Genes to predict arthritis treatment response – Pave the way for future drug development

Arthritis as known is the swelling and tenderness of one or more joints. The main symptoms are joint pain and stiffness, which typically worsen with age. More than 22% of adults have arthritis or another rheumatic condition. While there has been much progress made over the past decades in treating arthritis, a significant number of patients (approximately 40%) do not respond to specific drug therapies, and 5-20% of people with the disease are resistant to all current forms of medication.

New research from Queen Mary University of London, published in Nature Medicine, has shown that molecular profiling of the diseased joint tissue can significantly impact whether specific drug treatments will work to treat rheumatoid arthritis (RA) patients. The researchers also identified specific genes associated with resistance to most available drugs therapies, commonly referred to as refractory disease, which could provide the key to developing new, successful drugs to help these people.

The researchers carried out a biopsy-based clinical trial, involving 164 arthritis patients, in which their responses to either rituximab or tocilizumab two drugs commonly used to treat rheumatoid arthritis were tested. The results of the original trial demonstrated that in those patients with a low synovial B-cell molecular signature only 12% responded to a medication that targets B cells (rituximab), whereas 50% responded to an alternative medication (tocilizumab). The study strongly supports the case for performing gene profiling of biopsies from arthritic joints before prescribing expensive so-called biologic targeted therapies. Hence, the researchers concluded that This could save considerable time and money and also help avoid potential unwanted side-effects, joint damage, and worse outcomes which are common amongst patients.