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Diagnosis of Rheumatoid Arthritis

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 23290

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Special Issue Editors

Dr. Alejandro Escudero-Contreras

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Guest Editor

Hospital Universitario Reina Sofia, Cordoba, Spain
Interests: rheumatology; rheumatoid arthritis; spondyloarthritis; synovitis; spondylarthropathies; gout; prothrombin; osteoarthritis; systemic lupus erythematosus

Dr. Rosario Löpez-Pedrera

E-Mail Website
Guest Editor

Hospital Universitario Reina Sofia, Cordoba, Spain
Interests: systemic autoimmune diseases; rheumatoid arthritis; systemic lupus erythematosus; antiphospholipid syndrome; cardiovascular disease; biomarkers; machine learning

Special Issue Information

Dear Colleagues,

Rheumatoid arthritis (RA) is a chronic, progressive inflammatory disorder that manifests as a symmetric polyarthritis of small and large joints that may lead to joint and periarticular structural damage and the consequences of systemic inflammation and associated extra-articular manifestations and comorbidities.

Unmet needs and challenges in RA are still best for diagnosing RA, so that early recognition, diagnosis, and treatment initiation are key to appropriately managing the disease and optimizing long-term outcomes.

This Special Issue “Diagnosis of Rheumatoid Arthritis” will focus on the identification of the wide spectrum of clinical and molecular mechanisms involved in the establishment and evolution of the disease and its associated comorbidities, as well as their implication in the development of precision medicine to manage these patients.

We invite authors to contribute to this Special Issue with original research and review articles, focusing on, but not limited to, laboratory and imaging tools for the diagnosis and therapeutic response of RA; genetic, transcriptomic and epigenetic biomarkers with diagnostic value; the diagnostic value of autoantibodies and immune cells; factors related to CVD and interstitial lung disease development; influence of microbiome, diet quality and obesity on the risk of RA; RA disease determinants in older individuals; bioinformatic approaches as novel tools for diagnosis.

Dr. Alejandro Escudero-Contreras
Dr. Rosario Löpez-Pedrera
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

RA diagnostic
Clinical and analytical tools
Inflammation
Comorbidities
Extra-articular manifestations
Therapies
Immune response
Genomic and epigenetic biomarkers

Published Papers (11 papers)

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Research

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14 pages, 965 KiB

Open AccessArticle

Anti-Citrullinated Protein Antibody Titers Are Independently Modulated by Both Disease Activity and Conventional or Biologic Anti-Rheumatic Drugs

by Miren Uriarte Ecenarro, Daniel Useros, Aranzazu Alfranca, Reyes Tejedor, Isidoro González-Alvaro and Rosario García-Vicuña

Diagnostics 2022, 12(7), 1773; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12071773 - 21 Jul 2022

Viewed by 1219

Abstract

This study aimed to analyze the factors that influence anti-citrullinated protein antibody (ACPA) titers in a seropositive early arthritis (EA) population under non-protocolized treatment with disease-modifying anti-rheumatic drugs (DMARDs). A total of 130 ACPA-positive patients from the PEARL (Princesa Early Arthritis Longitudinal) study were studied along a 5-year follow-up. Sociodemographic, clinical, and therapeutic variables, along with serum samples, were collected at five visits by protocol. Anti-cyclic citrullinated peptide 2 (CCP2) ACPA titers were measured by ELISA. The effect of different variables on anti-CCP2 titers was estimated using longitudinal multivariate analysis models, nested by visit and patient. Data from 471 visits in 130 patients were analyzed. A significant decrease in anti-CCP2 titers was observed at all time-points, compared to baseline, following the decline of disease activity. In the multivariate analysis, active or ever smoking was significantly associated with the highest anti-CCP2 titers while reduction in disease activity was associated with titer decline. After adjusting for these variables, both conventional synthetic (cs) and biologic (b) DMARDs accounted for the decline in anti-CCP2 titers as independent factors. Conclusion: In patients with EA, an early and sustained reduction in ACPA titers can be detected associated with the decline in disease activity, irrespective of the treatment used. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

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22 pages, 2369 KiB

Open AccessArticle

Pharmacogenomics of Methotrexate Pathway in Rheumatoid Arthritis Patients: Approach toward Personalized Medicine

by Hoda Y. Abdallah, Maha E. Ibrahim, Noha M. Abd El-Fadeal, Dina A. Ali, Gehad G. Elsehrawy, Rasha E. Badr and Howayda M. Hassoba

Diagnostics 2022, 12(7), 1560; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12071560 - 27 Jun 2022

Cited by 1 | Viewed by 2086

Abstract

Background: Methotrexate (MTX) is one of the most common medications used for rheumatoid arthritis (RA) treatment. Single-nucleotide polymorphisms (SNPs) could potentially predict variability in therapeutic outcomes. Aim: This study aims to assess the impact of SNPs in genes encoding for the MTX pathway for predicting clinical and therapeutic responses to MTX in a cohort of Egyptian patients with RA. Subjects and Methods: Data from 107 Egyptian RA patients (aged 44.4 ± 11.4 years) treated with MTX monotherapy, for a duration of 3.7 ± 3.3 years, were collected. Genotypes of 10 SNPs from four different genes were analyzed using the allelic discrimination PCR technique. Results: The ATIC rs3821353 G/T (p = 0.034) and the C/T and C/C of SLC19A1 rs7279445 (p = 0.0018) were associated with a non-response to MTX, while DHFR rs10072026 C/T and C/C were associated with a good response (p < 0.001). Carriers of the ATIC rs382135 3 G (p = 0.001) and ATIC rs4673990 G (p < 0.001) alleles were more likely to develop RA, while the SLC19A1 rs11702425 T (p < 0.001) and GGH rs12681874 T (p = 0.003) allele carriers were more likely to be protected against RA. Carriers of the ATIC rs4673990 A/G genotype (p < 0.001) were at risk of developing RA, while carriers of the following genotypes were mostly protected against RA: ATIC rs3821353 T/T (p < 0.001), ATIC rs3821353 G/G (p = 0.004), SLC19A1 rs11702425 T/T (p = 0.001), SLC19A1 rs11702425 C/T (p = 0.003), GGH rs12681874 C/T (p = 0.004) and GGH rs12681874 T/T (0.002). Conclusion: The genotyping of genes involved in the MTX pathway may be helpful to predict which RA patients will/will not benefit from MTX, and thus, may help to apply a personalized medicine approach in RA. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

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7 pages, 225 KiB

Open AccessArticle

24 h Holter ECG Monitoring of Patients with Rheumatoid Arthritis—A Potential Role for a Precise Evaluation of QT Interval Duration and Associated Arrhythmic Complications

by Elena E. Saramet, Robert D. Negru, Andra Oancea, Maria Magdalena Leon Constantin and Codrina Ancuta

Diagnostics 2022, 12(3), 638; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12030638 - 05 Mar 2022

Cited by 1 | Viewed by 1213

Abstract

Background: Patients with rheumatoid arthritis (RA) have increased systemic inflammatory burden associated with elevated cardiovascular mortality. Prolonged ventricular repolarisation evaluated by QT interval duration is a risk factor for cardiovascular and total mortality. In RA, mortality risk is correlated with dynamics and cumulative incidence of QTc prolongation rather than QTc value. The aim is to evaluate if QT parameters evaluated with 24 h Holter ECG are a better option to complete the cardiovascular profile of RA patients than parameters from short ECG recordings. Materials and methods: A total of 58 patients (22 males, 36 females) with RA were submitted to short ECG recordings at admission and to 24 h Holter ECG. QT interval parameters and ventricular ectopy generated from both types of recordings were analyzed. Results: QTc interval values obtained from Holter ECG were significantly higher than the values from short term ECG and were correlated with severity of inflammatory process. The number of QRS complexes with QTc > 450 ms recorded during 24 h Holter was strongly correlated with the number of ventricular events and severity of the inflammatory process. Conclusions: In patients with RA, the Holter ECG recordings could realize a more precise evaluation of the extent and dynamics of QTc interval duration and of ventricular ectopic events with potential risk of sudden death. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

18 pages, 2256 KiB

Open AccessArticle

Antibodies against 4 Atypical Post-Translational Protein Modifications in Patients with Rheumatoid Arthritis

by Lorena Rodríguez-Martínez, Cristina Regueiro, Sámer Amhaz-Escanlar, Carmen Pena, Paloma Herbello-Hermelo, Antonio Moreda-Piñeiro, Javier Rodriguez-Garcia, Antonio Mera-Varela, Eva Pérez-Pampín and Antonio González

Diagnostics 2022, 12(2), 352; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12020352 - 29 Jan 2022

Cited by 3 | Viewed by 2200

Abstract

Patients with rheumatoid arthritis (RA) show autoantibodies against post-translational protein modifications (PTMs), such as anti-citrullinated protein antibodies. However, the range of recognized PTMs is unknown. Here, we addressed four PTMs: chlorination, non-enzymatic glycation, nitration, and homocysteinylation, identified as targets of atypical RA autoantibodies in studies whose protocols we have followed. The modified antigens included collagen type II, an extract of synovial proteins and a selection of peptides. We interpreted the results according to the optical density (OD) obtained in an enzyme-linked immunosorbent assay ( ELISA) with the modified antigen and the corrected OD obtained after subtracting the reactivity against the unmodified antigen. The results showed evidence of specific antibodies against glycated collagen type II, as the corrected ODs were higher in the 182 patients with RA than in the 164 healthy controls (p = 0.0003). However, the relevance of these antibodies was doubtful because the magnitude of the specific signal was small (median OD = 0.072 vs. 0.027, respectively). There were no specific antibodies against any of the other three PTMs. Therefore, our results showed that the four PTMs are not inducing a significant autoantibody response in patients with RA. These results indicated that the repertoire of PTM autoantigens in RA is restricted. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

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9 pages, 481 KiB

Open AccessArticle

High Sensitivity C Reactive Protein in Patients with Rheumatoid Arthritis Treated with Antibodies against IL-6 or Jak Inhibitors: A Clinical and Ultrasonographic Study

by Beatriz Frade-Sosa, Andrés Ponce, Virginia Ruiz-Esquide, Maria Jesús García-Yébenes, Rosa Morlá, Nuria Sapena, Julio Ramirez, Ana Belen Azuaga, Juan Camilo Sarmiento, Juan D. Cañete, Jose A. Gomez-Puerta and Raimon Sanmarti

Diagnostics 2022, 12(1), 182; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12010182 - 13 Jan 2022

Cited by 3 | Viewed by 1775

Abstract

Background: We examined whether high-sensitivity CRP (hsCRP) reflected the inflammatory disease status evaluated by clinical and ultrasound (US) parameters in RA patients receiving IL-6 receptor antibodies (anti-IL-6R) or JAK inhibitors (JAKi). Methods: We conducted a cross-sectional study of patients with established RA receiving anti-IL-6R (tocilizumab, sarilumab) or JAKi (tofacitinib, baricitinib). Serum hsCRP and US synovitis in both hands were measured. Associations between hsCRP and clinical inflammatory activity were evaluated using composite activity indices. The association between hsCRP and US synovitis was analyzed. Results: 63 (92% female) patients (42 anti- IL-6R and 21 JAKi) were included, and the median disease duration was 14.4 (0.2–37.5) years. Most patients were in remission or had low levels of disease. Overall hsCRP values were very low, and significantly lower in anti-IL-6R patients (median 0.04 mg/dL vs. 0.16 mg/dL). Anti-IL-6R (82.4%) patients and 48% of JAKi patients had very low hsCRP levels (≤0.1 mg/dL) (p = 0.002). In the anti-IL-6R group, hsCRP did not correlate with the composite activity index or US synovitis. In the JAKi group, hsCRP moderately correlated with US parameters (r = 0.5) but not clinical disease activity, and hsCRP levels were higher in patients with US synovitis (0.02 vs. 0.42 mg/dL) (p = 0.001). Conclusion: In anti-IL-6R RA-treated patients, hsCRP does not reflect the inflammatory disease state, but in those treated with JAKi, hsCRP was associated with US synovitis. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

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12 pages, 305 KiB

Open AccessArticle

Association between Carotid Intima-Media Thickness and the Use of Biological or Small Molecule Therapies in Patients with Rheumatoid Arthritis

by Marta Rojas-Giménez, Clementina López-Medina, Jerusalem Calvo-Gutiérrez, María Ángeles Puche-Larrubia, Ignacio Gómez-García, Pedro Seguí-Azpilcueta, María del Carmen Ábalos-Aguilera, Desirée Ruíz, Eduardo Collantes-Estévez and Alejandro Escudero-Contreras

Diagnostics 2022, 12(1), 64; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12010064 - 28 Dec 2021

Cited by 2 | Viewed by 1321

Abstract

Objective: The objective of this study was to assess the association of carotid intima-media thickness (CIMT), and also the presence of atheromatous plaque, with biological and targeted synthetic disease-modifying antirheumatic drugs, in an established cohort of patients with rheumatoid arthritis (RA). Patients and Methods: We conducted a cross-sectional observational study based on a cohort of patients with RA and a registry of healthy controls, in whom the CIMT and presence of atheromatous plaque were assessed by ultrasound. Data were collected on disease activity, lab results and treatments. Descriptive and bivariate analyses were performed and two multivariate linear regression models (with CIMT as the dependent variable) were constructed to identify variables independently associated with CIMT in our sample of patients with RA. Results: A total of 176 individuals (146 patients with RA and 30 controls) were included. A higher percentage of patients than controls had atheromatous plaque (33.8% vs. 12.5%, p = 0.036), but no differences were found in terms of CIMT (0.64 vs. 0.61, p = 0.444). Compared to values in patients on other therapies, the CIMT was smaller among patients on tumour necrosis factor alpha (TNFα) inhibitors (mean [SD]: 0.58 [0.10] vs. 0.65 [0.19]; p = 0.013) and among those on Janus kinase inhibitors (mean [SD]: 0.52 [0.02] vs. 0.64 [0.18]; p < 0.001), while no differences were found as a function of the use of the other therapies considered. The multivariate linear regression analysis to identify factors associated with CIMT in our patients, adjusting for traditional cardiovascular risk factors such as hypertension, high levels of low-density lipoproteins, diabetes mellitus and smoking, showed that male sex, older age and having a greater cumulative erythrocyte sedimentation rate were independently associated with a larger CIMT, while patients on TNFα inhibitors had a CIMT 0.075 mm smaller than those on other treatments. Conclusions: The use of TNFα inhibitors may protect against subclinical atherosclerosis in patients with RA, patients on this biologic having smaller CIMTs than patients on other disease-modifying antirheumatic drugs. Nonetheless, these results should be confirmed in prospective studies with larger sample sizes. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

8 pages, 1190 KiB

Open AccessArticle

SCORE2 Assessment in the Calculation of Cardiovascular Risk in Patients with Rheumatoid Arthritis

by Iván Ferraz-Amaro, Alfonso Corrales, Belén Atienza-Mateo, Nuria Vegas-Revenga, Diana Prieto-Peña, Julio Sánchez-Martín, Cristina Almeida, Juan Carlos Quevedo-Abeledo, Ricardo Blanco and Miguel Á. González-Gay

Diagnostics 2021, 11(12), 2363; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11122363 - 15 Dec 2021

Cited by 3 | Viewed by 3904 | Correction

Abstract

Patients with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease (CVD). Risk chart algorithms, such as the Systematic Coronary Risk Assessment (SCORE), often underestimate the risk of CVD in patients with RA. In this sense, the use of noninvasive tools, such as the carotid ultrasound, has made it possible to identify RA patients at high risk of CVD who had subclinical atherosclerosis disease and who had been included in the low or moderate CVD risk categories when the SCORE risk tables were applied. The 2003 SCORE calculator was recently updated to a new prediction model: SCORE2. This new algorithm improves the identification of individuals from the general population at high risk of developing CVD in Europe. Our objective was to compare the predictive capacity between the original SCORE and the new SCORE2 to identify RA patients with subclinical atherosclerosis and, consequently, high risk of CVD. 1168 non-diabetic patients with RA and age > 40 years were recruited. Subclinical atherosclerosis was searched for by carotid ultrasound. The presence of carotid plaque and the carotid intima media wall thickness (cIMT) were evaluated. SCORE and SCORE2 were also calculated. The relationships of SCORE and SCORE2 to each other and to the presence of subclinical carotid atherosclerosis were studied. The correlation between SCORE and SCORE2 was found to be high in patients with RA (Spearman’s Rho = 0.961, p < 0.001). Both SCORE (Spearman’s Rho = 0.524) and SCORE2 (Spearman’s Rho = 0.521) were similarly correlated with cIMT (p = 0.92). Likewise, both calculators showed significant and comparable discriminations for the presence of carotid plaque: SCORE AUC 0.781 (95%CI 0.755–0.807) and SCORE2 AUC 0.774 (95%CI 0.748–0.801). Using SCORE, 80% and 20% of the patients were in the low or moderate and high or very high CVD risk categories, respectively. However, when the same categories were evaluated using SCORE2, the percentages were different (58% and 42%, respectively). Consequently, the number of RA patients included in the high or very high CVD risk categories was significantly higher with SCORE2 compared to the original SCORE. (p < 0.001). In conclusion, although predictive capacity for the presence of carotid plaque is equivalent between SCORE and SCORE2, SCORE2 identifies a significantly higher proportion of patients with RA who are at high or very high risk of CVD. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

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11 pages, 278 KiB

Open AccessArticle

Ability to Participate in Social Activities of Rheumatoid Arthritis Patients Compared with Other Rheumatic Diseases: A Cross-Sectional Observational Study

by Laura Cano-García, Natalia Mena-Vázquez, Sara Manrique-Arija, Rocío Redondo-Rodriguez, Carmen María Romero-Barco and Antonio Fernández-Nebro

Diagnostics 2021, 11(12), 2258; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11122258 - 02 Dec 2021

Cited by 8 | Viewed by 1614

Abstract

Objectives: To compare the ability to participate in social activities among rheumatoid arthritis patients with other rheumatic disease patients and identify potentially implicated factors. Patients and methods: Between June and November 2019, we consecutively selected patients aged ≥18 years with RA (defined according to ACR/EULAR 2010), SpA (ASAS/EULAR 2010), and SLE (ACR 1997). Main outcome measures: Ability to participate in social roles and activities evaluated using the PROMIS score v2.0 short-form 8a (PROMIS-APS). Secondary outcomes: Participation in social activities according to a series of variables (mobility, depression, satisfaction with social relationships, social isolation, company, emotional support, instrumental support, and support via information). We evaluated the association between the ability to participate in social activities and associated variables using multivariable linear regression analysis. Results: The study population comprised 50 patients with RA (33.1%), 51 patients (33.8%) with SpA, and 50 patients (33.1%) with SLE. The mean PROMIS-APS scores were similar in the three groups. The multivariable analysis for the whole sample showed that the ability to participate in social activities was inversely associated with depression and directly with social satisfaction, mobility, company, and age. The stratified analysis revealed an inverse association between inflammatory activity and ability to participate in social activities in patients with RA and SpA, but not in those with SLE. Conclusion: All patients with RA, SpA, and SLE had a similar ability to participate in social activities. This was associated with other psychosocial factors (social satisfaction, mobility, company, depression) and clinical factors (age and inflammatory activity). Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

12 pages, 728 KiB

Open AccessArticle

Characteristics and Predictors of Progression Interstitial Lung Disease in Rheumatoid Arthritis Compared with Other Autoimmune Disease: A Retrospective Cohort Study

by Natalia Mena-Vázquez, Marta Rojas-Gimenez, Carmen María Romero-Barco, Sara Manrique-Arija, Ana Hidalgo Conde, Rocío Arnedo Díez de los Ríos, Eva Cabrera César, Rafaela Ortega-Castro, Francisco Espildora, María Carmen Aguilar-Hurtado, Isabel Añón-Oñate, Lorena Pérez-Albaladejo, Manuel Abarca-Costalago, Inmaculada Ureña-Garnica, Maria Luisa Velloso-Feijoo, Rocio Redondo-Rodriguez and Antonio Fernández-Nebro

Diagnostics 2021, 11(10), 1794; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101794 - 28 Sep 2021

Cited by 11 | Viewed by 2201

Abstract

Objectives: To describe the characteristics and progression of interstitial lung disease in patients with associated systemic autoimmune disease (ILD-SAI) and to identify factors associated with progression and mortality. Patients and methods: We performed a multicenter, retrospective, observational study of patients with ILD-SAI followed between 2015 and 2020. We collected clinical data and performed pulmonary function testing and high-resolution computed tomography at diagnosis and at the final visit. The main outcome measure at the end of follow-up was forced vital capacity (FVC) >10% or diffusing capacity of the lungs for carbon monoxide >15% and radiological progression or death. Cox regression analysis was performed to identify factors associated with worsening of ILD. Results: We included 204 patients with ILD-SAI: 123 (60.3%) had rheumatoid arthritis (RA), 58 had (28.4%) systemic sclerosis, and 23 (11.3%) had inflammatory myopathy. After a median (IQR) period of 56 (29.8–93.3) months, lung disease had stabilized in 98 patients (48%), improved in 33 (16.1%), and worsened in 44 (21.5%). A total of 29 patients (14.2%) died. Progression and hospitalization were more frequent in patients with RA (p = 0.010). The multivariate analysis showed the independent predictors for worsening of ILD-SAI to be RA (HR, 1.9 [95% CI, 1.3–2.7]), usual interstitial pneumonia pattern (HR, 1.7 [95% CI, 1.0–2.9]), FVC (%) (HR, 2.3 [95% CI, 1.4–3.9]), and smoking (HR, 2.7 [95%CI, 1.6–4.7]). Conclusion: Disease stabilizes or improves after a median of 5 years in more than half of patients with ILD-SAI, although more than one-third die. Data on subgroups and risk factors could help us to predict poorer outcomes. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

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Review

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12 pages, 509 KiB

Open AccessReview

Precision Medicine for Rheumatoid Arthritis: The Right Drug for the Right Patient—Companion Diagnostics

by Richard Thomas Meehan, Isabelle Anne Amigues and Vijaya Knight

Diagnostics 2021, 11(8), 1362; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11081362 - 29 Jul 2021

Cited by 7 | Viewed by 3548

Abstract

Despite the growing number of biologic and JAK inhibitor therapeutic agents available to treat various systemic autoimmune illnesses, the lack of a validated companion diagnostic (CDx) to accurately predict drug responsiveness for an individual results in many patients being treated for years with expensive, ineffective, or toxic drugs. This review will focus primarily on rheumatoid arthritis (RA) therapeutics where the need is greatest due to poor patient outcomes if the optimum drug is delayed. We will review current FDA-approved biologic and small molecule drugs and why RA patients switch these medications. We will discuss the sampling of various tissues for potential CDx and review early results from studies investigating drug responsiveness utilizing advanced technologies including; multiplex testing of cytokines and proteins, autoantibody profiling, genomic analysis, proteomics, miRNA analysis, and metabolomics. By using these new technologies for CDx the goal is to improve RA patient outcomes and achieve similar successes like those seen in oncology using precision medicine guided therapeutics. Full article

(This article belongs to the Special Issue Diagnosis of Rheumatoid Arthritis)

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