Désirée van der Heijde, MD, PhD, learned early in her career that serendipity often plays a role in clinical research and treatment advances. She devoted her PhD thesis to the development of the Disease Activity Score (DAS), under the supervision of her mentor Piet van Riel, MD, PhD.1 In the course of that work, she also expanded upon radiographic assessment with the van der Heijde modification of the Sharp score, which became the standard in measuring radiographic progression in rheumatoid arthritis (RA).2 Then, in the late 1990s, pharmaceutical companies were searching for standardized assessments to test the efficacy of biologics for rheumatoid arthritis. The DAS and the Sharp score fit the bill, and the ability to evaluate new treatments with consistent metrics led to an exponential advancement in treatments for RA.3
Currently professor of rheumatology at Leiden University Medical Center in the Netherlands as well as a senior researcher at Diakonhjemmet Hospital in Oslo, Norway, Dr. van der Heijde reflects on the meteoric progression of RA treatments: “You need to be a little bit lucky when you develop something. We had all the measures ready when the new drugs became available and then they wanted to have outcomes measures for assessing them.”
Those who have known and collaborated with Dr. van der Heijde would argue that she has made her luck by devoting her intellectual drive and organizational abilities to furthering clinical research methodologies. This has been especially true in the field of spondylarthritis. Since 1994, when she became assistant professor in Sjef van der Linden’s department of rheumatology at the University Hospital Maastricht, in the Netherlands, she has worked intensely with a dedicated core of colleagues who comprised the original AS Working Group. Following the principles of the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) process, the group began development of response and remission criteria for ankylosing spondylitis (AS), and formally organized in 1995 as the Assessment of SpondyloArthritis international Society (ASAS). Again, the instruments were in the right place at the right time. And the result, says Robert B. M. Landewé, MD, professor of rheumatology at the Academic Medical Center of the University of Amsterdam, is that “further development of these drugs [the biologics] went rocket fast.”4 Whereas it took 15 years to develop biologics as efficacious treatments in RA, it took only a few years to secure approvals for their indication in AS.