Dr Alessandra Nerviani, Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London

After decades of treating rheumatoid arthritis patients with a “one size fits all” approach, we learned that using the best drug for the right patient at the correct time is possible. When rheumatoid arthritis appears, many different cells migrate to the joints and populate the synovium, a layer of tissue that covers the inside of the joint, causing inflammation, pain, swelling and, ultimately, irreversible damage. However, the characteristics of the inflamed synovium in rheumatoid arthritis vary significantly between patients, even if their symptoms are the same!