Dr Nidhi Sofat is a clinician scientist and her research interest is primarily in rheumatic diseases, osteoarthritis and pain perception.
Dr Sofat investigates the mechanisms responsible for pain and reduced function in osteoarthritis, the most common form of arthritis worldwide. She is involved in a number of clinical studies evaluating the effectiveness of medication in relieving pain in rheumatoid arthritis and osteoarthritis.
She uses non-invasive techniques including quantitative sensory testing (QST) methods to identify pain pathways. QST identifies sensation and pain thresholds by stimulating the skin. Dr Sofat also uses magnetic resonance imaging techniques to discover which brain regions are activated by osteoarthritis pain, and a basic science mechanistic approach to investigate the role of molecules within the body in driving chronic inflammation in joints.
Dr Sofat is principal investigator of Pain management in osteoarthritis using centrally acting analgesics. Funded by the Rosetrees Trust, the trial is testing whether drugs that inhibit pain processing pathways in the brain can help with pain in the hand caused by osteoarthritis.
Her group has a translational approach in identifying the factors leading to joint damage and pain in arthritis. She has a tissue repository for patients housed at St George's, University of London.
Dr Sofat completed her medical training at University College London in 1996 with an Intercalated BSc in Immunology. She completed her specialist rheumatology training in 2007 and in the same year obtained a PhD at the Kennedy Institute of Rheumatology (then part of Imperial College London). Dr Sofat was awarded a Clinical Research Training Fellowship by the Wellcome Trust in 2003 which supported her training at the Kennedy Institute of Rheumatology where she investigated the mechanisms driving chronic inflammation in osteoarthritis. She was awarded a British Society for Matrix Biology prize in 2005 for her work.
Dr Sofat joined St George’s in 2009 as a Clinical Senior Lecturer while working to develop a translational research facility in rheumatic diseases. She has been a Consultant Rheumatologist at St George’s University Hospitals NHS Foundation Trust since 2009.
In 2013, Dr Sofat was awarded the Michael Mason Prize in Rheumatology, awarded by the British Society of Rheumatology (BSR) in recognition of innovative work in rheumatology research.
Dr Sofat has served on several committees aimed at improving standards of care in rheumatology, including the BSR External Relations Committee (concerned with influencing policy makers and the National Institute of Health and Care Excellence (NICE) for technology appraisals in osteoarthritis.
She has helped write Standards of Care documents produced by the Arthritis and Musculoskeletal Alliance (ARMA), an umbrella organisation working towards better care in the discipline. The Standards of Care documents are for healthcare professionals and patients.
Fuggle NR, Smith TO, Kaul A, Sofat N. Hand to Mouth: A systematic review and meta-analysis of the association between rheumatoid arthritis and periodontitis. Frontiers in Immunology, 2016
Mar 2;7:80. doi: 10.3389/fimmu.2016.00080. eCollection 2016
Imada K, Tsichida A, Ogawa K, Sofat N, Nagase H, Ito A, Sato T. Anti-arthritic actions of beta-cryptoxanthin against the degradation of articular cartilage in vivo and in vitro. Biochemical and Biophysical Research Communications. doi: 10.1010/j.bbrc.2016.05.126
Assi L, Kuttapitiya, A, Howe F, Heron C, Ejindu V, Harrison A, Hing C, Bridle S, Mitchell P, Sofat N. Painful knee osteoarthritis demonstrated features of pain sensitization that correlate with synovitis detected by magnetic resonance imaging. Osteoarthritis and Cartilage 2016, S453
Howe FA, Harrison A, Barrick T, Sofat N. Developing a brain biomarker of pain in hand osteoarthritis using magnetic resonance spectroscopy. Osteoarthritis and cartilage. 2016, S259
Sofat N, Hing CB. Sensitisation in arthritis: cause or effect? International Journal of Clinical Rheumatology, 2015, 10(3): 143-147
Hosny S, Strambi F, Sofat N, Field R. A systematic review investigating inflammatory synovitis in major joint replacement. Arthritis. 2015: 29410. doi: 10.1155/2015/729410
Sofat N, Wait R, Robertson SD, Baines DL, Baker EH. Interaction between extracellular matrix molecules and microbial pathogens: evidence for the missing link in autoimmunity with rheumatoid arthritis as a disease model, Frontiers in Microbiology, 2015; 5: 783
Osteoarthritis - Progress in Basic Research and Treatment, entitled ‘Hand Osteoarthritis – Clinical Presentation, Phenotypes and Management’: ISBN 978-953-51-2136-7, edited by Qian Chen
Ahmed S, Magan T, Vargas M, Harrison A, Sofat N. Use of the painDETECT tool in rheumatoid arthritis suggests neuropathic and sensitization components in pain reporting, 2014, Journal of Pain Research, 7: 579 -88. Doi: 10.2147/JPR.S69011.
Fuggle N, Howe FA, Allen RL, Sofat N. New insights into the impact of neuro-inflammation in rheumatoid arthritis. Front Neurosci. 2014; 8: 357. Doi: 10.3389/fnins.2014.00357. eCollection 2014
Sofat N, Kuttapitiya A. Future directions for the management of pain in osteoarthritis. International Journal of Clinical Rheumatology, 2014, 9(2): 197-216
Sofat N, Smee C, Hermansson M, Howard M, Baker EH, Howe FA, Barrick T. Functional MRI demonstrates pain perception in hand osteoarthritis has features of central pain processing. Journal of Biomedical Graphics and Computing. 2013; 3(4): 20-26.
Davis AJ, Smith TO, Hing CB, Sofat N. Are bisphosphonates effective in the treatment of osteoarthritis pain? A research synthesis and meta-analysis. PLoS ONE. 2013, published 4 Sep.
Wajed, J, Ejindu V, Heron C, Hermansson, Kiely P, Sofat N. Quantitative sensory testing in painful hand osteoarthritis demonstrates features of peripheral sensitisation. International Journal of Rheumatology. 2012, 703138.
Sofat N, Robertson SD, Wait R. The fibronectin III 13-14 domains induce joint damage via Toll-like receptor 4 activation and synergise with IL-1 and TNF. Journal of Innate Immunity. 2012, 4(1): 69-79.
Sofat N, Robertson SD, Hermansson M, Jones J, Mitchell P, Wait R. Tenascin-C fragments are endogenous inducers of cartilage matrix degradation. Rheumatology International. 2012; 32(9): 2809-1.
Midwood K, Sacre S, Piccinini AM, Inglis J, Trebaul A, Chan E, Drexler S, Sofat N, Kashiwagi M, Orend G, Brennan F, Foxwell B. Tenascin-C is an endogenous activator of TLR4 that is essential for maintaining inflammation in arthritic joint disease. Nature Medicine. 2009, 15(7): 774-80.
Sofat N. Analysing the role of endogenous matrix molecules in the development of osteoarthritis. International Journal of Experimental Pathology. 2009, 90:463-479.
Sofat N, Ejindu V, Kiely P. What makes OA painful? The evidence for peripheral and central pain processing. Rheumatology. 2011, 50(12): 2157-65.
Sofat N, Malik O, Higgens CS. Neurological involvement in patients with rheumatic disease. Quarterly Journal of Medicine. 2006, 99: 69-79.
Dr Sofat's research group includes:
- Abiola Harrison and Lena Assi (clinical research co-ordinators)
- Clinical research nurses Margaret Sibley and Janis Jegede
- PhD student Anasuya Kuttapitiya
- NIHR-funded Academic Clinical Fellows Zoe Rutter-Locher and Mark Russell
- Dr Nicholas Fuggle, Clinical Fellow in Rheumatology
- Mr Francesco Strambi (who is also part of orthopaedic surgeon Richard Field's group at Epsom and St Helier University Hospital NHS Trust)
Dr Sofat is working with Dr Robin Wait at The Kennedy Institute of Rheumatology, University of Oxford, investigating the interaction of pathogens with endogenous extracellular matrix molecules in chronic inflammation.
She is also collaborating with Dr Matt Howard, who specialises in pain research, in the Department of Neuroimaging at the Institute of Psychiatry, King's College London.
At St George's, she is working collaboratively with Professor Franklyn Howe and Dr Tom Barrick (both based in the Stroke and Dementia Research Centre) to develop imaging techniques to investigate pain perception in osteoarthritis.
She is conducting a clinical trial of novel analgesic drugs in osteoarthritis with Professor Emma Baker, Professor of Clinical Pharmacology in the Biomedical Sciences Research Centre.
Dr Sofat also works in collaboration with orthopaedic surgeons Caroline Hing (St George’s University Hospitals NHS Foundation Trust) and Richard Field (Epsom and St Helier University Hospital NHS Trust).
In addition, she is working with several pharmaceutical companies:
- Pfizer - clinical trials of analgesics
- MSD (the UK subsidiary of Merck & Co. Inc.)– clinical trial of golimumab therapy in rheumatoid arthritis
- Roche – clinical observational study of TNF inhibitor switching in rheumatoid arthritis;
- Boehringer Ingelheim – clinical trial of biosimilar drugs in rheumatoid arthritis.
Pain perception in osteoarthritis (PAPO)
Awarded to Sofat N
Pfizer Neusentis and St George's, University of London
2013 to 2016, £103,448
Pain management in osteoarthritis using centrally acting analgesics (DUPRO)
Awarded to Sofat N
Rosetrees Trust and NIHR Comprehensive Local Research Network funding
2012 to 2014, £114,080
Understanding the relationship between psychosocial impact of chronic joint pain and exercise to improve patient management: a synthesis of quantitative and qualitative research
Awarded to Hurley M, Walsh N, Sofat N, Oliver S, Grant R and Cumming J
Arthritis Research UK
2012 to 2014, £42,475
What is the best measure of pain in the arthritis clinic?
Awarded to Magan T, Sofat N
Arthritis Research UK (to enable medical student to work in Sofat lab)
Developing a back pain pathway in South London
Awarded to Beith I, Sofat N
South West London Academic Health and Social Care Network (now System)
2011 to 2012, £10,000
Developing a care pathway for osteoarthritis
Awarded to Sofat N, Howe FA
St George's Charitable Trust
2010 to 2011, £5,400
The role of fibronectin in response to lung infection
Awarded to Sofat N, Robertson SD
British Pharmacological Society Summer Studentship
Protein citrullination in rheumatoid arthritis as a diagnostic marker and therapeutic agent
Awarded to Sofat N, Robinson C
St George's Enterprise Fund
2009 to 2010, £7,500
How does tissue become degraded in osteoarthritis?
Awarded to Sofat N
Hammersmith Hospitals' Research Committee
2007 to 2008
Investigating the mechanisms of tissue breakdown in osteoarthritis
Awarded to Sofat N, Nagase H, Feldmann M
2003 to 2006, £189,000
Dr Sofat teaches medical students on topics including musculoskeletal medicine and clinical pharmacology. She also supervises laboratory-based research projects undertaken by MSc and BSc students.
She is involved in the question writing committee for the Joint Royal Colleges of Physicians Training Board (JRCPTB) Specialty Certificate Examination.