Professor Susanna Proudman - RAH Research Fund

Professor Susanna Proudman

Head of the Rheumatology Unit, Royal Adelaide Hospital

> Rheumatology

The Rheumatology Unit is taking a “bench to bedside” approach to research with an emphasis on treating chronic auto-immune diseases such as crippling Rheumatoid Arthritis – and gaining an international reputation.

Collaboration and building a significant research base of patients with rheumatic diseases is putting the Rheumatology Unit at the RAH at the forefront of developing patient-centred treatments, both nationally and internationally.

Professor Susanna Proudman’s recent research interests include best practice management of early rheumatoid arthritis with an emphasis on “treat-to- target” therapy.

Rheumatoid Arthritis is an autoimmune disease where the body’s immune system attacks the lining of joints, causing swelling and pain. It can’t be cured, only managed.

Professor Proudman’s research includes the role of dietary omega-3 fatty acids, typically fish oil, in reducing inflammation.

This research led to a breakthrough discovery around the benefits of fish oil in controlling the progression of rheumatoid arthritis; finding that patients did not needing many of the disease modifying therapies that are normally used to manage the disease.

The effect of omega 3 fats in reducing disease activity in rheumatoid arthritis was found to be greater than the impact of treating the adverse health effects of smoking and obesity.

Professor Proudman also has a special interest in research on treatments for Systemic Sclerosis an autoimmune disease which results in the thickening of the skin caused by accumulation of collagen. The disease causes swelling of skin, joints, and can involve internal organs and arteries.

The Rheumatology Unit’s research has led to new approaches to the diagnosis of pulmonary arterial hypertension in patients with Systemic Sclerosis, which enables earlier treatment and improved outcomes.

Professor Proudman says one of the advantages of the well-defined registry is the ease with which patients can be recruited for clinical trials with the resultant access to new therapies.

The Early Arthritis Clinic enables clinicians to fast-track the diagnosis and treatment of recent onset rheumatoid arthritis, such that significant joint damage and disability no longer occur.

Professor Proudman said that when she first started in Rheumatology nearly 30 years ago, the options for treating rheumatoid arthritis were “limited and applied haphazardly”, with an over-reliance on certain steroid hormones and joint surgery.

“The result was that many patients had severe joint deformities, loss of function and independence,” she said.

“With better use of old drugs and advances in new drug development, a diagnosis of rheumatoid arthritis is now compatible with a full and rewarding life.”

Another area of research is investigating standardized management of Pulmonary Arterial Hypertension, a form of high blood pressure that affects arteries in the lungs and in the heart.

By establishing a Centre of Excellence with colleagues from other RAH medical disciplines for the treatment of Pulmonary Arterial Hypertension in System Sclerosis and as Chair of the Australian Scleroderma Interest Group with its national tissue bank located in Adelaide, Professor Proudman’s leadership ensures Adelaide has a reputation at the forefront of collaborative research, both nationally and internationally.

“We have accrued some the largest cohorts of patients in Australia with these particular diseases,” Professor Proudman says.

“They come to us knowing that we have developed programs that deliver best practice care. The point of difference offered by these programs is the time dedicated to meeting with patients and applying the best practices to meet their individual needs.

“Since we have a large cohort of patients we have become experts in best practice for the diagnosis and treatment of these diseases. I think our patients benefit from that.”

In addition, collaborative studies with the University of South Australia are looking at the relationships between blood levels of the drugs used in Rheumatoid Arthritis treatment and disease outcomes.

This involves putting information together about patient genetics, measure of drug levels, and good and bad outcomes. This will inform modelling that could lead to individualised treatments.

Professor Proudman graduated from Adelaide University in 1987 and trained in rheumatology at the Royal Adelaide Hospital. As an ARA Michael Mason Fellow, she trained with Professor Paul Emery in Leeds, establishing one of the first Early Arthritis Clinics in the world. She is Medical Director of Arthritis Australia.

An author of more than 174 published articles, Professor Proudman was the recipient of the Affiliate Teaching Award, University of Adelaide in 2017 and the ARA President’s Collaborative Research Prize in 2018.