Three sets of genes could predict response to rheumatoid arthritis therapies

Three gene markers can help rheumatologists work out who is more likely to respond to tumour necrosis factor (TNF) inhibitors or B-cell depletion therapies in people with rheumatoid arthritis, according to findings presented at the American College of Rheumatology Annual Scientific Meeting.

Experts looked for gene expression markers that would help predict responses to either TNF inhibitor drugs or the B-cell therapy rituximab using data from the ORBIT study, a randomized, controlled trial of people with rheumatoid arthritis in the UK.

The researchers identified three gene expression signatures that predicted therapy responses. Eight genes predicted general responsiveness to both TNF inhibitor and rituximab, 23 genes predicted responsiveness to TNF inhibitor and 23 genes predicted responsiveness to rituximab.

“There are indeed gene expression markers that predict drug-specific response,” explains Dr Duncan Porter. “If confirmed, this will allow stratification of patients into groups more likely to respond to one drug rather than another. This would lead to higher response rates, and reduced likelihood of receiving a trial of an ineffective drug. Because ineffective treatment is associated with pain, stiffness, disability and reduced quality of life, this will lead to better patient care.

“Ultimately, a commercial testing kit would be developed to allow clinicians to test patients before they receive treatment to guide them to the most effective treatment.”

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