Autoimmune diseases are receiving record levels of national attention during this time of unparalleled scientific discovery. Last fall, National Institutes of Health (NIH) Director Francis Collins, MD, PhD, spoke at a conference in New York presented jointly by the Lupus Research Institute and the Alliance for Lupus Research, in part, to promote that rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have been included in the diseases to be targeted by the Accelerating Medicines Partnership (AMP). AMP is a partnership between the NIH, the U.S. Food and Drug Administration, 10 biopharmaceutical companies and multiple nonprofit organizations to find new diagnostics and treatments by jointly identifying and validating promising biological targets for therapeutics.
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For an update, The Rheumatologist recently spoke with Robert Carter, MD, deputy director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), one branch of the NIH.
Question: Why were RA and SLE included in the debut of AMP?
Answer: The selection of autoimmune diseases as an AMP focus was based on extensive polling of the NIH and industry partners to identify the most compelling research needs and opportunities. Given the genetic overlap in lupus and RA, it was felt that it would be advantageous to work on them together. This approach could point to targets that are shared across several autoimmune conditions.
Q: Should rheumatologists be hopeful that when the initial five-year program expires, future rounds of the program may also include autoimmune diseases?
A: It was the hope and expectation that the pilot projects would set the stage for broadening AMP to other diseases and conditions. The partnership will make the data available to the broad research community for further analysis. We expect [those data] to benefit the entire community and spur future research. However, it is important to note that, at least in this round, both NIH and industry developed the project, and future projects may also need to identify potentially interested partners.
Q: For rank-and-file rheumatologists, what is the takeaway from AMP?
A: As a rheumatologist, I understand the many challenges in caring for patients with diseases, such as RA and lupus. Most people with RA have only a partial response to available drugs and many only respond to drugs for a limited period of time. In the case of lupus, no effective targeted therapies exist for the most severe forms of the disease.
With AMP, the focus is clearly on the disease tissues and associated changes in the blood. We believe that our ability to develop better biomarkers and design better clinical trials will be made possible through the AMP. Insights gained should help reveal the most promising new biological targets for drug development and match existing drugs to patients with specific molecular profiles who are the most likely to benefit. Essentially, the AMP helps lay a foundation for precision medicine for autoimmune diseases. NIH Director Francis Collins has said that precision medicine can be thought of as the opposite of the standard one-size-fits-all medicine. We hope that the AMP and other efforts will enable doctors to better tailor treatment for each individual patient.