Images courtesy of Dr Toby Garrood
Guy's Hospital, London
Maraciclatide is for investigational use only and is not approved by the FDA or UK and European regulatory authorities.
Bringing molecular imaging to rheumatology
Rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA) are chronic, progressive, painful, incurable conditions in which the body’s own immune system attacks the joints. If untreated they can result in irreversible joint damage and permanent disability. Multiple therapies are available that can slow or even halt disease progression but it remains a challenge to identify which treatment is best for each individual patient:
- There is no definitive blood marker, such as blood glucose levels in diabetes
- X-rays show the damage that has already been done to the joints
- Full clinical assessments require significant hands-on time with a rheumatologist and symptoms do not always correlate with the underlying disease process
- MRI is expensive and not readily accessible
- Ultrasound is highly dependent upon the skill of the operator and time-consuming
There is, therefore, a clear need for a simple, rapid, robust, reliable, readily accessible and cost effective technique to assess disease activity and guide treatment decisions.
Data from clinical studies suggest that imaging with 99mTc-maraciclatide may allow rheumatologists to see inflammation in the joints which could help them deliver the right treatment to the right patient at the right time (personalised medicine) potentially leading to improved outcomes and better quality of life.
Endometriosis: the invisible pain
Endometriosis is estimated to affect about 10% of women of child-bearing age. In this condition, cells similar to the ones lining the uterus (the endometrium) grow elsewhere in the abdomen and sometimes even farther afield. These cells react to the menstrual cycle each month and also bleed. However, there is no way for this blood to leave the body. This can cause inflammation, pain and the formation of scar tissue. Endometriosis can have a significant impact on a person's life in a number of ways, including:
- Chronic pain
- Problems with a couple’s sex life/relationships
- An inability to conceive
- Difficulty in fulfilling work and social commitments
There is no cure for endometriosis but treatments can reduce the severity of symptoms and improve the quality of life. A definitive diagnosis requires laparoscopy - an operation in which a camera (a laparoscope) is inserted into the pelvis via a small cut near the navel – and there is an average of 7.5 years from onset of symptoms to diagnosis.
The growth of endometrial tissue is dependent upon new blood vessel formation (angiogenesis) which pre-clinical studies have shown can be imaged with 99mTc-maraciclatide. This raises the exciting possibility that 99mTc-maraciclatide has the potential to be a non-invasive diagnostic for endometriosis and an alternative to laparoscopic surgery which could benefit millions of women worldwide. A pilot clinical study to evaluate the utility of 99mTc-maraciclatide is underway.