A multi-methods study to improve our understanding and decision making when switching high-cost drugs for Psoriatic Arthritis: Switch PsA

This project is one of a number that are in competition for funding from the University of Bath URSA competition, for entry in September 2025.

PLEASE BE AWARE: Applications for this project may close earlier than the advertised deadline if a suitable candidate is found. We therefore recommend that you contact the lead supervisor prior to applying and submit your formal application as early as possible.

Overview of the Research:

Psoriatic arthritis (PsA) is a chronic, heterogenous inflammatory condition that affects around 190,000 people in the UK. PsA manifests as a combination of arthritis, enthesitis, dactylitis, and skin and nail psoriasis. Approximately 30% of individuals with psoriasis may develop PsA, which leads to significant morbidity and impacts quality of life. Up to half of PsA patients require treatment with biologic and targeted synthetic Disease Modifying Anti-Rheumatic Drugs (b/tsDMARDs), and many need to switch therapies due to inefficacy or adverse effects. Understanding and identifying when drugs lose effectiveness and the best strategies for regaining disease control are key concerns for PsA patients.

Currently, there is a lack of data on how patients respond to sequential lines of advanced therapy. This has led to regional inequalities in treatment access, with some areas limiting patients to three therapy options. Additionally, little is known about patients’ experiences of switching therapies or what prompts clinicians to initiate these discussions. This project aims to generate evidence on the clinical effectiveness of switching b/tsDMARDs.

The main research question is: What are patient and clinician priorities when switching high-cost advanced therapies for psoriatic arthritis, and does the likelihood of response diminish with sequential lines of therapy?

The objectives are: (1) to understand patient experience and priorities when switching b/tsDMARDs for PsA; (2) to understand healthcare professionals’ perspectives and their decision-making processes when considering the switch of b/tsDMARDs for PsA; and (3) to evaluate clinical response to b/tsDMARD therapy amongst people commencing 2nd and 3rd, 4th and 5th, and 6th + lines for active PsA in routine care.  

The methodology includes two components. First, qualitative research will be conducted through two multicentre focus groups- one with patients and one with healthcare professionals- to explore patient priorities and clinician decision-making. Second, a prospective observational study will be conducted to evaluate clinical responses to advanced lines of b/tsDMARD therapy. This study will recruit patients from ten centres within the British Consortium of Psoriatic Arthritis (BritPACT) network.

Ultimately, this research aims to enhance the quality of care for people living with PsA by guiding better-informed choices around advanced therapy transitions.

Project keywords: Psoriatic Arthritis, Biologics, Advanced Therapies 

Candidate Requirements:

Applicants should hold, or expect to receive, a First Class or good Upper Second Class UK (or international equivalent) Degree degree in medicine (MD/ MBChB or equivalent). A national training number in Rheumatology would be advantageous.  

Non-UK applicants must meet the programme’s English language requirement by the application deadline.

External sponsor details :

We have successfully secured co-funding from the Bath Institute for Rheumatic Diseases (BIRD). Additionally, this partnership will provide access to a dedicated conference budget, allowing for broader dissemination of research findings. Having BIRD as an external sponsor will further strengthen the long-term collaborations with the Royal National Hospital for Rheumatic Diseases (part of Royal United Hospitals) and the University of Bath. These established partnerships ensure that the research will benefit from clinical insights and academic expertise, promoting high-impact outcomes.

Enquiries and Applications:

Informal enquiries are encouraged and should be directed to Dr William Tillett: cwrt20@bath.ac.uk

Formal applications should be submitted via the University of Bath’s online application form for a PhD in Pharmacy and Pharmacology prior to the closing date of this advert.

IMPORTANT:

When completing the application form:

1.      In the Funding your studies section, select ‘University of Bath URSA’ as the studentship for which you are applying.

2.      In the Your PhD project section, quote the project title of this project and the name of the lead supervisor in the appropriate boxes. 

Failure to complete these two steps will cause delays in processing your application and may cause you to miss the deadline.

More information about applying for a PhD at Bath may be found on our website.

Equality, Diversity and Inclusion:

We value a diverse research environment and aim to be an inclusive university, where difference is celebrated and respected. We welcome and encourage applications from under-represented groups.

If you have circumstances that you feel we should be aware of that have affected your educational attainment, then please feel free to tell us about it in your application form. The best way to do this is a short paragraph at the end of your personal statement.