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Professor Nidhi Sofat

Professor of Rheumatology
Clinical Academic Rheumatologist working on studies in pain and inflammation in arthritis

Nidhi Sofat is Professor of Rheumatology at St George's, University of London. Her research is focused on understanding the causes of pain and inflammation in musculoskeletal diseases using a bench-to-bedside experimental approach. She has conducted several clinical trials and studies investigating the mechanisms of pain in arthritis. Professor Sofat’s group was the first research group to discover and describe the OsteoArthritis Bone Score (OABS) in 2021, which is the first scoring system for bone marrow lesions in Osteoarthritis (in collaboration with University of Nottingham).

Professor Sofat qualified in medicine from University College London. She completed her specialist training in rheumatology in 2007 and earned her PhD from The Kennedy Institute for Rheumatology, then part of Imperial College London, in the same year.

Nidhi has been a consultant at St George's University Hospitals NHS Foundation Trust since 2009. She conducts clinics in general rheumatology, inflammatory arthritis, vasculitis and osteoarthritis at the Hotung Centre for musculoskeletal diseases at St George's University Hospitals NHS Foundation Trust. She is a member of the rheumatology team caring for patients on rheumatology specialist wards.

Professor Sofat is the NIHR Integrated Academic Programme lead for Clinical Academic Trainees at St George’s, overseeing a programme of research and training, including the PGCert in Research Skills and Methods and workshops for IAT trainees.

Professor Sofat completed her medical training at University College London in 1996 with First Class Honours Intercalated BSc in Immunology. She completed her specialist rheumatology training in 2007 and in the same year obtained a PhD at the Kennedy Institute for Rheumatology (then part of Imperial College London). Professor 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.

Nidhi joined St George’s in 2009 and developed a translational research facility in rheumatic diseases. She is also a Consultant Rheumatologist at St George’s University Hospitals NHS Foundation Trust.

In 2013, Professor Sofat was awarded the Michael Mason Prize in Rheumatology, awarded by the British Society for Rheumatology (BSR) as recognition of innovative work in rheumatology research. She has served on several National and International committees aimed at improving standards of care in rheumatology, including the BSR Heberden Committee, External Relations Committee (concerned with influencing policy makers, the National Institute of Health and Care Excellence (NICE) for technology appraisals in osteoarthritis and the Finance Committee for OARSI (Osteoarthritis Research Society International). Nidhi 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 research group led by Professor Sofat have established the importance of distinct characteristics of pain in arthritis using techniques including quantitative sensory testing and imaging of the joint by magnetic resonance imaging (MRI). Her group has shown how the brain is activated during arthritis pain (in collaboration with Professor Franklyn Howe). Professor Sofat’s group have tested drugs to combat pain in arthritis patients from her rheumatology clinics which target pain sensitisation.

As well as carrying out clinical studies, Professor Sofat’s group investigates how different parts of the joint trigger pain and inflammation. Her group performed the first gene expression study of bone marrow lesions in osteoarthritis. Ultimately, a better understanding of the mechanisms inducing pain and inflammation could be used to develop improved diagnostic tools and treatments for arthritis.

Professor Sofat’s team has worked on several Investigator-Initiated trials, including DUPRO (Duloxetine and Pregabalin for Hand Osteoarthritis), the Pain Perception in Osteoarthritis (PAPO) and the ARPAIN (Early biomarkers for Arthritis Pain) study.

The research team led by Professor Sofat is also involved in multi-center phase III clinical trials involving new treatments for rheumatoid arthritis and osteoarthritis with companies including Pfizer, Merck, Sharpe and Dohme and Roche.

  • Walsh DA, Sofat N, Guermazi A, Hunter DJ. Osteoarthritis Bone Marrow Lesions. Osteoarthritis & Cartilage, 2022; Sep 30:S1063-4584(22)00859-7. doi: 10.1016/j.joca.2022.09.007
  • Biddle K, White JPE, Sofat N, JAK Inhibitors in Rheumatoid Arthritis, 2022, EMJ Allergy Immunol. 2022;7(1):76-89
  • Saha P, Srikantharajah D, Kaul A, Sofat N. Tocilizumab for relapsing and remitting Giant Cell Arteritis: a case series of 16 subjects and implications for clinical practice. Journal of Medical Case Reports, 16 (1), 1-10
  • Biddle K, White J, Sofat N. What is the full potential of baricitinib in treating patients with COVID-19? Expert Review of Clinical Immunology, 2022; DOI: 10.1080/1744666X.2022.2072298
  • Koushesh S, Shahtaheri SM, McWilliams DF, Walsh DA, Sheppard MN, Westaby J, Haybatollahi SM, Howe FA, Sofat N. The osteoarthritis bone score (OABS): a new histological scoring system for the characterisation of bone marrow lesions in osteoarthritis. Osteoarthritis & Cartilage; 2022; 30(5):746-755
  • Vincent C Marconi, Athimalaipet V Ramanan, Stephanie de Bono, et al., on behalf of the COV-BARRIER Study Group. Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER): a randomised, double-blind, parallel-group, placebo-controlled phase 3 trial. 2021 Lancet Respiratory Medicine; https://doi.org/10.1016/S2213-2600(21)00331-3
  • Blundell A, Sofat N. Which Biologic Therapies Should We Use to treat active Rheumatoid Arthritis and when? European Medical Journal, 2021, EMJ Allergy Immunol. 2021;6[1]:86-95.
  • Sofat N, Watt F, Tan AL. Development of medical therapeutics in osteoarthritis: time for action to improve patient care. Rheumatology., 2021, Editorial. keab263, https://doi.org/10.1093/rheumatology/keab263
  • Gill D, Karhunen V, Malik R, Dichgans M, Sofat N. Cardiometabolic traits mediating the effect of education on osteoarthritis risk: a Mendelian Randomisation study. Osteoarthritis and Cartilage 2020; 10.1016/j.joca.2020.12.015 .
  • Sandhar S, Smith T, Howe F, Toor K, Sofat N. Risk factors for pain and functional impairment in people with knee and hip osteoarthritis: a systematic review and meta-analysis. 2020. BMJ Open, 2020; 10: e038720. doi: 10.1136/bmjopen-2020-038720
  • Burrage DR, Koushesh S, Sofat N. Immunomodulatory drugs in the management of SARS-CoV-2. Frontiers in Immunology, 2020; 11:1844. https://doi.org/10.3389/fimmu.2020.01844
  • Mennan C, Hopkins T, Channon A, Elliott M, Johnstone B, Kadir T, Loughlin J, Peffers M, Pitsillides A, Sofat N, Stewart C, Watt FE, Zeggini E, Holt C, Roberts S, & the OATech Network + Consortium. The Use of Technology in the Sub-categorisation of Osteoarthritis: A Delphi Study Approach. Osteoarthritis and Cartilage Open, 2020; https://doi.org/10.1016/j.ocarto.2020.10081
  • Sofat N, Ejindu V, Heron C, Harrison A, Koushesh S, Assi L, Kuttapitiya A, Whitley GS, Howe FA. Biomarkers in painful symptomatic knee OA demonstrate that MRI assessed joint damage and type II collagen degradation products are linked to disease progression. Frontiers in Neuroscience, 2019; 13:1016. doi: 10.3389/fnins.2019.01016.
  • Sofat N. Drilling down to the bone: Evaluating Bone Marrow Lesions in Osteoarthritis. European Medical Journal. 2018; 3 (4):103-110.
  • Russell MD, Barrick T, Howe FA, Sofat N. Reduced anterior cingulate grey matter volume in painful hand osteoarthritis. Rheumatol Int. 2018. 38(8):1429-1435; doi: 10.1007/s00296-018-4085-2
  • Kuttapitiya A, Assi L, Laing K, Hing CB, Mitchell P, Whitley G, Harrison A, Howe FA, Ejindu V, Heron C, Sofat N. Microarray analysis of bone marrow lesions in osteoarthritis demonstrates upregulation of genes implicated in osteochondral turnover, neurogenesis and inflammation. Annals of the Rheumatic Diseases. 2017; 76(10):1764-1773. http://dx.doi.org/10.1136/annrheumdis-2017-211396
  • Rutter-Locher Z, Smith T, Giles I, Sofat N. Association between Systemic Lupus Erythematosus and Periodontitis: A Systematic review and Meta-analysis. Front Immunol. 2017; 8: 1295 https: doi: 10.3389/fimmu.2017.01295.
  • Sofat N, Harrison A, Russell M, Ayis S, Kiely PD, Baker EH, Barrick TB, Howe FA. The effect of pregabalin or duloxetine on arthritis pain: a clinical and mechanistic study in people with hand osteoarthritis. J Pain Research 2017, 10: 2437-2449. https://doi.org/10.2147/JPR.S147640.
  • Amin O, Kaul A, Smith TO, Howe FA, Sofat N. The correlation between Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) syndromes and clinical findings on magnetic resonance imaging: a systematic review and meta-analysis. Rheumatology: Diseases and Therapy, 2017: 2:1-11
  • Imada K, Tsuchida 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. Biochem Biophys Res Commun 2016; 476(4): 352-8
  • 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. Front Immunol 2016; 7: 80
  • A systematic review investigating inflammatory synovitis in major joint replacement. Hosny S, Strambi F, Sofat N, Field R. Arthritis. 2015: 29410. doi: 10.1155/2015/729410.
  • Sofat N, Hing CB Sensitisation in arthritis: cause or effect? International Journal of Clinical Rheumatology, 2015, 10(3): 143-147
  • 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 Jan 14;5:783. doi: 10.3389/fmicb.2014.00783
  • Kuttapitiya A, Harrison A, Assi L, Christidis D, Ejindu V, Heron C, Howe FA, Hing C, Mitchell P, Bridle S, Sofat N. Relation of synovitis, effusions, bone marrow lesions and cartilage damage to pain sensitisation in people with knee osteoarthritis presenting for total knee replacement: an observational study. Annals of Rheumatic Diseases 76(10):1764-1773
  • Clarke N, Garrard P, Sofat N. Screening for evidence of mild semantic impairment as a marker of underlying tpd43 neuropathology in autoimmune conditions. Alzheimer’s & Dementia 11 (7S_Part_7), P355-356
  • 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
  • Robinson H, Moynihan B, Sofat N. Rheumatoid meningitis masquerading as a left hemisphere stroke in a patient receiving anti-TNF treatment for a diagnosis of Rheumatoid Arthritis.’ Rheumatology: 2014, 77700
  • 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.
  • Ahmed S, Magan T, Vargas M, Harrison A, Sofat N. Patient reported pain by the PAINDETECT questionnaire reveals multimodal elements to pain perception in rheumatoid arthritis. Arthritis Rheumatology, 2014: 2921
  • Sofat N, Kuttapitiya A. Future directions for the management of pain in osteoarthritis. International Journal of Clinical Rheumatology, 2014, 9(2): 197-216
  • 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; 8(9):e72714
  • Sofat N, Jegede J, Islam N. Assessment of pain in rheumatoid arthritis: how well do we do as rheumatologists? Rheumatology, 2014, 53(1): i172-i173
  • 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). doi: 10.5430/jbgc.v3n4p20
  • Magan T, Chaudary M, Lazic S, Sofat N. What is the best measure of pain in the arthritis clinic? Rheumatology, 2013
  • Kuttapitiya A, Davis A, Hing C, Dennis J, Sofat N. Identifying target molecules mediating pain in osteoarthritis: assessing TRPV1, TRPA1 and TRPM8 expression in joint tissue. Annals of Rheumatic Diseases, 2013
  • 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; 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; 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
  • Thompson MK, Axford JS, Sofat N. Rheumatoid arthritis in 2011: An Editorial. Current Best Practice and Research in Rheumatology, 25(4):435-46
  • 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, Robertson S, Wait R. Proteases produced by Porphyromonas Gingivalis can cleave and citrullinate substrates found in the joint and oral mucosa: Implications for Autoimmunity in rheumatoid arthritis. Arthritis and Rheumatism 64(10); S513
  • Sofat N, Beith I, PG Anilkumar, Mitchell P. Recent Clinical Studies in Osteoarthritis: What we have learned. Reviews on Recent Clinical Trials, 2011; 7:1-13
  • Brakspear K, Culley K, Davidson R, Sofat N, Tew S. Bone and cartilage biology – lessons from development, vascular interactions and dysplasias. International Journal of Experimental Pathology 2010; 91(2). A1-A14
  • Sofat N, Hamann P, Barrick TR, Howe FA. Activation of Central Pain Pathways in Rheumatic Diseases: What we have learned from functional neuroimaging studies. Current Rheumatology Reviews 2010; 6(3): 208-15
  • Midwood K, Sacre S, Piccinini AM, Inglis J, Trebaul A, Chan E, Drexler S, Sofat N, Kashiwagi M, Orend G, Brennan F and 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, Venables P. Is Sjögren myelopathy Devic disease? Annals of Rheumatic Diseases. 2008; 67(5):730-1
  • Sofat N, Robertson SD, Wait R. Proteases produced by Porphyromonas Gingivalis can Cleave and citrullinate substrates found in the joint and oral mucosa: Implications for autoimmunity in Rheumatoid Arthritis. Arthritis & Rheumatism 2012; 1195
  • Sofat N, Wajed J, Smee C, Hermansson M, Howe FA, Barrick TR Pain perception in hand osteoarthritis: relation between clinical nodes, radiological severity, pain threshold and brain pain processing, Osteoarthritis & Cartilage 2012: 702
  • Sofat N, Smee C, Hermansson M, Wajed J, Sanyal K, Kiely P, Howard M, Howe FA, Barrick TR. Hand osteoarthritis pain has peripheral and central components demonstrated by algometer scores and functional MRI. Rheumatology 2012; 51(3): iii66
  • Sofat N. The role of endogenous matrix molecules in the development of osteoarthritis Rheumatology 2011; 50 (suppl 3): iii91(129) doi: 10.1093/rheumatology
  • Wajed J, Hermansson M, Axford J, Sofat N. Pain threshold testing using algometers is a reliable measure of pain in hand osteoarthritis and correlates with patient-reported pain scores. Rheumatology 2011; 50 (suppl 3): iii91(129) doi: 10.1093/rheumatology/ker160
  • Hermansson M, Wait R, Jallow O, Coulton G, Sofat N. Identifying a signature for protein post-translational modifications in arthritic tissue. Annals Rheumatic Diseases, 2010: 61
  • Sofat N, Wait R, Nagase H. The fibronectin III 13-14 domains activate catabolic pathways in joint tissue via TLR4. Arthritis & Rheumatism 2009; 2039
  • Sofat N, Kashiwagi M, Midwood K, Nagase H. Proteolytic fragments of tenascin-C promote cartilage degradation. International Journal of Experimental Pathology, 2009; 91: A47-A48
  • Sofat N, Troeberg L, Nagase H. The type III 8-10 repeats of fibronectin induce aggrecanase activity via alpha5beta1 integrin and the type III 13-14 repeats act via TLR4 receptors. International Journal of Experimental Pathology; 2008; 90: A129-A130
  • Sofat N, Kashiwagi M, Nagase H. Tenascin-C fragments induce aggrecanase activity in cartilage. Rheumatology 2008; 47: II177-II177
  • Sofat N, Gendron C, Enghild J, Nagase H. Proteolytic fragments of fibronectin containing the type III-13 and III-14 repeats induce aggrecanase activity in cartilage. Rheumatology; 2006; 45:I82-I82
  • CB Talbot, RKP. Benninger, P de Beule, J Requejo-Isidro, DS Elson, C Dunsby, I Munro, M. A Neil, A Sandison, N Sofat, H. Nagase, P. M. W. French, MJ Lever. Application of fluorescence lifetime and hyperspectral imaging to tissue autofluorescence: Arthritis. SPIE. 5862, Diagnostic Optical Spectroscopy in Biomedicine III 58620T; 2005 doi: 10.1117/12.633034
  • Sofat N. What does the doctor do? Postgraduate Diploma in Musculoskeletal Medicine (PG Dip MsMed), Middlesex University, London, RILA Publications, 2008
  • Sofat N, Malik O, Higgens CS. Neurological involvement in patients with rheumatic disease. Quarterly Journal of Medicine, 2006; 99: 69-79
  • Sofat N, Keat A. Alcohol Intake in Rheumatic Disease – Good or Bad? Rheumatology, 2002; 41(2): 125-8
  • Sofat N, Pitcher M, Price A, El-Jabbour JN, Higgens CS. Lesson of the Month ‘A Case of Weak Muscles’ Annals of Rheumatic Diseases. 2002; 61(1): 10-12
  • Sofat N, Rogers Y, Hall MA. How much physical activity do children with JIA perform? Archives of disease in childhood 2002; 86 Supp 1 G145: A49
  • Sofat N, HoUghton J, McHale J, Higgens CS. Azathioprine Hypersensitivity. Annals of Rheumatic Diseases 2002; 82: 10-12
  • Sofat N, Higgens CS. A State of Confusion. Postgraduate Medical Journal. 2001; 77(912): 666
  • Sofat N, Higgens CS. Diagnostic Issues in SLE. Postgraduate Medical Journal 2001; 77(706): 266; 274-5
  • Sofat N, Turner J, Khoo B, Sohail M, Krausz T, Evans P, Meeran K. An unusual cause of Cushing’s syndrome: primary pigmented nodular adrenal dysplasia International Journal of Clinical Practice. 2000; 54(4): 269-271
  • Sofat N. A Question of Consent Student BMJ. 1997 p 277-8

 

Bristol Myers Squibb

British Pharmacological Society

Engineering and Physical Sciences Research Council (EPSRC)

NIHR

Orthopaedic Research UK

Pathological Society

Rosetrees’ Trust

UKRI

Versus Arthritis

Wellcome Trust

King’s College London Clinical Trials Unit

OATech project (led by University of Cardiff)

Orthopaedic surgeons at Epsom Orthopaedic Centre and St George’s University Hospitals NHS Trust (Philip Mitchell, Caroline Hing, Richard Field)

Royal Veterinary College (Professor Andy Pitsillides and Chantal Chenu)

Toby Smith (University of Oxford)

Versus Arthritis Pain Centre in Nottingham (Professor David Walsh)

Course Co-Director for PGCert in Research Skills and Methods

MBBS Medicine teaching in Musculoskeletal Medicine (pre-Clinical and Clinical)

ResearchAware teaching programme for George's Academic Training

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