Goals of BRASS
The goal of the BRASS registry is to establish a prospective observational cohort of rheumatoid arthritis patients
in order to:
- Determine and validate biomarkers that predict drug response and toxicity in rheumatoid arthritis.
- Determine and validate biomarkers that predict disease activity and prognosis in rheumatoid arthritis.
- Evaluate the natural history of treated rheumatoid arthritis by measuring clinical, functional, psycho-social, and economic outcomes
What is BRASS?
The Brigham and Women’s Hospital Rheumatoid Arthritis Sequential Study (BRASS) is a prospective observational study of over 1,500 patients diagnosed with RA at the Robert Breck Brigham Arthritis Clinic in Boston, MA. The study began enrollment in March 2003 and has a follow up retention rate of 80% after four years.
At the baseline visit and at each annual follow up visit, the patient’s rheumatologist fills out a form detailing any extra-articular manifestations, infections, medication changes, 28- joint count and overall disease activity score. A trained staff member interviews the patient and the patient fills out a self-administered questionnaire. Details of the questionnaire domains are attached. In addition to the questionnaires, DNA, RNA and serum specimens are also collected. CRP, anti-CCP and RF titers are run on each patient. Bilateral hand x-rays are collected at baseline, year 2, year 5, year 7, year 10, year 12, year 15, year 17 and year 20. At six-month intervals patients are mailed questionnaires inquiring about functional status, medication changes, resource utilization as well as employment status.
Patients who agree to participate in this study have the following exams and tests during their yearly visits with their rheumatologist:
- A typical joint count exam by your rheumatologist to determine pain and swelling of the joints;
- Information including your age, sex, race (first visit only);
- Information on the treatments you receive for RA, your overall medical condition, the extent you are able to function with your RA, how active your RA disease is, how it affects your day to day living as well as your overall quality of life;
- A blood sample for C-reactive protein, rheumatoid factor, and anti-CCP status (markers for inflammation).
Why is BRASS Important?
In the future, results from the registry may enable physicians to identify patients who will respond to particular medications by conducting a simple blood test. Prescribing patients the medications most effective for them at the first symptoms may slow progression of the disease and potentially reduce toxic side effects from the medications. This project could also enable shorter drug trials for new medications by targeting patients expected to respond quickly.
The BRASS research team has published results from analysis of registry data in several rheumatology journals, such as Journal of Rheumatology, Current Opinions in Rheumatology, Annals of Rheumatic Medicine, and presented at the annual rheumatology conference (abstract and publications titles attached). Topics have included osteoporosis and RA; the effects of caffeine on one of the major RA medications, methotrexate; factors affecting the physician’s decision to change patient medications; genetics predicting severity and types of RA; genetic and clinical predictors of discontinuation of TNF alpha inhibitors, another group of RA medications.
For more detailed information please check out the provided presentations: