Three Gene Signatures May Predict Response to Rheumatoid Arthritis Therapies

Three gene expression signatures can help rheumatologists predict which patients are more likely to respond to tumor necrosis factor inhibitors (TNFi) or B-cell depletion therapies in patients with moderate to severe rheumatoid arthritis (RA), according to new research findings presented this week at the American College of Rheumatology Annual Scientific Meeting in Washingto, D.C. RA is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men. Drawing on data from the ORBIT study, a randomized, controlled trial of RA patients in the United Kingdom, researchers looked for gene expression markers that would help predict responses to either TNFi drugs or the B-cell therapy rituximab, or both. The ORBIT data "showed that patients who have seropositive rheumatoid arthritis are just as likely to respond to rituximab therapy when compared to anti-TNF therapy," said Duncan Porter, M.D., Honorary Associate Professor and a consultant rheumatologist at Queen Elizabeth University Hospital in Glasgow, Scotland, and one of the lead authors of the study. "However, a significant proportion of patients failed to respond to their first biologic drug, but responded when they were switched to the alternative. If we could identify markers in the blood that predicted which drug patients were most likely to respond to, that would allow us to choose the best treatment for that patient at the start, rather than rely on a trial-and-error approach." Dr.
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