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Ocular morbidity associated with Giant Cell Arteritis and Polymyalgia Rheumatica – PhD project (YatesMU19SF)


Project Description

Polymyalgia Rheumatica (PMR) often co-exists with GCA. PMR is an inflammatory condition of unknown aetiology causing shoulder and hip girdle pain and stiffness. It is a clinical diagnosis. PMR and GCA often coexist, with 40-60% of patients with GCA having PMR symptoms. Visual loss is one of the most serious potential consequences of a diagnosis of polymyalgia rheumatic (PMR) and giant cell arteritis (GCA). While glucocorticoids (GC or ‘steroids’) are commonly used to reduce the risk to the eyes, this treatment itself carries a risk of cataract and glaucoma.

To date little is known about who is at most risk of eye complications in these diseases and how drugs might best be used. The GC treatment regimens used in GCA are based on consensus opinion opposed to sound clinical trial evidence. This has led to a large and increasing evidence gap for the management of patients with these conditions. Judicious use of GCs should be the norm; however, data from community-based registries such as the CPRD and THIN datasets has revealed that the duration and total dosage of GC exposure is increasing for patients with these conditions.

The successful candidate will work with data already obtained from the CPRD and explore descriptive epidemiology and pharmacoepidemiologic hypotheses to investigate risks increasing ocular morbidity.
This PhD project will be hosted at the Versus Arthritis Centre for Epidemiology at UEA. Working within this dynamic group the candidate will undertake statistical training and analysis in epidemiology and causal inference to understand the wider societal impact of their research findings.

For more information on the project’s supervisor, please visit: https://people.uea.ac.uk/m_yates/publications
Type of programme: PhD
Start date of project: October 2020
Mode of study: part time or full time
Studentship length: . 3 year studentships have a (non-funded) 1 year ‘registration only’ period
Location: UEA


ENTRY REQUIREMENTS:
A minimum upper second class in their first undergraduate degree (or equivalent) in biomedical sciences, genetics, statistics/mathematics or related scientific discipline. A Master’s degree in a relevant subject and/or experience in biomedical sciences, genetics, statistics/mathematics or a related scientific discipline is desirable.

Funding Notes

Please attach a copy of your grant award letter/AN paperwork that includes details of awarded funding. Where there is a CASE partner please also attach confirmation of the award from the partner.

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References

(i) Incidence of inflammatory polyarthritis in polymyalgia rheumatica: a population-based cohort study.
Yates M, Kotecha J, Watts RA, Luben R, Khaw KT, MacGregor AJ.
Ann Rheum Dis. 2018 Oct 26. pii: annrheumdis-2018-214386.
(ii) Glucocorticoid withdrawal in polymyalgia rheumatica: the theory versus the practice.
Yates M, Watts RA, Swords F, MacGregor AJ.
Clin Exp Rheumatol. 2017 Jan-Feb;35(1):1-2
(iii) The association of vascular risk factors with visual loss in giant cell arteritis.
Yates M, MacGregor AJ, Robson J, Craven A, Merkel PA, Luqmani RA, Watts RA.
Rheumatology (Oxford). 2017 Apr 1;56(4):524-528.
(iv) The prevalence of giant cell arteritis and polymyalgia rheumatica in a UK primary care population.
Yates M, Graham K, Watts RA, MacGregor AJ.
BMC Musculoskelet Disord. 2016 Jul 15;17:285.
(v) Prednisolone combined with adjunctive immunosuppression is not superior to prednisolone alone in terms of efficacy and safety in giant cell arteritis: meta-analysis.
Yates M, Loke YK, Watts RA, MacGregor AJ.
Clin Rheumatol. 2014 Feb;33(2):227-36.

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