Scientists are bringing precision medicine to rheumatoid arthritis for the first time by using genetic profiling of joint tissue to see which drugs will work for which patients, reports a new Northwestern Medicine multi-site study.
In the near future, patients won’t have to waste time and be disappointed with months of ineffective therapy, scientists said.
“Now we can start to predict which drugs a patient will respond to,” said co-senior author Harris Perlman, chief of rheumatology at Northwestern University Feinberg School of Medicine. “We can truly do precision medicine for rheumatoid arthritis. I believe this could be game changing. ”
The paper was recently published as an uncorrected proof in Arthritis & Rheumatology and will be officially published in the journal in late May. Richard Pope and Deborah Winter also are lead Northwestern authors.
Treatment for rheumatoid arthritis now is trial and error.
“We have so many different biologic drugs and there’s no rhyme or reason to give one drug versus the other,” Perlman said. “We waste $2.5 billion a year in ineffective therapy. And patients go through 12 weeks of therapy, don’t respond and get upset.”
Scientists in the multi-site study were the first in the U.S. to use ultrasound-guided therapy to take a tissue biopsy in the affected joint. In the past, blood samples were used to try to determine the effectiveness of the therapy and disease progression.
“It’s just like oncology, where you go to the tumor,” Perlman said. “Why go anywhere else? In rheumatoid arthritis, we’ve never gone to the target organ.”
Improved ultrasound guided techniques make the new technique possible, Perlman said, noting joint biopsies began in Europe about six years ago.
Scientists in the six-site study analyzed the tissue in 41 rheumatoid arthritis patients, separating out different immune cell populations. They focused on macrophages, essentially the garbage collectors of the immune system that are overactive in rheumatoid arthritis. These cells produce toxic, inflammatory proteins that destroy the joints. Biologic therapy removes the protein molecules being secreted by the macrophages.
The study included 30 patients from Northwestern and the remaining 11 from the University of Alabama at Birmingham; Washington University, Columbia University, Mayo Clinic and University of Michigan.
In the past, scientists have tried to determine therapeutic effectiveness by separating patients into groups based on their clinical parameters such as what antibodies they are producing against themselves, how swollen their joints are and medications they are taking. Then scientists tried to see if these parameters could predict therapeutic efficacy. But that hasn’t worked, Perlman said.
Instead, Perlman and colleagues segregated patients based on the genes being produced by their macrophages. They identified two patient groups who shared aspects of the genetic profiles.
Next, the scientists identified which of these patient populations had joints that were getting better and what biologic therapies they were taking. They also identified a gene sequence associated in patients with early disease. The earlier the patient is treated, the more effective the therapy.
The next goal is to predict which patients will have the best response — based on their genetic signature — to a specific drug.
In a new study, researchers are taking joint biopsy tissue from patients at the start of a new therapy and then six weeks later to see if they can find a predictor gene sequence that will clearly identify which patients respond to a particular therapy.
“The idea is to develop gene sequences to predict whether a patient will respond or not,” Perlman said. “Our goal is that this procedure will become the standard of care of for all patients with rheumatoid arthritis.”
Learn more: Rheumatoid arthritis meets precision medicine
The Latest on: Rheumatoid arthritis
via Google News
The Latest on: Rheumatoid arthritis
- Does Sexism Play a Role in Rheumatoid Arthritis Care? on November 11, 2018 at 3:20 pm
Growing up, Maya Dusenbery, 32, never thought about her health, which, as a high school and college soccer star, was stellar. She also didn’t give much thought to her doctors, since she saw them prima... […]
- What It's Like to Be a Single Mom With Rheumatoid Arthritis on November 10, 2018 at 10:09 pm
What is it like when constant unrelenting fatigue and pain consume your world? Making every aspect of your life a consistent struggle to maintain some quality of life requiring hours of seemingly self... […]
- Generic arthritis drug comes up short against inflammation in heart disease on November 10, 2018 at 1:51 pm
Giving a generic anti-inflammatory drug widely used to treat rheumatoid arthritis to people who previously had a heart attack or stroke worked no better than placebo in preventing another cardiovascul... […]
- Rheumatoid arthritis (RA): Prognosis on November 9, 2018 at 7:14 am
Healthline Media, Inc. would like to process and share personal data (e.g., mobile ad id) and data about your use of our site (e.g., content interests) with our third party partners (see a current lis... […]
- Rheumatoid Arthritis Treatment Market 10-Year Market Forecast and Trends Analysis Research Report on November 9, 2018 at 4:24 am
Future Market Insights has announced the addition of the “Rheumatoid Arthritis Treatment Market: Global Industry Analysis and Opportunity Assessment 2017-2027" report to their offering Rheumatoid arth... […]
- Celltex autologous stem cell case study published by Gavin Publishers demonstrates potential cure for rheumatoid arthritis on November 8, 2018 at 5:54 am
Dr. Jane Young contributes to peer-reviewed case study that follows the treatment of adult rheumatoid arthritis patient HOUSTON, Nov. 8, 2018 /PRNewswire/ -- Houston-based biotechnology company ... […]
- Medical News Today: What to know about rheumatoid arthritis and weight loss on November 8, 2018 at 5:00 am
While being overweight or obese can increase the risk of developing rheumatoid arthritis (RA), some people with the condition lose weight. In this article, learn about the relationship between RA ... […]
- 34 Things You Need to Know About Arthritis on November 2, 2018 at 9:27 am
followed by gout (27 percent of cases), psoriatic arthritis (14 percent), and rheumatoid arthritis (3 percent). There is no cure for any of them, but science has made several breakthroughs in understa... […]
- Johnson & Johnson drops OSE’s rheumatoid arthritis drug on November 2, 2018 at 6:08 am
Johnson & Johnson has dumped OSE Immunotherapeutics’ autoimmune candidate FR104. J&J picked up the rights to the CD28 antagonist for €10 million ($11 million) upfront in 2016 but clinical progress sta... […]
via Bing News