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Biomarker could help doctors tailor treatment for rheumatoid arthritis
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Investigators have identified a biomarker that could help doctors select patients with rheumatoid arthritis who will benefit from therapy with drugs such as Enbrel, according to a study published in the February issue of Arthritis & Rheumatism.
The study, led by researchers at Hospital for Special Surgery in collaboration with rheumatologists at University of Southern California, involved three cohorts of patients: those with rheumatoid arthritis (RA) who received a tumor necrosis factor (TNF)-antagonist drug; arthritis patients who received no drug; and healthy volunteers.
Outcomes were evaluated during a window of therapy consisting of more than 3 months but fewer than 9 months, allowing for sufficient time for clinicians to determine clinical response. Researchers used the Disease Activity Score in 28 joints to deem whether patients had moderate, good or no response to the drug.
Investigators focused specifically on interferon beta (IFN-beta) for the study, noting that previous studies revealed that levels of IFN-beta are present in the joint tissue of some patients with RA. The study aimed to see if variable levels of IFN-beta could play a role in how patients respond to TNF-antagonist drugs by determining the relationship between levels of type I interferon activity in the blood prior to beginning therapy and the ability of the drug to control RA in patients.
Patients with higher baseline levels of type I IFN were more likely to respond to therapy with TNF antagonists. Patients who had an increased IFN-beta/alpha ratio were also more likely to respond to therapy.
“While our study was performed on a relatively small group of patients and will need to be confirmed in a larger cohort, the data are promising and may be clinically significant for the medical management of patients,” stated Mary K. Crow, MD, director of Rheumatology Research and co-director of the Mary Kirkland Center for Lupus Research at Hospital for Special Surgery.
“Treatment with these drugs is very expensive … if you are going to use them, you would like to know that they are likely to work in your patient,” she continued. Her comments were taken from a press release.
Orthopedics Today Basic Science & Research section editor Gunnar B. Andersson, MD, PhD, labeled the study “small … but potentially very important.”
“TNF antagonist drugs have had an enormous positive influence on patients with rheumatoid arthritis,” Andersson told Orthopedics Today. “Since the cost of the TNF-antagonist is very high and the side effects not trivial, it would be very important to be able to predict who will respond and who will not.”
“The study by Dr. Crow and collaborators is promising in that effect is predicted based on a biochemical marker,” he added. “Although this study is small and needs to be replicated, it potentially opens up an important opportunity which should be explored.”
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