Genes can predict success of arthritis treatment

The concept of genetic modification of DNA

Scientists have found that molecular profiling of affected joint tissue might considerably affect whether or not sure drug remedies for rheumatoid arthritis (RA) sufferers work.

A current examine reveals that genes might predict how nicely folks will reply to arthritis remedies.

In accordance with a brand new examine from Queen Mary College of London, molecular profiling of diseased joint tissue might considerably affect whether or not sure drug therapies can be efficient in treating rheumatoid arthritis (RA) sufferers. The examine was printed within the journal nature drugs Could 19, 2022. Researchers additionally discovered particular genes linked to resistance to most present drug remedies, typically referred to as treatment-resistant illness, which will give the important thing to discovering new and efficient medicine to assist these sufferers.

Whereas there was vital enchancment in arthritis therapy over the previous a long time, a big share of people (about 40%) don’t reply to sure drug remedies, and 5-20% of individuals with this situation are immune to all forms of current medicines.

Researchers performed a biopsy-based scientific examine with 164 sufferers with rheumatoid arthritis and examined their reactions to rituximab or tocilizumab – two medicine routinely used to deal with rheumatoid arthritis. The outcomes of the unique experiment had been printed in

The study strongly supports the case for performing gene profiling of biopsies from arthritic joints before prescribing expensive so-called biologic targeted therapies. This could save the NHS and society considerable time and money and help avoid potential unwanted side effects, joint damage, and worse outcomes that are common among patients. As well as influencing treatment prescription, such testing could also shed light on which people may not respond to any of the current drugs on the market, emphasizing the need for developing alternative medications.

Professor Costantino Pitzalis, Versus Arthritis Professor of Rheumatology at the Queen Mary University of London, said: “Incorporating molecular information prior to prescribing arthritis treatments to patients could forever change the way we treat the condition. Patients would benefit from a personalized approach that has a far greater chance of success, rather than the trial-and-error drug prescription that is currently the norm.

“These results are incredibly exciting in demonstrating the potential at our fingertips, however, the field is still in its infancy and additional confirmatory studies will be required to fully realize the promise of precision medicine in RA.

“The results are also important in finding solutions for those people who unfortunately don’t have a treatment that helps them presently. Knowing which specific molecular profiles impact this, and which pathways continue to drive disease activity in these patients, can help in developing new drugs to bring better results and much-needed relief from pain and suffering.”

The incorporation of these signatures in future diagnostic tests will be a necessary step to translate these findings into routine clinical care.

Reference: “Rituximab versus tocilizumab in rheumatoid arthritis: synovial biopsy-based biomarker analysis of the phase 4 R4RA randomized trial” by Felice Rivellese, Anna E. A. Surace, Katriona Goldmann, Elisabetta Sciacca, Cankut Çubuk, Giovanni Giorli, Christopher R. John, Alessandra Nerviani, Liliane Fossati-Jimack, Georgina Thorborn, Manzoor Ahmed, Edoardo Prediletto, Sarah E. Church, Briana M. Hudson, Sarah E. Warren, Paul M. McKeigue, Frances Humby, Michele Bombardieri, Michael R. Barnes, Myles J. Lewis, Costantino Pitzalis, and the R4RA collaborative group, 19 May 2022, Nature Medicine.
DOI: 10.1038/s41591-022-01789-0