The arc Epidemiology unit predominantly offers the opportunity for a clinical fellow to spend time training in clinical epidemiology or genetic epidemiology. Fellows based in our Unit usually do a maximum of two clinics per week. The unit has clinical links with the Manchester Royal Infirmary (Clinical lead: Ian Bruce) which is a referral centre for SLE and has special lupus, connective tissue disease and vasculitic clinics. It has also links with Salford Royal Hospital where there are special scleroderma (Clinical lead: Ariane Herrick), myositis (Clinical lead: Robert Cooper) - chronic pain (Clinical lead: Anthony Jones) and osteoporosis (Clinical lead: Terence O’Neill) clinics. Clinical fellowships in these hospitals can be facilitated. The arc Epidemiology unit has five ongoing programmes of research: the genetic and nongenetic epidemiology of inflammatory arthritis (predominantly Ra, JIA amd psoriatic arthritis), understanding treatment response (including the large Biologics register), the epidemiology of chronic pain across the lifespan, the relationship between rheumatic disease and premature senescence and health economic evaluation.

Further information to be found at: www.medicine.manchester.ac.uk/epidemiology/research/arc

1. studies in the genetics of psoriatic arthritis
2. the long term influence of anti-TNF agents on myocardial infarction
3. the 15 year outcome of undifferentiated inflammatory arthritis
4. the relationship between self-reported pain and cardiovascular health at the population level
5. the influence of treatment on outcome in childhood arthritis

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Thomson W, Barton A, Ke X, Eyre S, Hinks A, Bowes J, Donn R, Symmons D, Hider S, Bruce IN, Wilson AG, Marinou I, Morgan A, Emery P, Carter A, Steer S, Hocking L, Reid DM, Wordsworth P, Harrison P, Strachan D, Worthington J. Rheumatoid arthritis association at 6q23. Nat Genet 2007; 39(12): 1431- 1433

Dixon WG, Watson KD, Lunt M, Hyrich KL, Silman AJ, Symmons DP. Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor alpha therapy: Results from the British Society for Rheumatology Biologics Register. Arthritis Rheum 2007; 56(9): 2905-2912.

McBeth J, Symmons DP, Silman AJ, Allison T, Webb R, Brammah T, Macfarlane GJ. Musculoskeletal pain is associated with a long-term increased risk of cancer and cardiovascular-related mortality. Rheumatology (Oxford) 2009; 48(1): 74-77.