Lars Klareskog: "We want to prevent RA from breaking out"

Lars Klareskog: "We want to prevent RA from breaking out"

Professor Lars Klareskog is one of Elsa's founders and a world-leading researcher in rheumatoid arthritis. Among other things, he was involved in starting the EIRA project. He is positive about future research and being able to detect RA at as early a stage as possible. He sees easily accessible knowledge and tools in lifestyle change as one of the most important parts. And Elsa can play a big role.

How did you start researching rheumatism?

When I read medicine, I became interested in chronic diseases and the causes of illness. After some time researching the function of a certain molecule and how it works differently in humans, I wanted to investigate whether this could be useful in treating inflammatory diseases. This in turn led me to start studying it! I trained as a rheumatologist. In 1980, I started a research group where we learned a lot about how a joint inflammation can occur. I then became a professor of immunology. In the late 1990s, our focus area was on understanding why rheumatoid arthritis (RA) actually occurs.

What is the EIRA study?

EIRA * is a long-term research study that Lars Alfredsson and I started in 1996. The aim of the study is to understand the importance of lifestyle and environmental factors in the development of RA. By comparing the lifestyle and environment of people who have RA and those who do not have RA, we can see which factors increase or decrease the risk of falling ill. We want to try to understand how to be able to treat the disease as early as possible and, ideally, prevent it from breaking out.

The large amount of data we have collected over the years includes both lifestyle and environmental factors as well as genetic factors. The combination gives researchers a fantastic opportunity to answer a variety of questions from several angles. So far, we have only had time to look at a fraction of the data that is available. In the coming years, we will allow the database to grow further. This is done by continuing to collect data from RA patients and healthy people that we can compare. Through this work, we want to take the research further towards the goal of solving the number of riddles that still exist around RA. We have already learned a lot about risk factors, of which smoking is the biggest, but also about the impact of air pollution, diet and alcohol.

During the Eira study, we also saw that immune reactions in RA started years before the first symptoms broke out. With the help of this, a completely new field of research has been created. It provides an opportunity to be able to take action with those who have a high risk of getting RA. What we want is to be able to go in with prevention, treat earlier, and prevent the disease from even breaking out.

* The abbreviation EIRA stands for Epidemiological Investigation of Risk Factors for Rheumatoid Arthritis.

Do you want to read more about the Eira study? Click here!

What are you most passionate about in your work with RA right now?

I want to inform and spread knowledge to those who are at risk of getting RA. So people can change their lifestyle and perhaps avoid risk factors. What if we could create a tool that can tell that a person is at risk, just like when measuring blood pressure at the health center? I want RA to be treated as early as possible and to find new ways for people to detect the disease. From symptoms to treatment, today is a number of months and it is a critical time. We want to shorten this to days! In the long run, I hope for a vaccination program against the immunity of those individuals who are at risk of RA.

What does Elsa mean to you?

Today, people often have far too little of the knowledge they need to be able to change their own situation! There is so much research on this, but the knowledge doesn’t get out there. We want to find ways to reach out with the knowledge we have been researching for 25 years. This is where Elsa comes into the picture.

What is the most important thing about Elsa?

Everyone is different. This is partly due to genetics and disease development. This means that they need different treatments and lifestyle changes to get better. We all also have specific preferences that are important to us. It could be running, playing tennis, playing the piano or crocheting. It can also be getting rid of fatigue or other disease-related symptoms. Research does not fully take into account these individual needs. Elsa can be a way in which the individual himself is able to state what they want to set as goals. Through Elsa, the user can answer questions such as: Who are you? What qualities do you have? What do you want to achieve? Imagine being able to use this in communication with your doctor and over time be able to follow up on different goals together.

What can Elsa users help within future research?

We researchers often have insufficient information about what happens in-between visits to the doctor: what we call "real life" studies. This can be about how the patient feels about things we are bad at measuring, like fatigue (chronic fatigue) or pain. This is where Elsa comes into the picture. By logging a daily status, we’ll be able to use that data in future research on how the patient feels - on an individual level. Here, too, it will hopefully be possible to see connections between how different groups of people react to different lifestyle changes and treatments. In this way, we can make analyses of which types of treatment suit which type of person and symptoms best.

How do you see Elsa in the future?

Elsa should be able to help people with many different chronic diseases. and you should be able to follow both your own symptoms, the measurable and the individual and be able to relate it to the treatment you receive. Anyone who uses Elsa should be able to test and measure what works just for them. If people at increased risk continuously follow their symptoms with Elsa, treatment can be started immediately as soon as the first symptoms appear. It also means that it is possible to adapt to different treatments quickly.

What tips would you give to an Elsa user?

Today, people who use Elsa are part of a development project. The user is an important partner for Elsa to help us develop an instrument that will help the individual to take great control of their illness. The user should feel like a partner of this instrument! It makes sense. In addition, there is the benefit of what you log in to the app now and in the future you can take with you to your doctor's visits.

What do you see in the future for RA patients? What do you dream of happening in the "market" in terms of RA?

What I think is most hopeful in the short term is new medicines. Then I think mainly of new so-called jackhammers that are taken in tablet form. In the medium term, a shift to even earlier treatment together with these new drugs can create a great improvement, even if it is not a complete solution. Here it is important to detect RA early. In the longer term, I see the opportunity to be able to go in even earlier and discover those who are at risk of getting RA and being treated with changing lifestyles and medicines. It can be compared with the fact that, for example, high blood pressure is detected and in this way people can be treated before they suffer from a stroke, for example.

What do you see in the future for RA patients? What do you dream of happening in the "market" in terms of RA?

I find it strange that there are no giant projects to bring out the possibilities of individual treatments and lifestyle changes in a systematic way today. If Elsa can develop better tools to give that knowledge individualized in a simple way - then I think that Elsa should be able to have great opportunities to become a leading player in this.