NIHR Barts Biomedical Research Centre & Precision Musculoskeletal Care theme

NIHR Barts Musculoskeletal Biomedical Research Centre

The NIHR Barts musculoskeletal BRC combines the second largest NHS Trust, serving ~7.5 million people from 97 nations, with the strengths of Queen Mary University of London partnered with St George’s University of London and St George’s University Hospitals NHS Foundation Trust.

Our vision is to:

  • Detect disease early, carefully sub-divide patients into groups and provide effective individualised treatments. We will use real-world data to identify different patient groups that will enable us to better understand disease so we can develop more precise treatments.
  • Build on our world-leading track record of translational digital precision healthcare from the 100,000 Genomes Project.
  • Integrate real time multi-modal digital health data (clinical, digital pathology, imaging, deeper phenotyping), precision multi-omics, functional characterisation and advanced analytics to maximise new diagnoses, early disease detection, and tailored therapeutic innovation.
  • Create the NHS of the future in cardiovascular disease (CVD), musculoskeletal disease (MSK) and cancer, accelerating translational research from patient to gene variant to function to phenotype into stratified healthcare that transforms lives.

Our goals are to transform outcomes in arthritis by: 

  1. Improved risk assessment through the development and testing of new genetic risk scores for arthritis prevention.
  2. Optimising treatments using information from tissue samples to select tailored treatments for arthritis.
  3. Placing patient-shaped digital precision healthcare research, with full engagement and equality, diversity, and inclusion at the heart of this BRC.
  4. Harnessing our population scale to engage niche diverse groups with a disproportionate burden of musculoskeletal conditions in research that transforms outcomes in our diverse community.

Background – Precision Musculoskeletal Care theme

Musculoskeletal (MSK) conditions affect over 14.9m people nationally, represent 20% of GP consultations and are the second biggest cause of sickness absence, costing the UK economy £7bn per year and £5bn per year directly to the NHS.

While biologic therapies have revolutionised management of rheumatoid arthritis, huge clinical challenges remain with 40% of patients reporting a poor therapeutic response, 10-20% remain refractory to all current medications leading to delayed disease control and disability. No biologics are currently available for Sjorgrens syndrome, while in osteoarthritis absence of disease-modifying therapy leads to >250,000 NHS joint replacements per year.

Our multidisciplinary research team will apply multi-modality data integration to high burden, common MSK diseases to address major areas of unmet need.


Precision Musculoskeletal Care pioneered the selection of biologics tailored to patients’ synovial pathotype (Lancet 2021). We will combine deeper phenotyping and remote patient disease activity monitoring (see Precision Digital Health, Cardiovascular Devices and Trials), with pan-BRC digital pathology (with Cardiovascular and Cancer) and single cell multi-omic profiling, including a novel method of immune repertoire sequencing across a suite of funded trials with Manchester (joint MRC funding), Oxford (joint Versus Arthritis Osteoarthritis Centre), Bristol & Nottingham (Perioperative Care TRC).

Aims & Objectives – Precision Musculoskeletal Care

Through deep clinical, biomechanical, molecular and imaging phenotyping we will drive AI analyses generating novel predictive algorithms to answer the research questions of:

  1. Who will rapidly progress and when? (precision detection/surveillance).
  2. Which cellular, molecular, bio-mechanical mechanisms/pathways underpin disease progression/treatment resistance for novel target identification? (precision pathogenesis/discovery).
  3. Who will respond/non-respond to current/novel medications? (precision stratification/therapy).

funded by

National Institute for Health and Care Research

Our Team – Precision Musculoskeletal Care

Co-Theme Leads

Professor Costantino Pitzalis

Professor Xavier Griffin

Personalised healthcare, multi-omics & Clinical Trials

Professor Michele Bombardieri

Professor Jack Cuzik

Professor Rhian Gabe

Professor Xavier Griffin

Dr Myles Lewis

Professor Dylan Morrissey

Professor Costantino Pitzalis

Dr William Marsh

Novel Therapeutics & Target Discovery

Professor Francesco Dell’Accio

Dr Karin Hing

Professor Mauro Perretti

Professor Gleb Sukhorukov

In-vitro Testing/Organ-chip Models/Tissue-Engineering/Biomechanical-Imaging-Pain phenotyping

Professor Michael Barnes

Professor Shaogang Gong

Professor Himadri Gupta

Professor Martin Knight

Professor David Lee

Professor Hazel Screen

Dr Shafaq Sikandar

Professor Greg Slabaugh