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Dr Felice Rivellese

Felice

Clinical Senior Lecturer

Centre: Experimental Medicine & Rheumatology

Email: f.rivellese@qmul.ac.uk
Twitter: @FeliceRivellese

Profile

ORCID iD: 0000-0002-6759-7521

Felice Rivellese studied Medicine at the University of Naples Federico II. During the final years of his speciality training in Clinical Immunology, with the support of a EULAR bursary and of an ARTICULUM (now FOREUM) fellowship, he attended the Department of Rheumatology at Leiden University as a visiting research fellow, where he studied the involvement of cells of the innate immunity in the pathogenesis of inflammatory arthritis.

In 2014, he moved to the Centre of Experimental Medicine & Rheumatology at Queen Mary University of London, led by Prof Costantino Pitzalis, and he was awarded a Marie-Curie fellowship, with a project on the Study of Mast cells in Rheumatoid Arthritis, which was also the focus of his PhD in Clinical Pathophysiology and Experimental Medicine, with sub specialization in Immunological and Rheumatologic Sciences (PhD thesis).  

In 2018, he was awarded a Transitional Research Fellowship by the National Institute of Health Research (NIHR), with a project on the study of Synovial B cells to inform treatment response in Rheumatoid Arthritis (SyBRA). During this time, he transitioned from basic/laboratory research to clinical research, acquiring new skills in clinical trials, epidemiology, and bioinformatics, as he was actively involved in the setup, delivery, and analysis of stratified medicine clinical trials in inflammatory arthritis.

In January 2022, Dr Rivellese was appointed as Clinical Senior Lecturer and he is currently managing the EMR Clinical Research Team, where he is responsible for joint ultrasound assessment and ultrasound-guided synovial biopsies, coordinating a team of 2 nurses, 3 clinical trial practitioners and 2 clinical fellows at PhD level. He is also affiliated to the Centre for Translational Bioinformatics, where he collaborates with Prof Michael Barnes and Dr Myles Lewis and their teams on several research projects in stratified medicine.

Dr Rivellese is a member of the EULAR Council (European Alliance of Associations for Rheumatology). He is Past-Chair (2021-2022) of the EMEUNET (Emerging EULAR Network) Committee, and he is a member of the EULAR Research Committee.

Further information

Research

Group members

Mile-End Clinical Research Team
Mary Githinji, Victoria Amosun (Research nurses)
Fatima Bibi, Ishraat Miah (Clinical Trial Practitioners)
Dr Susan Wang, Dr Sotiria Manou-Stathopoulou (Clinical Research Fellows)

Innate immunity and inflammatory arthritis

During the first years of my career, my research interests focused on the role of cells of the innate immunity, such as mast cells and basophils, in inflammatory arthritis. I showed that mast cells, best known as effector cells of hypersensitive (i.e. allergic) reactions,  infiltrate the joints of patients with Rheumatoid Arthritis, where they can induce the activation of B cells, leading to the production of autoantibodies (https://doi.org/10.1136/annrheumdis-2018-213418). On the other hand, I also found that mast cells, depending on the type of stimuli, can induce either pro- or anti-inflammatory responses (https://doi.org/10.1002/art.39192). Altogether, the results of my research suggest that mast cells can act as immunomodulatory cells (https://doi.org/10.1016/j.autrev.2017.04.001).

Stratified medicine clinical trials: from bench to bedside

Following the award of an NIHR Transitional Research fellowship, building on my expertise in basic and translational science, I aimed at transferring the results obtained in the laboratory to the clinical practice.

To this aim, I focused on the study of samples obtained from the joints of patients recruited in three large, stratified medicine trials in Rheumatoid Arthritis:

  • Patients with early untreated arthritis recruited into the Pathobiology of Early Arthritis Cohort (PEAC);
  • Patients in whom the first-line medication failed, recruited into the Stratification of biologic Therapies for RA by Pathobiology (STRAP);
  • Patients in whom the first biologic medication failed, recruited into the Randomised, open labelled study in anti-TNFa inadequate responders to investigate the mechanisms for Response - Resistance to Rituximab versus Tocilizumab in RA (R4RA)

A key output of my research has been the validation of the scores used to assess the presence of B cells in synovia, including immunohistochemistry techniques (e.g. looking at B cells under the microscope) and molecular analyses, the latter assessing a signature of genes highly specific for B cells (https://doi.org/10.1002/art.41184). Using the molecular score, the results of the R4RA trial, recently published in The Lancet, have shown that patients with a low B cell signature in the joints have a poor response to B cell depletion with Rituximab, as compared with Tocilizumab, the latter targeting the IL6 receptor (10.1016/S0140-6736(20)32341-2).

Current/future research

My current research is focused on expanding the above findings, by combining histology and molecular analyses to build integrated models to predict treatment response, an ongoing work in collaboration with the Centre for Translational Bioinformatics.

In parallel, I’m leading the analysis of the STRAP trial, where, building on the experience with the R4RA trial, we are combining histological and molecular approaches to study treatment response/non-response.

Our next step will be to combine the results from the above cohorts, which have been recruiting patients at different disease stages.  One of the next aims will be to dissect the mechanisms of non-response, by focusing on patients in whom multiple medications fail, i.e. patients with so-called Difficult-to-treat Rheumatoid Arthritis. In parallel, I’m also contributing to the setup of a new IMI-EU-funded multi-centre, biopsy-driven clinical trial (https://3tr-imi.eu/), that will recruit up to 400 patients to test the hypothesis that synovial biomarker-positive patients have a better response than biomarker-negative patients, thus providing the next step towards personalised medicine in inflammatory arthritis.

 

Publications

Sponsors

Collaborators

Internal

External

  • Professor Anne Barton (University of Manchester)
  • Professor Paul McKeigue and Dr Athina Spiliopoulou (University of Edinburgh)
  • Professor Tom Huizinga and Professor Rene Toes (Leiden University)
  • Dr Andreas Ramming (Erlangen University)
  • Professor Amato de Paulis and Professor Francesca W Rossi (University of Naples Federico II) 
  • STRAP and R4RA Investigators and Recruiting Centres
  • 3TR partners

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