR Birmingham BRC.”

Professor Neil Hanley, Pro-Vice-Chancellor and Head of the College of Medicine and Health at the University of Birmingham, added: “I’m really excited by Andrew’s appointment. It really does reflect the strength of clinical research leadership in Birmingham. His vision and energy will be instrumental for the next phase of the BRC’s mission to deliver inclusive impact, health improvement and economic growth.”

Dr Victoria Day, Head of Infrastructure at the Birmingham BRC, commented: “Andrew brings deep knowledge of the NIHR landscape and a long-standing commitment to patient-focused research. His leadership and collaborative approach will be key to driving the Birmingham BRC forward and delivering meaningful health impact.

“I would like to take this opportunity to sincerely thank Professor Paul Moss for his support during his time as Interim Director. His leadership and commitment have contributed to the many achievements we’ve made during this period.”

Professor Andrew Filer is a Professor of Translational Rheumatology in the Department of Inflammation and Ageing at the University of Birmingham. A Fellow of the Royal College of Physicians, he holds a PhD in immunology and is an Honorary Consultant Rheumatologist. He is internationally recognised for his work in early inflammatory arthritis, particularly in developing novel imaging and biopsy techniques to study disease mechanisms and improve diagnosis.

He co-leads the Birmingham Early Arthritis Clinic and has pioneered the use of musculoskeletal ultrasound and ultrasound-guided synovial biopsy in clinical research. His research focuses on Synovial cellular biology, disease stratification, and the development of targeted therapies for rheumatoid arthritis. Professor Filer is a passionate advocate for integrating patient cohorts with high-quality basic science to accelerate translational impact.