What the FLAMIN-GO project could mean for people with rheumatoid arthritis
If you live with rheumatoid arthritis, you might know this story very well: A new medicine, a few months of hope… and then disappointment – the pain and swelling are still there. Then another medicine. And another one. And precious time is passing.
Even though we now have several effective treatments, each one only works well for some patients. That means many people still spend years “jumping” from one therapy to another until they finally find something that really helps.
That’s why a few years ago, researchers in the European project FLAMIN-GO set themselves an ambitious goal: to help rheumatologists choose the right drug for each patient faster and more reliably than today. The aim is clear: instead of “try something and hope it works”, doctors would get solid data to help them choose the most promising therapy for each patient.
What is the FLAMIN-GO project?
FLAMIN-GO is a European research project that is developing a “joint-on-a-chip” – a small, high-tech platform that mimics the joint of a person with RA and allows doctors and researchers to test medicines on that person’s own cells.
Instead of you having to try different drugs on your body for months or years, in the future, they could first be tested on the mini twin of your joint in the lab, so that within the first three months after diagnosis, your doctor would have a much better idea which treatment is most likely to work for you.
The project is coordinated by prof. Annalisa Chiocchetti from the University of Eastern Piedmont in Italy, and brings together 12 partners from 10 countries – universities, research institutes, and companies working in nanotechnology, tissue engineering, microfluidics, rheumatology and science communication.
“Joint-on-a-chip” in simple words
The FLAMIN-GO team uses organ-on-a-chip technology. These are very small “chips” with tiny channels inside, where fluids can flow, similar to blood and joint fluid in your body. In practice, this is supposed to work in three major steps:
1. A small tissue sample: From the rheumatology clinic, a very small sample of your joint lining (synovial tissue) would be taken (a biopsy). This is the place where inflammation in RA is very active.
2. A mini-joint grown from your cells: From this sample, researchers can grow different micro-tissues in the lab, such as inflamed synovial tissue, cartilage and bone, tiny blood vessels and immune cells. First they develop and test each tissue separately, and then they assemble them into a full RA joint-on-a-chip.
3. Testing medicines on your mini-joint: Once this mini-joint is built, several different medicines can be tested in parallel. Using tiny sensors for oxygen, pH and other signals, and by analysing how the cells behave, the researchers can see, which drug best reduces inflammation and protects the tissues from damage.
Main challenges on the way
FLAMIN-GO has already come a long way, but bringing such a complex technology into everyday clinical practice is not easy. The researchers themselves highlight several key challenges. In the first years, the partners developed individual tissue models – synovium, cartilage, bone, and blood vessels. Now the biggest challenge is to reliably combine all of these into one functioning joint model. This means connecting the biological part (cells and tissues), the technological part (the chip, sensors, fluid flow) and the clinical part (what doctors and patients actually need in real life).
Another challenge is working safely and ethically with human samples. FLAMIN-GO and related projects have organised workshops on the practical, ethical and legal aspects of using patient biopsies – from how to collect and store them to how to protect patient rights and privacy.
Even if something works well in the lab, it must be approved and safe before it can be used in hospitals and clinics. Without this regulatory work “on paper”, the technology cannot move into real-world clinical use.
What has FLAMIN-GO achieved so far?
Despite the challenges, the project has reached several important milestones that are very encouraging for people living with RA. The researchers have successfully grown 3D models of synovial tissue from patient cells and used them to test how the cells respond to different medicines. The responses closely match what is seen in real patients, which gives strong clinical credibility to the model. FLAMIN-GO has also achieved pilot testing in clinical research, and many individual parts of the platform have been validated. The current focus is on final integration into a single, working system.
On the engineering side, the team has made important progress: they developed a microfluidic system that can measure oxygen and pH inside the chip and has grown vascular, synovial, and osteochondral tissues together on the same platform. This is crucial for making the model behave like a “small, living joint”.
Industrial partners in the project have developed a compact reader device and a disposable chip (EliChip), along with protocols that are already oriented towards future industrial production.
A spin-off company AI-TWIN has been created to help bring this technology step by step closer to the market.
What could this mean for patients in the long run?
It is important to be honest: the joint-on-a-chip is not yet a routine clinical tool. It is still a cutting-edge research technology that needs further testing and refinement. However, if things go as planned, the choice of the right medicine will be much faster. Instead of trying different therapies for years, doctors could narrow down the options to the medicines that look most promising on your mini-joint – already in the first months after diagnosis. If unsuitable drugs are filtered out on the chip, they will not be used on you for long periods. That means less “blind” exposure to treatments that do not really help you. Choosing an effective medicine early increases the chance that inflammation will be controlled quickly and long-term joint damage may be reduced. The same idea could be adapted to other diseases, such as osteoarthritis or conditions that affect only a specific part of the joint.
Of course, nothing can replace regular check-ups and open communication with your rheumatologist. Technology is a tool – the relationship between you and your care team remains central.
Powerful reason for hope
Rheumatoid arthritis demands persistence from patients, doctors, and researchers. FLAMIN-GO does not promise a magic pill. Instead, it aims for a smarter way of choosing therapies, so that future RA treatment will involve less “wandering around” between drugs.
For now, the joint-on-a-chip belongs to advanced research labs. But the results from recent meetings of the consortium show that the “puzzle pieces” are coming together, and the vision – that within a few months of diagnosis we could have a much better idea, which medicine will help a particular patient, is slowly becoming more realistic. Until then, the most important things remain:
- early diagnosis and early treatment,
- regular follow-up with your rheumatology team,
- honest conversations about how you feel, what works for you, and what does not.
Science is working to make your next step with RA less dependent on luck and more guided by precise insights from your own cells – a quiet but powerful reason for hope.
Just like the flamingo bird balances gracefully on one slender leg, the FLAMIN-GO project is all about helping people with rheumatoid arthritis regain balance in their lives and joints. The bird’s long, delicate legs may look fragile, but they carry it through water, wind, and long journeys – a bit like patients who keep going despite pain and stiffness.
