Professor Deborah Symmons
Professor Deborah Symmons is director of the Arthritis Research UK epidemiology unit at Manchester University and a consultant rheumatologist in Macclesfield.
What does your work involve?
I've recently taken over as the medical director and head of the Arthritis Research UK epidemiology unit. The unit has a staff of approximately 100 whose task is to investigate risk factors (both genetic and non-genetic) for the development and outcome of the whole spectrum of musculoskeletal conditions. In addition, I work as an honorary consultant rheumatologist at the East Cheshire NHS Trust.
How long has Arthritis Research UK been funding you?
I was first funded by Arthritis Research UK when I did a clinical research fellowship at the University of Birmingham in 1983–1985. I came to Manchester in 1989 and Arthritis Research UK has been funding the research in which I have been involved ever since then.
What’s the most important thing you've found out in the past 12 months? Why?
The British Society for Rheumatology Biologics Register is run by the epidemiology unit. We've now recruited 4,000 patients on each of the anti-TNF drugs as well as a comparison group of almost 4,000 patients with rheumatoid arthritis not treated with biological therapies.
The researchers analysing these data have found some very important results. These concern the pattern of infection that's seen in patients treated with anti-TNF drugs and, in particular, the pattern of TB infections. It's been interesting to see that the risk of infection in anti-TNF patients is increased in the first three months of treatment but then comes down to the background rate in those patients who continue on anti-TNF agents beyond three months.
What do you hope or expect to achieve as a result of your Arthritis Research UK funding?
We're working towards being able to 'personalise' the risk of developing musculoskeletal conditions and of knowing which patients are most likely to respond to or develop side-effects to which treatments. We can already do this to a modest degree, but we need a high degree of certainty for this sort of information to be useful to the individual patient.
What do you do in a typical day?
When I'm in the unit, I spend most of my time meeting with people individually or in large or small groups. We meet to discuss our research plans and the results of recent analyses. When I'm at the hospital, I spend my time seeing patients in the outpatient clinic or on the ward service.
What's your greatest research achievement?
Establishing the Norfolk Arthritis Register, which is now following over 3,500 patients, and establishing the Biologics Register. It's very satisfying to see answers to important clinical questions emerge from these studies, but I'm aware that the most important aspect is that the data being analysed is completely reliable and comprehensive.
Why did you choose to do this work?
Life is made up of a series of decisions and it's not always easy to see where each one is leading. I chose to do medicine because I wanted to play a role in diagnosing and treating people who were sick. I chose to do rheumatology because I admired the patients that I come across with rheumatic diseases and was fascinated by the disease processes which lead to their symptoms and signs. I chose to do epidemiology because it was the best tool to provide the answers to the questions which I could see arising from everyday clinical practice.
Do you ever think about how your work can help people with arthritis?
All the time. There are three key questions that people with arthritis ask and which drives the work that I do: 'What's wrong with me?', 'Why did this happen to me?' and 'What will happen to me now?'
What would you do if you weren’t a clinician/researcher?
If I had to give up practising medicine now, then I think I'd opt to do something completely different. I'd love to know and understand more about art and architecture so I think I'd enrol on a course to do that.
I have season tickets for the Manchester Chamber Concert Society, the Hallé Orchestra and the Royal Exchange Theatre. I have a large collection of recipe books and enjoy cooking for friends and family (always sticking strictly to the recipe as I have no idea about the principles underlying cooking!). I'm also very involved in my local church and spend much of my time at the weekend helping with its activities.
This article first appeared in Arthritis Today Summer 2009, issue 145.