What is DyNAMISM?

We are studying the use of non-steroidal anti-inflammatory drugs (NSAIDs, such as ibruprofen or diclofenac) in axial spondyloarthritis (axSpA). Magnetic Resonance Imaging (MRI) is commonly used to look for inflammation in the sacroiliac joints (the joints where the spine meets the pelvis), something which is a key feature of the disease. Many patients with axSpA take NSAIDs to help manage their pain – these may be over-the-counter medicines, or on prescription from their doctor. We believe, however, that the use of NSAIDs may hide the appearance of inflammation in the sacroiliac joints when viewed on MRI. If this is true, it (a) may prevent some patients from receiving the correct diagnosis; and (b) may mean that some patients are unable to be given the most appropriate medication for their disease. The purpose of this study is to investigate whether, among patients with axSpA, the use of NSAIDs reduces the appearance of inflammation in the sacroiliac joints when viewed with MRI. This will allow us to investigate whether a ‘NSAIDs free’ period helps doctors make a diagnosis of axSpA.

Can I take part?

You may be eligible for the study if you:

have been diagnosed with axSpA; or your doctor thinks you need an MRI scan to help him or her decide whether you have axSpA,
are currently taking daily (not PRN) NSAIDs.
Are (a) male and HLA B27 positive or (b) have had a previous positive MRI of the SIJs.

Our research nurse will ask for more details to check your eligibility with you.

At the moment, we can only recruit patients from the following list of centres. If you are from one of these centres, and think you meet the above criteria, you may be eligible to take part in the DyNAMISM study.

Staffordshire and Stoke on Trent Partnership NHS Trust

Norfolk and Norwich University Hospital

Royal United Hospitals Bath NHS Foundation Trust

West Suffolk NHS Foundation Trust

Lanarkshire NHS

Aintree University Hospital NHS Foundation Trust

Cambridge University Hospitals NHS Foundation Trust

Newcastle Upon Tyne Hospitals NHS Foundation Trust

University College London Hospital

Royal Cornwall Hospitals NHS Trust

Lister Hospital

East Surrey Hospital

King's College Hospital NHS Foundation Trust

Hospitals of Morecambe Bay NHS Foundation Trust

North West Anglia NHS Foundation Trust (Peterborough)

Ashford and St Peter's Hospitals NHS Trust

Blackpool Teaching Hospitals NHS Foundation Trust

Gateshead NHS Trust

Guys and St Thomas' NHS Foundation Trust

South Tees Hospitals NHS Foundation Trust

Lancashire Teaching Hospitals NHS Trust

North West Anglia NHS Foundation Trust (Hinchingbrooke)

NHS Grampian

If you are interested in taking part, or have any questions?

Staffordshire and Stoke on Trent Partnership NHS Trust

Key people:

Investigator:

Dr Jon Packham

Address:

Research Delivery Unit
Haywood Hospital
High Lane, Burslem
Stoke-On-Trent
ST6 7AG

Norfolk and Norwich University Hospital

Key people:

Investigator:

Dr Karl Gaffney

Address:

Rheumatology – East Outpatients
East Block, Level 2
Colney Lane
Norwich
NR4 7UY

Royal United Hospitals Bath NHS Foundation Trust

Key people:

Investigator:

Dr Raj Sengupta

Address:

Royal United Hospitals Bath NHS Foundation Trust
Coombedown
Bath
BA1 3NG

West Suffolk NHS Foundation Trust

Key people:

Investigator:

Dr Shweta Bhagat

Address:

West Suffolk Hospital
Hardwick Lane
Bury St Edmunds
Suffolk
IP33 2QZ

NHS Lanarkshire

Key people:

Investigator:

Dr Robin Munro

Address:

NHS Lanarkshire Clinical Trials Room
Ward 15, Level 2
Wishaw General Hospital
50 Netherton Street, WISHAW
ML2 ODP

Aintree University Hospital NHS Foundation Trust

Key people:

Investigator:

Dr Nicola Goodson

Address:

Aintree University Hospital NHS Foundation Trust
Rheumatology Research Department
3rd Floor Clinical Sciences Centre
Longmoor Lane, Liverpool
L9 7AL

Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital

Key people:

Investigator:

Dr Gavin Clunie

Address:

Rheumatology Clinical Research Unit E6 Box 194
Cambridge Biomedical Campus
Hills Road
Cambridge
CB2 0QQ

The Newcastle Upon Tyne Hosptials NHS Foundation Trust

Key people:

Investigator:

Dr Ben Thompson

Address:

Room 49 Level 1
The Freeman Hospital
High Heaton
Newcastle Upon Tyne
NE7 7ND

University College London Hospital

Key people:

Investigator:

Dr Pedro Machado

Address:

Rheumatology Department
3rd Floor Central
250 Euston Road
London
NW1 2PG

Royal Cornwall Hospitals NHS Trust

Key people:

Investigator:

Dr David Hutchinson

Address:

Royal Cornwall Hospitals NHS Trust
Room B15
The Knowledge Spa
Truro, Cornwall
TR1 3HD

Lister Hospital

Key people:

Investigator:

Dr Jananath Wijeyekoon

Address:

Lister Hospital
Coreys Mill Lane
Stevenage Hertfordshire

SG1 4AB

East Surrey Hospital

Key people:

Investigator:

Dr Raad Makadsi

Address:

Surrey and Sussex Healthcare NHS Trust
Contact Centre, 1st Floor, Trust Headquarters
East Surrey Hospital, Canada Avenue
Redhill
RH1 5RH

King's College Hospital NHS Foundation Trust

Key people:

Investigator:

Dr James Gallloway

Address:

Department of Rheumatology - Portacabib B
King's College Hospital
Denmark Hill
London
SE5 9RS

University Hospitals of Morecambe Bay NHS Foundation Trust

Key people:

Investigator:

Dr Marco Massarotti

Address:

Rheumatology Department
Medical Unit 2
Royal Lancaster Infirmary
Ashton Road, Lancaster
LA1 4RP

North West Anglia NHS Foundation Trust (Peterborough)

Key people:

Investigator:

Dr Poonam Sharma

Address:

Peterborough City Hospital
Bretton Gate
Peterborough
PE3 9GZ

Ashford and St Peter's Hospitals NHS Trust

Key people:

Investigator:

Dr Gulam Patel

Address:

St Peter's Hospital
Guilford Road
Chertsey
KT16 0PZ

Blackpool Teaching Hospitals NHS Foundation Trust

Key people:

Investigator:

Dr Sari-Kouzel

Address:

Whinneys Heys Road
Blackpool
FY3 8NR

Gateshead NHS Trust

Key people:

Investigator:

Dr Saravanan Vadivelu

Address:

Queen Elizabeth Avenue
Sheriff Hill
Gateshead
NE9 6SX

Guys and St Thomas' NHS Foundation Trust

Key people:

Investigator:

Dr Sangita Agarwal

Address:

Great Maze Pond
London
SE1 9RT

South Tees Hospitals NHS Foundation Trust

Key people:

Investigator:

Dr Muddassir Shaikh

Address:

Marton Road
Middlesbrough
TS4 3BW

Lancashire Teaching Hospitals NHS Trust

Key people:

Investigator:

Dr Ayesha Madan

Address:

Lowthorpe Road
Deepdale
Preston
PR1 6SB

North West Anglia NHS Foundation Trust

Key people:

Investigator:

Dr Mark Lillicrap

Address:

Ground Floor Education Centre
Hinchingbrooke Park
Huntingdon
PE29 6NT

NHS Grampian

Key people:

Investigator:

Dr Hazem Youssef

Address:

Health Sciences Building
Foresterhill
Aberdeen
AB25 2ZD

Southend University Hospital NHS Foundation Trust

Key people:

Investigator:

Prof Bhasker Dasupta

Address:

Prittlewell Chase
Westcliff-On-Sea
Essex
SS0 0RY

Royal Berkshire NHS Foundation Trust

Key people:

Investigator:

Dr Antoni Chan

Address:

London Road
Reading
Berkshire
RG1 5AN

University Hospitals of Leicester NHS Trust

Key people:

Investigator:

Dr Kehinde Sunmboye

Address:

Leicester Royal Infirmary
Infirmary Square
Leicester
LE1 5WW

NHS Tayside

Key people:

Investigator:

Dr Su-Yin Tan

Address:

Clinical Research Centre
James Arnott Drive
Dundee
DD1 9SY

NHS Lothian

Key people:

Investigator:

Dr Barbara Hauser

Address:

Rheumatology Department,
Western General Hospital
Edinburgh
EH4 2XU

University Hospitals Plymouth NHS Trust

Key people:

Investigator:

Dr Ognjenka Savanovic-Abel

Address:

Derriford Hospital
Plymouth
PL6 8DH

Stockport NHS Foundation Trust

Key people:

Investigator:

Dr Louise Mercer

Address:

Steppinghill Hospital
Poplar Grove
Stockport
SK2 7JE

Royal Free London NHS Foundation Trust

Key people:

Investigator:

Dr Voon Ong

Address:

Royal Free Hospital
Pond Street
London
NW3 2QG

Homerton University Hospital NHS Foundation Trust

Key people:

Investigator:

Dr Claire Gorman

Address:

Homerton University Hospital
Homerton Row
London
E9 6SR

Brighton & Sussex University Hospitals NHS Trust

Key people:

Investigator:

Dr Cristina Tacu

Address:

Eastern Road
Brighton
BN5 5BE

Leeds Institute of Rheumatic and Musculoskeletal Medicine

Key people:

Investigator:

Dr Helena Marzo-Ortega

Address:

Chapel Allerton Hospital
Chapeltown Road
Leeds
LS7 4SA

Royal Wolverhampton HNS Trust

Key people:

Investigator:

Prof Nick Barkham

Address:

Brunswick Road
Cannock
WS11 5XY

Study news

Recruitment

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Trial sites

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Key facts about the study and documents

What is this study about?

The purpose of our study is to investigate whether, among patients with axSpA, the use of NSAIDs reduces the appearance of inflammation in the sacroiliac joints when viewed with MRI. This will allow us to investigate whether a 'NSAIDs free' period helps doctors make a diagnosis of axSpA. At the end of the study, we may make the recommendation that patients should stop taking NSAIDs, for a short period, before MRI scans. Because of this, it is also important to find out whether patients can tolerate a short period without their NSAIDs, although other pain medication may be taken during this period if required.

How do I get involved?

If you would like to be involved in DyNAMISM, you need to be eligible and have a local hospital site that is acting as a recruiting centre. Please contact your local recruiting centre and they can advise you about whether you are eligible to take part.

What we are asking you to do

If you volunteer for the study we will ask you to come into your local hospital for an initial visit with a research nurse, after which you will stop taking any NSAIDs for two weeks. During this visit the research nurse will discuss the NSAIDs free period and answer any further questions. After the two weeks without NSAIDs you will return for an MRI scan of your sacroiliac joints. The scan will take around 25 minutes, although the total visit may last 1.5 to 2 hours. The scan will be examined by experts who will decide whether there is any inflammation in your sacroiliac joints.

After the scan, you will then restart your usual NSAIDs medication and depending on the results of the first scan, you may be asked to return for a second scan six weeks later. We will also ask you to provide a blood sample and complete questionnaires at each study visit. You will be compensated for your time with a £50 gift voucher.

Where can I get more information?

If you would like any more information about DyNAMISM, please contact the study office at the University of Aberdeen on 01224 437421 or email the study co-ordinator, prj-dynamism1@abdn.ac.uk. You can find the patient information sheet in the documents section below.

You can find out more information about DyNAMISM here:

Download documents:

Patient Information Sheet (V4)

ConsentForm (v2,15_09_17)

Key contacts

Click on cards to find out more

                                    
                                      Co-investigator
                                      Dr Raj Sengupta
                                  
Consultant Rheumatologist

                                      Dept of Rheumatology

                                      Royal National Hospital for Rheumatic Diseases

                                      Upper Borough Walls, Bath

                                      BA1 1RL

                                                                                                                                                            Email: rajsen99@gmail.com
                                  
                                      Co-investigator
                                      Wing Commander Dr Alex Bennett
                                  
Head of Research

                                      Academic Department of Military Rehabilitation

                                      Headley Road

                                      Epsom, Surrey

                                      KT18 6JW

                                                                                                                                                            Email: dmrc-consultantrr3@mod.uk
                                  
                                      Co-investigator
                                      Dr Lorna Aucott 
                                  
Medical Statistics

                                      School of Medicine and Dentistry

                                      University of Aberdeen

                                      Foresterhill, Aberdeen

                                      AB25 2ZD

                                                                                Tel: +44 (0)1224 437150

                                                                                                                      Email: l.aucott@abdn.ac.uk
                                  
                                      Co-investigator
                                      Prof Gary McFarlane
                                  
Epidemiology Group, School of Medicine

                                      Medical Sciences and Nutrition, University of Aberdeen

                                      Health Sciences Building (1st floor)

                                      Foresterhill, Aberdeen

                                      AB25 2ZD

                                                                                Tel: +44 (0)1224 437143

                                                                                                                      Email: g.j.macfarlane@abdn.ac.uk

Organisation

This project was funded by Arthritis Research UK and is run by the University of Aberdeen, in conjunction NHS-Grampian. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of Arthritis Research UK, NHS Grampian or University of Aberdeen. Please visit each organisation's website for more information.

General Data Protection Regulation (GDPR) - Participant Information

The University of Aberdeen and NHS Grampian are the sponsor’s for this study based in the United Kingdom. We will be using information from you and your medical records in order to undertake this study and will act as the data controller for this study. This means that we are responsible for looking after your information and using it properly. The University of Aberdeen will keep identifiable information about you for a minimum of 3 years after the study has finished.

Your rights to access, change or move your information are limited, as we need to manage your information in specific ways in order for the research to be reliable and accurate. If you withdraw from the study, we will keep the information about you that we have already obtained. To safeguard your rights, we will use the minimum personally-identifiable information possible.

You can find out more about how we use your information http://www.abdn.ac.uk/privacy and/or by contacting Iain Gray, University Data Protection Officer.

Your healthcare site will use your name, NHS number and contact details to contact you about the research study, and make sure that relevant information about the study is recorded for your care, and to oversee the quality of the study. Individuals from the University of Aberdeen and regulatory organisations may look at your medical and research records to check the accuracy of the research study. Your healthcare site will pass these details to University of Aberdeen along with the information collected from you and your medical records. The only people in University of Aberdeen who will have access to information that identifies you will be people who need to contact you in regards to the study. The people who analyse the information will not be able to identify you and will not be able to find out your name, NHS number or contact details.

Your healthcare site will keep identifiable information about you from this study for a minimum of 3 years after the study has finished.

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WELCOME TO DyNAMISM

Do Non-steroidal Anti-inflammatory drugs (NSAIDs) reduce the appearance of sacroiliac joint bone marrow oedema on MRI, in spondyloarthritis?

What is DyNAMISM?

Can I take part?

If you are interested in taking part, or have any questions?

Where can I take part?

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