Senior Lecturer and Honorary Consultant Rheumatologist

• Fellow of the Royal College of Physicians, 2014
• PhD in immunology, 2006
• Member of the Royal College of Physicians, 1998
• MBChB (with honours), 1995
• BSc (hons) in Medical Biochemical Studies, 1992

Andrew Filer graduated from Medical School at the University of Birmingham in 1995, working in Birmingham at first, then in Australia before returning to take up an MRC clinical training fellowship and gaining his PhD in Birmingham. With Dr Karim Raza he has run the Birmingham Early Arthritis Clinic for five years, working on novel clinical, serological and imaging predictors of outcome in the very early window of arthritis. He is an experienced musculoskeletal sonographer, and uses his skills to answer clinical questions, practice a wide variety of imaging guided procedures, and also to investigate the role of musculoskeletal ultrasound as a predictive tool in early arthritis. His Arthritis Research UK clinician scientist fellowship focuses on the role of stromal cell subpopulations in the pathobiology of early rheumatoid arthritis, and the development of stromal cell based therapies for inflammatory arthritis. This interest is linked to imaging via the use of novel, minimally invasive ultrasound guided biopsy techniques to obtain samples from the joint.

Teaching Programmes

• BMedSc
• Intercalated Clinical Sciences BMedSc - Rheumatology and Orthopaedics Musculoskeletal module coordinator
• Clinical Oncology MSc/PG Dip
• MBChB
  • 4th year lead for Musculoskeletal Medicine
  • Tutor and Lecturer on the Immunology module for 2nd year and GEC students
  • Regular clinical teaching commitments with 3rd year/4th year students and foundation doctors
• MSc Immunology and Immunotherapy - Lecturer on this and anatomy courses
• PSIBS imaging research training and PhD programme

Other Teaching

• Graduate school coordinator for MD students in the College
• Member of the EPSRC Physical Sciences for Health (Sci-Phy-4-Health) Integrated PhD imaging consortium and Lecturer
• Supervisor of doctors on the Academic Clinical Training program
• Teacher on selected clinical Ultrasound Courses

Dr Filer has previously supervised or co-supervised 4 PhD students to completion and continues to supervise or co-supervise a further 4 current students. Dr Filer is interested in supervising doctoral research students in the following areas:

• Stromal-Leucocyte interactions
• The role of stroma cells in the progression of rheumatoid arthritis
• The role of ultrasound Imaging in research in early arthritis
• The role of tissue biomarkers in prediction of outcome and disease stratification in early arthritis
• The role of multiple frequency optical imaging as a research tool in arthritis

If you are interesting in studying any of these subject areas please contact Dr Filer on the contact details above, or for any general doctoral research enquiries, please email: dr@contacts.bham.ac.uk or call +44 (0)121 414 5005.

For a full list of available Doctoral Research opportunities, please visit our Doctoral Research programme listings.   

Investigating pathways of persistence of disease and resolution of inflammation in early arthritis:

This work uses stromal cell resources and tissue from patients in the BEACON cohort that captures patients in the early stages of arthritis. I use multiple methodologies through a collaborative approach to interrogate the phenotype of stromal cells from different diseases and different stages of rheumatoid arthritis to understand fully the contribution of these cells to inflammation and damage in arthritis, and the change in cellular phenotype during the early development and progression of rheumatoid arthritis. In vitro cellular work is validated in tissue (Scheel-Toellner group). Methodologies include transcriptomics (Clark group), microRNA and methylome analysis (Gay group, Zurich, Novartis), metabolomics (Young, Tennant groups). The functional phenotype of these cells is investigated in multicellular models of disease investigating stromal cell:leucocyte interactions (McGettrick group and Novartis).

Translation and intervention:

Understanding the processes underlying persistence and resolution of inflammation would be of little use if it did not inform patient treatment. This work includes development of mesenchymal stromal cellular therapies in arthritis (Orbsen therapeutics) and repurposing of therapies targeting stromal cells in cancer for use in rheumatoid arthritis (MRC dpfs funded TRAFIC trial with AR-UK RACE Centres).

Imaging:

Use and development of novel imaging modalities including musculoskeletal ultrasound in clinical research. Ultrasound imaging is a key technology enabling the collection of tissue and cellular resources from patients in the BEACON cohort, but has an increasingly important role in objective measurement of synovial inflammation. This work includes: Identifying predictors of outcome in the early phases of disease and the use of ultrasound as an outcome measure in clinical trials. I am a member of the OMERACT US SIG and run ultrasound imaging in the APIPPRA international multicentre trial intervening with biologic therapy in patients with inflammatory arthralgia at high risk of RA.

• OMERACT Ultrasound Special Interest Group, 2014-present
• Birmingham and the Black Country CLRN Musculoskeletal Speciality Group Lead, 2012-2014
• University Hospitals Birmingham CDRC executive board, 2011-2013
• Midland Rheumatology Society Treasurer and Executive Committee member, 2009-2013
• British Society for Rheumatology Education and Training Committee, 2001-2005
• ARC Education Subcommittee, 2001-2004

Juarez M, McGettrick HM, Scheel-Toellner D, Yeo L, Spengler J, de Paz B, Hardy R, Cooper M, Raza K, Buckley CD and Filer A (2016) DKK1 expression by synovial fibroblasts in very early rheumatoid arthritis associates with lymphocyte adhesion in an in vitro flow co-culture system. Arthritis Res Ther 18(1):14

Sahbudin I, Bell J, Kumar K, Raza K and Filer A (2016) Observing real-time images during ultrasound-guided procedures improves patients' experience. Rheumatology (Oxford) 55(3):585-6

Juarez M, Bang H, Hammar F, Reimer U, Dyke B, Sahbudin I, Buckley CD, Fisher B, Filer A and Raza K (2016) Identification of novel antiacetylated vimentin antibodies in patients with early inflammatory arthritis. Ann Rheum Dis 75(6):1099-107

Humby F, Kelly S, Bugatti S, Manzo A, Filer A, Mahto A, Fonseca JE, Lauwerys B, D'Agostino MA, Naredo E, Lories R, Montecucco C, Tak PP, Fitzgerald O, Smith MD, Veale DJ, Choy EH, Strand V and Pitzalis C (2016) Evaluation of Minimally Invasive, Ultrasound-guided Synovial Biopsy Techniques by the OMERACT Filter-determining Validation Requirements. J Rheumatol 43(1):208-13

Reynolds G, Gibbon JR, Pratt AG, Wood MJ, Coady D, Raftery G, Lorenzi AR, Gray A, Filer A, Buckley CD, Haniffa MA, Isaacs JD and Hilkens CM (2016) Synovial CD4+ T-cell-derived GM-CSF supports the differentiation of an inflammatory dendritic cell population in rheumatoid arthritis. Ann Rheum Dis 75(5):899-907

Spengler J, Lugonja B, Ytterberg AJ, Zubarev RA, Creese AJ, Pearson MJ, Grant MM, Milward M, Lundberg K, Buckley CD, Filer A, Raza K, Cooper PR, Chapple IL and Scheel-Toellner D (2015) Release of active peptidyl arginine deiminases by neutrophils can explain production of extracellular citrullinated autoantigens in RA synovial fluid. Arthritis Rheumatol 67(12):3135-45

Jani M, Chinoy H, Warren RB, Griffiths CE, Plant D, Fu B, Morgan AW, Wilson AG, Isaacs JD, Hyrich K and Barton A; Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate Collaborators (2015) Clinical Utility of Random Anti-Tumor Necrosis Factor Drug-Level Testing and Measurement of Antidrug Antibodies on the Long-Term Treatment Response in Rheumatoid Arthritis. Arthritis Rheumatol 67(8):2011-9

Lazarou I, D'Agostino MA, Naredo E, Humby F, Filer A and Kelly SG (2015) Ultrasound-guided synovial biopsy: a systematic review according to the OMERACT filter and recommendations for minimal reporting standards in clinical studies. Rheumatology (Oxford) 54(10):1867-75

Nanus DE, Filer AD, Yeo L, Scheel-Toellner D, Hardy R, Lavery GG, Stewart PM, Buckley CD, Tomlinson JW, Cooper MS and Raza K (2015) Differential glucocorticoid metabolism in patients with persistent versus resolving inflammatory arthritis. Arthritis Res Ther 17(1):121

Chimen M, McGettrick HM, Apta B, Kuravi SJ, Yates CM, Kennedy A, Odedra A, Alassiri M, Harrison M, Martin A, Barone F, Nayar S, Hitchcock JR, Cunningham AF, Raza K, Filer A, Copland DA, Dick AD, Robinson J, Kalia N, Walker LS, Buckley CD, Nash GB, Narendran P and Rainger GE (2015) Homeostatic regulation of T cell trafficking by a B cell-derived peptide is impaired in autoimmune and chronic inflammatory disease. Nat Med 21(5):467-75