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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?

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.

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Can I take part?

You may be eligible for the study if you:

  1. have been diagnosed with axSpA; or your doctor thinks you need an MRI scan to help him or her decide whether you have axSpA,
  2. are currently taking daily (not PRN) NSAIDs.
  3. 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.

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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.

  1. Bath
  2. Cambridge Addenbrooke's
  3. Cornwall
  4. Lanarkshire
  5. Liverpool Aintree
  6. Newcastle
  7. Norwich
  8. Stoke
  9. Lister
  10. University College London
  11. West Suffolk

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

Where can I take part?

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
Research Department Royal National Hospital for Rheumatic Diseases
Upper Borough Walls
Bath
BA1 1RL
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

Study news

Recruitment

58/500

Trial sites

Latest addition to sites:

King's College Hospital NHS Foundation Trust
East Surrey Hospital
Lister Hospital
Royal Cornwall Hospitals NHS Trust

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 one week. During this visit the research nurse will discuss the NSAIDs free period and answer any further questions. After the one week 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.

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 437562 or email the study co-ordinator, prj-dynamism@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:

Key contacts

Click on cards to find out more

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.